Hair loss can be caused by various factors such as stress, vitamin or mineral deficiency, age, hormones, or drugs. Diabetes is one of the potential causes of hair loss.

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What is hair loss?

The American Academy of Dermatology estimates that the average person sheds 50-100 hairs each day, which is considered normal. Hair loss is a natural aspect of the hair cycle. When one hair falls out, another grows in its place.

Alopecia, or hair loss, happens when anything prevents the hair from growing. Hair loss can appear in patches and may not recover until the underlying cause is addressed.

On the other hand, excessive hair shedding might happen when you’re stressed or after you’ve given birth. It’s vital to realize that this isn’t the same as hair loss. So if you see a mature hairline, it’s not necessarily caused by your diabetes.

When blood sugars are out of range, diabetes can cause hair loss. Diabetes has also been linked to alopecia areata, an immune system illness that causes hair loss. Hair loss is upsetting, especially if you don’t know what’s causing it or how to treat it.

Of all the hair loss causes, we covered COVID-19 and DHT.

How does diabetes cause hair loss?

Hair loss in people with diabetes can be inherited and linked to other immune system issues such as thyroid illness or alopecia areata. Poor circulation, pharmaceutical side effects, inadequate blood sugar control, and dietary shortages are all possible reasons for hair loss in diabetics.

It’s critical to figure out what’s causing the problem to get the most acceptable treatment alternatives.

Immune System Disorder

Diabetes patients are more likely to acquire other immune system diseases. Thyroid problems can occur in people who have diabetes. Because changes in the thyroid hormone can influence the hair cycle and lead to hair thinning or hair loss, a thyroid problem can cause hair loss.

If you have diabetes and feel you have a thyroid problem because of weight loss, gain, exhaustion, or anxiousness, see your doctor.

Alopecia areata is another form of autoimmune illness that is linked to diabetes. When the immune system attacks the hair follicles, patches of hair loss appear on the scalp and elsewhere on the body. An accumulation of invading immune cells usually characterizes it.

The amount of hair loss is determined by the number of hair follicles damaged. While the disease might harm hair follicles, it seldom destroys them; thus, hair can regrow, especially if you haven’t lost much.

Hair loss may be genetically prone in some persons. This appears to be more common in people with type 1 diabetes, rheumatoid arthritis, asthma, hay fever, atopic dermatitis, thyroid disease, vitiligo, or Down syndrome, among other inflammatory illnesses.

Poor blood circulation

Insulin resistance, vascular damage, and poor circulation are signs of hyperglycemia or chronically elevated blood sugar. Chronic hyperglycemia can cause vascular damage by reducing oxygen and nutrition availability.

This can result in hair thinning, hair fragility, hair sparing, or slowed hair development. 4 Insulin resistance may cause microvascular dysfunction, contributing to androgenic alopecia’s pathogenesis.

According to researchers, type 2 diabetes was linked to an increased incidence of severe central scalp hair loss in Black women. The researchers concluded that type 2 diabetes should be continuously monitored for significant scalp hair loss to provide appropriate treatment.

Side effects of medication

Hair loss can be caused by drugs that interrupt the hair cycle. It might be challenging to determine the source of the problem, especially if a person is taking many medications.

Hair loss is a side effect of some cancer treatments, such as chemotherapy and radiation. When some drugs cause hair loss, the hair usually regrows once the medicine is stopped. Hair loss can be caused by a variety of drugs, including:

  • Steroids
  • Psoriasis medicines
  • Anticonvulsants
  • Antiarrhythmics
  • Antifungals
  • Acne treatment medications
  • Anticoagulants (blood thinners)
  • High blood pressure medications (ACE inhibitors)
  • Cholesterol-lowering medications, including certain statins
  • Medications for gout
  • Antidepressants
  • Arthritis medications

High blood sugar levels

When sugar lingers in the blood and cannot be absorbed into the cells for energy, hyperglycemia (high blood sugar) ensues. This can be caused by a shortage of insulin, insulin resistance, or combining the two. Damage to the microvascular and macrovascular vessels can develop over time.

Hair follicles below the knees, for example, can be harmed if blood vessels in the legs are broken, disrupting the supply of oxygen and nutrients and, as a result, affecting the hair development cycle.

Signs and symptoms you have hair loss due to diabetes

Hair loss comes in a variety of forms. The reason for the fallout will determine how it falls out. Alopecia areata is a condition in which your hair starts to fall out in places on your scalp or other regions of your body if you have type 1 diabetes. This could be a single episode or a remission and recurrence pattern.

Hair loss in other areas of the body, such as the scalp, is possible. It’s crucial to distinguish how rapidly and where hair is falling out for a correct diagnosis so that you can provide your doctor an accurate image.

Skin-related symptoms, such as dry, itchy skin and various skin problems, are more common in people with diabetes. People with diabetes are more likely to get infections when their blood sugars are high. Folliculitis is a skin infection caused by bacteria that affects the hair follicles.

How do doctors diagnose?

The location of your hair loss—is it on your scalp, legs, or elsewhere?—influences your diagnosis. Does it fall out in clumps or patches? A sex-specific hair loss feature frequently causes hair to fall out in male and female patterns.

Other aspects to consider are:

  • Differentiating between sudden or gradual hair loss
  • Trauma
  • Stress level
  • Pregnancy
  • Medications
  • Ethnicity

Your doctor may order blood tests to see if you’re deficient in vitamins and minerals. A dermatologist can also use a dermoscopy to determine the reason for hair loss. They’ll also take a look at your nails.

How to treat hair loss due to diabetes?

It’s crucial to remember that not every treatment is effective for everyone. The type of hair loss you have and the cause of your hair loss will determine your treatment options. In most cases, hair can regrow after the intervention is completed.

Managing blood sugar

If you have diabetes and have been experiencing high blood sugars, reducing your blood sugars down to normal can help you slow down hair loss and even promote hair regrowth.

Because high blood sugar is linked to vascular disruption, poor circulation, and hormonal abnormalities, keeping your blood sugars in a healthy range can help you maintain a regular hair cycle.

Your average blood sugar range is determined by your age, the frequency with which you have hypoglycemia, and the length of time you’ve had diabetes. As well as your life expectancy.

Following fasting for eight hours or more, blood sugar levels should be 80-130 mg/dL and less than 180 mg/dL two hours after a meal. These goals should be discussed with your healthcare provider and tailored to your specific needs.

If your blood sugars are within normal range and you’re hitting your target numbers set with your healthcare team, but you’re still losing hair, speak with your doctor. You may be losing hair due to a medical or nutritional condition.

Medication

Certain drugs have been shown to aid with hair loss and restore hair. The American Academy of Dermatology has a list of medications that can help with various types of hair loss. The sort of medication administered will be determined by your age and the potential for adverse side effects:

Corticosteroid creams and injections: Injections are typically for adults and not children. Ointments can be applied to the patches in both children and adults. Injections seem to be more effective in adults, while creams seem to work better in children.

Rogaine (Minoxidil): Helps keep hair growth stimulated and is helpful for the scalp, beard, and eyebrows. This may also be an option for children. Minoxidil is known to cause unwanted side effects, therefore, you might want to read more on alternatives to minoxidil.

Anthralin: Another type of topical medication that is typically used with Minoxidil. This can cause skin irritation.

Some research has shown effectiveness in usage of turmeric-based products

Lifestyle (dietary, fitness) changes

Supplementing or modifying dietary patterns to include nutrient-rich foods may help with hair loss in people who have nutrient deficiencies, such as vitamin D or iron insufficiency. It’s vital to understand that supplementing excessively isn’t the solution.

Taking too much of some vitamins and minerals, especially if you don’t have a deficit, might be dangerous. Getting too much vitamin A and E, for example, has been related to hair loss. Because these vitamins are fat-soluble, taking too much of them can be hazardous. 

It’s always a good idea to start with food to see whether it has any influence on your hair. If dietary changes aren’t working, you might consider getting tested for nutrient deficiencies.

Supplementing may be necessary for nutrient deficiencies. However, supplementation advice should always be sought from a specialist, as supplements are not regulated, and too much of some vitamins can be dangerous.

Iron, zinc, biotin, niacin, fatty acids, selenium, vitamin D, and amino acids are essential vitamins and minerals for hair health.

A well-balanced diet rich in fruits, vegetables, healthy fats, whole grains, and various protein sources may usually meet required daily vitamin and mineral requirements. Supplementation under the supervision of a medical practitioner may be necessary when there is a genuine deficiency.

Iron

Hair loss has been linked to iron deficiency through unknown mechanisms of action. According to specific research, those with low iron levels also experience hair loss. 

People with severe iron shortages should see a doctor about getting iron supplementation. Vegans may require dietary coaching to maximize iron absorption and consumption and avoid deficiency. Animal proteins, shellfish, legumes, nuts, seeds, leafy greens like spinach, and whole grains are high in iron.

Zinc

Although zinc deficiency is uncommon, it can result in hair loss in extreme cases. Some studies have indicated that their hair loss can be reversed when persons with zinc deficiency are treated.

Zinc deficiency can be caused by various factors, including malabsorption problems, hereditary abnormalities, and the use of certain drugs. Red meat, poultry, shellfish such as oysters, crab, lobster, whole grains, dairy products, and fortified cereals are naturally high in zinc.

Plant-based foods do not absorb zinc as well as animal goods. Zinc levels may need to be checked in people who eat a vegan or vegetarian diet. You should not take zinc supplements without consulting a doctor.

Fatty acids

Because the body cannot produce essential fatty acids (omega-3 and omega-6 fatty acids), they must be consumed through the diet. According to some research, a deficit might induce hair loss on the scalp and brows.

It is crucial to eat enough fat because eating a diet rich in fatty acids has been linked to more incredible hair growth. Fatty fish, walnuts, chia seeds, flaxseed, sunflower seeds, pumpkin seeds, and canola oil are high in omega 3 and 6.

Selenium

Despite the lack of research, many companies provide selenium supplements for hair growth. Selenium is abundant in most diets, and deficits are uncommon. Because selenium poisoning is a possibility, eating foods high in selenium rather than supplementing is advised.

The amount of selenium in food is determined by the soil in which it is grown. All of your selenium needs for the day can be met with just one Brazilian nut. Fish, meat, poultry, grains, legumes, and dairy are all excellent sources of selenium.

Vitamin D

According to research, persons with alopecia areata can have insufficient vitamin D levels. Vitamin D is known as the “sunshine vitamin” since it is mainly derived through sunlight.

It can be more challenging to get enough vitamin D during the cold months. Because vitamin D is only contained in a few foods, supplementation may be necessary in the case of low blood levels or deficiency.

Salmon, trout, mackerel, tuna, fish liver oils, fortified milk and milk alternatives, egg yolks, fortified cereals, and orange juice are high in vitamin D.

Biotin

Hair loss, brittle nails, and dry skin have all been linked to a lack of biotin or a biotin deficiency. Deficiency is uncommon. However, it has been linked to enzyme deficiency, antibiotic overuse, eating too many raw egg whites, drinking, and antiepileptic medication.

Taking biotin or using biotin-containing products to help with hair loss may appear plausible. While biotin supplementation has been proven effective in treating brittle nails, there is inadequate evidence to support taking biotin for hair loss in the absence of a biotin deficiency.

You should be able to acquire enough from food if you don’t have a deficiency. Biotin-rich foods include spinach, oats, and egg yolk.

Amino acids

Amine acid is crucial for hair development and strength, and amino acids are the building elements of protein. Because hair follicles are formed mainly of protein, it’s understandable that a shortage of protein could lead to hair loss.

You may not be getting enough protein if you have diabetes and have been ordered to consume a very low-calorie diet. Inadequate calorie intake can reduce vital nutrients such as vitamins, minerals, and protein. Hair loss may occur as a result of this.

Exercise

Exercise offers numerous health benefits, one of which is improved insulin sensitivity, which can help with glucose control. To avoid hypoglycemia, patients with diabetes, especially those on glucose-lowering drugs like insulin, should monitor their blood sugar frequently.

Recommendations for diabetes-related hair loss

If you have diabetes, you’re more likely to have immune system problems like thyroid issues or alopecia areata. Insulin resistance has been linked to hair loss in several studies. As a result, persons with prediabetes will probably lose their hair.

Prediabetes, also known as reduced glucose tolerance or impaired fasting glucose, is a type 2 diabetes precursor. Prediabetes does not usually cause symptoms, but it can lead to type 2 diabetes if not treated.

A family history of diabetes, age, excess weight (particularly in the midsection), high blood pressure and cholesterol, and sedentary activity, to name a few, can all raise your risk of prediabetes.

If you’re losing your hair and have some other risk factors, you should see your doctor see if you have impaired glucose tolerance. Getting your blood sugar under control as soon as possible can help you avoid type 2 diabetes and hair loss.

References

Can diabetes affect your hair growth? (n.d.). https://beyondtype1.org/can-type-1-diabetes-affect-your-hair-growth/

Famenini, S., & Goh, C. (2014, July). Evidence for supplemental treatments in androgenetic alopecia [Abstract]. Journal of Drugs in Dermatology, 13(7), 809–812l. http://jddonline.com/articles/dermatology/S1545961614P0809X

Hammerschmidt, M., & Brenner, F. M. (2014, September–October). Efficacy and safety of methotrexate in alopecia areata. Anais Brasileiros de Dermatologia, 89(5), 729–734. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155950/

Jang, J. H., Kim, S. L., Lee, K. C., Kim, M. J., Park, K. H., Lee, W. J., … Kim, D. W. (2016, October). A comparative study of oral cyclosporine and betamethasone minipulse therapy in the treatment of alopecia areata. Annals of Dermatology, 28(5), 569–574. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5064185/

MacLean, K. J., & Tidman, M. J. (2013, September). Alopecia areata: More than skin deep [Abstract]. The Practitioner, 257(1764), 29–32. https://www.ncbi.nlm.nih.gov/pubmed/24383154

Propecia (finasteride): Tablets, 1 mg. (2010, December). https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020788s018lbl.pdf

Alopecia areata: Overview. (n.d.). aad.org/dermatology-a-to-z/diseases-and-treatments/a—d/alopecia-areata/diagnosis-treatment

Biotin. (2015). nlm.nih.gov/medlineplus/druginfo/natural/313.html

Famenini S, et al. (2014). Evidence for supplemental treatments in androgenetic alopecia. jddonline.com/articles/dermatology/S1545961614P0809X#close

Maclean KJ, et al. (2013). Alopecia areata: More than skin deep [Abstract]. ncbi.nlm.nih.gov/pubmed/24383154

Mayo Clinic Staff. (2016). Hair loss: Treatments and drugs. mayoclinic.org/diseases-conditions/hair-loss/basics/treatment/con-20027666

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Amy Revene M.B.B.S.
Amy Revene M.B.B.S. graduated from the University of Sharjah. She is currently working as a General Physician at New Hope Medical Center. Amy has a passion for research and offers her expertise and opinions helping people in their quest to lead healthy, happy lives.

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