Hair Loss Causes in Psoriasis

* Featured Image source: Fox, George Henry (1886) Photographic illustrations of skin diseases (2nd ed.)

If you experience hair loss with your scalp psoriasis there may be actually 4 different causes:

1. Hair loss is not directly caused by psoriasis
2. Hair loss directly caused by damaged hair follicles – caused by psoriasis
3. Hair loss is caused by some disease like alopecia areata
4. Psoriasis drugs cause hair loss

1. Hair loss is not directly caused by psoriasis

In this case the hair loss may not be directly connected to psoriasis. It may be caused by hormonal imbalance, malnutrition, bad blood flow in the scalp, etc…

baldness

A lot of men suffer from this type of hair loss.

Even though there may be genetic cause of this in most cases it is just another symptom of our health crisis. Since hair loss is not deadly we consider this health symptom generally as “it happens”. But actually it happens for some reason and in many cases that reason can be addressed and hair growth restored.

There are many herbal products which improve hair growth so hair loss is something what can be reversed and healed.

When trying to reverse hair loss we should pinpoint the cause. Well, I would start with the nutrition. Genes of cells responsible for hair growth are naturally set to grow new hair, so why they don’t do that?

Nutrition is the first answer that comes up to my mind immediately.

Then we may focus on improving the blood flow into the scalp area. This should take care of bringing the nutrients in and removing the wastes out.

2. Hair loss caused by damaged hair follicles – due to psoriasis

This type of hair loss is directly caused by psoriasis. Actually, since I believe that psoriasis is fungal infection of the skin; I must say that in my opinion the fungi grow so deep into the skin that the hair follicles get damaged and the hair loss occurs.

hair_follicle

Most people with psoriasis have normal hair and don’t suffer with noticeable hair loss but everyone is different and some people may have their hair roots not so deep in the skin and they may suffer from psoriasis (fungal infection) caused hair loss.

The mean depth of scalp hair follicle is 4.16mm.[1] In most cases it is enough to keep the epidermal fungal infection (psoriasis) from reaching the hair root. However, those who may have really serious cases of psoriasis on their scalps and their hair roots are not deep enough, they may suffer from psoriasis related hair loss.

3. Hair loss caused by fungal infection – broken off hair

This type of hair loss is not even a real hair loss. The disease is called Tinea capitis and is caused by fungal infection of the hair shaft which makes the hair to break off.

So the hair roots are not damaged and the hair didn’t fall off but the visible hair shaft gets damaged by fungal growth to the point the hair loose its strength and structure and break off eventually.

Broken off hair caused by Tine capitis. Image source: Pai VV, Hanumanthayya K, Tophakhane RS, Nandihal NW, Kikkeri NN. Clinical study of Tinea capitis in Northern Karnataka: A three-year experience at a single institute. Indian Dermatol Online J [serial online] 2013 [cited 2015 Jun 27];4:22-6. Available from: http://www.idoj.in/text.asp?2013/4/1/22/105461

Broken off hair caused by Tinea capitis.
Image source: Pai VV, Hanumanthayya K, Tophakhane RS, Nandihal NW, Kikkeri NN. Clinical study of Tinea capitis in Northern Karnataka: A three-year experience at a single institute. Indian Dermatol Online J [serial online] 2013 [cited 2015 Jun 27];4:22-6. Available from: http://www.idoj.in/text.asp?2013/4/1/22/105461

This type of hair damage with sample photos is more deeply discussed in one of my previous posts Ringworm causes psoriasis and it is contagious.

Keep in mind that this type of hair loss may be accompanied by psoriasis just like I discussed in my post linked above.

The damage the fungal infection does to your hair on the body is more easily visible than on the scalp. However, the cause why and the way how you lose your hair on the scalp is the same as in the case of hair loss on the body, especially in the spots where the psoriasis plaques are.

4. Hair loss caused by some disease like alopecia areata

Alopecia areata is considered as the autoimmune disease which presents as the random and unexpected hair loss mostly on the scalp. The bald patches have usually shape of a circle which makes me very skeptic about the autoimmunity and very suspicious about the infection as the cause of this disease.

Fungal infection is what comes to my mind. Maybe you can not see the fungus growing on the scalp but I think it is there and attack the hair and hair follicles. That’s the cause why the body decides the hair to better fall out than it would allow the fungi hidden in those hair spreading to the hair follicle and grow.

Fox, George Henry (1886) Photographic illustrations of skin diseases (2nd ed.)

Image source: Fox, George Henry (1886) Photographic illustrations of skin diseases (2nd ed.)

Hair loss does not just happen. Mostly not in symmetrical patterns like circles.

There are just 2 logically explainable explanations why hair loss may occur in patters like circles.

1. Autonomic Nervous System
2. (Fungal) Infection

And those two causes are interconnected. Fungi invade the hair follicles and the Autonomic Nervous System just “release” those hair in order to get rid off the fungus. There is also a possibility of viral infection which may interfere with the nerves controlling the hair growth.

5. Psoriasis drugs cause hair loss

Methotrexate, isotretinoin, ciclosporine, biologic drugs and corticosteroids – all are highly toxic drugs which cause the liver and whole body to suffer. Some of them directly inhibit the cell division which makes the fast growing parts of the body grow just very slowly or die – hair, blood cells, epithelial cells, skin cells (psoriasis).

If the cause of hair loss was the drugs you take for psoriasis then it would be very hard or even impossible to reverse it while you continue the drug treatment.

The only real solution would be to stop taking the drugs causing your hair loss (this step you should discuss with your doctor).

It is possible to attenuate somehow the hair loss effects of the drugs? Yes, but the desired gain is usually very little. If you take methotrexate your doctor will probably recommend you to supplement with folate (vitamin B 9) during the treatment. It helps to some people and they don’t loose so much hair, but there is not much effect of this for the others.

How to grow new hair?

The most important is to not to take anything which causes the hair loss. If some drug is causing your hair loss then you have just 2 options – take the drug and experience the hair loss or stop the drug and grow new hair. The choice is up to you.

new_hair

The detoxification and liver protecting herbs like artichoke and milk thistle are very recommended! Liver health is essential for hair regrowth.

Then the second most important step is the nutrition. If you want to grow new hair you have to eat and assimilate the nutrients the hair is made of.

Protein

Protein is the extremely important macronutrient many people omit. Especially Whey Protein Isolate or Whey Protein Concentrate (if you can eat lactose) is great and easy way how to ingest an easy to digest protein source. Protein supplements can make your new hair grow thicker and stronger.

Maybe you know a few vegetarians or vegans who lost their hair after starting their animal products free diets. I am not saying that one have to eat meat to keep the hair growing. If people are able to assimilate enough protein from their vegetarian or vegan diets then it is OK but hair loss is one of the symptoms that something is going wrong.

Choline

Choline is an essential nutrient for proper nervous system function. It is important part of the cell membrane structure and the deficiency leads to fatty liver disease.

Fatty liver can’t make its job well so choline deficiency ultimately leads to various health symptoms – one is hair loss. Traditional Chinese Medicine states the liver problems as cause of hair loss.

Good fats

Omega fatty acids are also important for cell membrane and immune system among many other pathways. Don’t focus only on omega 3 fatty acids because we need omega 6 fatty acids, too. Even though the proponents of inflammation as cause of disease recommend avoiding the omega 6 fatty acids, I say inflammation is just the symptom of disease. Supplementing the omega 6 doesn’t harm the body. Actually, it helps a lot.

Linoleic acid is the essential omega 6 fatty acid and must be consumed in diet. Sunflower oil, hemp oil and sesame oil – all are rich sources of this essential fatty acid.

B-complex

B vitamins are so important for the nervous system and energy production in cells that their deficiency may profoundly affect the hair growth or hair loss.

Magnesium

Toxins, infections, stress and drugs – all are the major causes of magnesium deficiency. Not mentioning the inadequate dietary intake of magnesium.

Supplementing the magnesium may do wonders for your hair growth.

The way magnesium deficiency affects the nervous system may cause a lot of health problems. Magnesium deficiency may cause insulin resistance, muscle spasm, vasoconstriction (low blood flow in the tissues and organs), low ATP production (low energy), depression, brain fog, anxiety,…

Chelated magnesium supplements are a good way how to get more magnesium into the body.

Our soils are depleted and nobody seems to be worried about the widespread magnesium deficiency.

Vitamin C

I would supplement this nutrient on a daily basis due to its antioxidant effects as well as its importance in collagen production. The deficiency may cause bleeding gums, weak skin and inadequate collagen formation.

Its effects on our immune system are well known for decades, however most of us supplement vitamin C only when we catch some cold or flu.

Zinc, Copper, Manganese, Molybdenum,….

Trace minerals are often overlooked but they play a major role in immune system, protection from oxidative stress, detoxification and energy production.

OTC antifungal shampoo

One of the most popular OTC treatments for fungal or yeast infections is Nizoral. It is a ketoconazole shampoo used most commonly to manage the dandruff.

nizoral_shampoo

Nizoral may be quite useful in case of fungi caused hair loss. Shampoo applied on scalp once in a while is less toxic than taking the drug orally and still effective. I think that this over-the-counter product may perfectly work for fungi caused hair loss but will do nothing if your hair loss is caused by something else.

The cause of dandruff (caused by scalp psoriasis or other fungal infection) – weak immune system and bad scalp blood flow – should be addressed with systemic approach. However, Nizoral can help if you need faster results like in order to eliminate the itching.

Keep in mind that Nizoral is a ketoconazole shampoo which is very hard on the liver. Sure, it is much less toxic than oral drug when applied on the scalp in low doses but it is still a drug. You can read more about the ketoconazole here.

 

References:

1) Jimenez F, Izeta A, Poblet E. Morphometric analysis of the human scalp hair follicle: practical implications for the hair transplant surgeon and hair regeneration studies. Dermatol Surg. 2011 Jan;37(1):58-64.

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