Understanding Hair Loss with Sjogren’s Syndrome
Sjogren’s syndrome is an autoimmune disorder that can cause dry eyes, dry mouth, joint pain, fatigue and other symptoms. Many people with Sjogren's also experience hair loss, which can be distressing.
Hair loss or thinning associated with Sjogren’s occurs when the immune system mistakenly attacks hair follicles, preventing normal hair regrowth. Understanding the types of hair loss, causes and treatments can help manage this symptom.
Types of Sjogren’s Related Hair Loss
Several forms of hair loss occur more often in Sjogren’s patients:
Telogen Effluvium
This causes diffuse thinning all over the scalp due to changes in the hair growth cycle. Up to 30% of hairs enter the “shedding” phase at once instead of the normal 10%, causing extra hair to fall out.
Alopecia Areata
This autoimmune condition causes round bald patches on the scalp or complete hair loss. It results from the immune system attacking hair follicles and can accompany other autoimmune diseases like Sjogren's.
Lupus Hair Loss
Some Sjogren’s patients also develop systemic lupus erythematosus (SLE). Hair loss is a common symptom, caused by chronic scalp inflammation that damages follicles.
Androgenic Alopecia
This genetic, hormonal form of hair loss is seen in both men and women. It causes a distinct pattern of thinning along the part line and temples.
What Causes Sjogren’s Hair Loss?
Experts aren’t entirely sure why Sjogren’s syndrome leads to hair loss, but some possible explanations include:
Autoimmune Response
The immune system mistakenly attacks hair follicles, preventing growth of new hairs. This underlies patchy alopecia areata associated with Sjogren’s.
Medication Side Effects
Some medications used to manage Sjogren's like hydroxychloroquine, NSAIDs, diuretics and beta blockers can trigger hair shedding as a side effect.
Nutrient Deficiencies
Sjogren's patients are at risk for deficiencies in iron, zinc, biotin and other hair-healthy nutrients due to malabsorption from gastrointestinal problems.
Hormonal Shifts
The same female hormones that influence Sjogren’s may contribute to hair loss. Lower estrogen after menopause or thyroid disorders common in Sjogren’s affect hair growth.
Stress Effects
Physical and emotional stress from dealing chronic illness can disrupt the normal hair regrowth cycle, leading to excessive shedding.
Risk Factors for Sjogren’s Hair Loss
Certain factors appear to increase risk of hair loss occurring in Sjogren’s patients:
Female Gender
Up to 9 out of 10 Sjogren’s patients are women. Female hormonal fluctuations may underlie increased hair loss.
Lupus Diagnosis
Those with both Sjogren’s and lupus are more likely to lose hair than Sjogren’s alone due to compounded autoimmune effects.
Family History
Having a close relative with autoimmune hair loss increases risk. Genetics play a role in alopecia areata.
Nutrient Deficiencies
Gastrointestinal issues that reduce nutrient absorption make hair loss more likely by depriving follicles of needed minerals and vitamins.
Post-Menopausal
Declining estrogen after menopause increases hair thinning and shedding in women with Sjogren’s.
High Stress
Severe physical or emotional stress can trigger telogen effluvium hair loss in Sjogren’s patients.
Hair Loss Prevention Tips for Sjogren’s Patients
While hair loss related to Sjogren’s cannot always be prevented, the following proactive tips may help reduce excessive shedding:
Follow an Anti-Inflammatory Diet
A diet high in omega-3 fatty acids, vegetables, fruits and whole grains but low in sugar, saturated fats and processed foods may help lower inflammation.
Take Supplements
Biotin, vitamin D, zinc and iron supplements support hair growth. Check with your doctor first about dosage and interactions.
Reduce Stress
Try relaxation techniques like yoga, meditation and mindfulness to minimize stress that can exacerbate hair shedding.
Use Gentle Hair Products
Skip perms, dyes and bleaches. Use sulfate-free shampoos and gentle styles to avoid damage to fragile hair.
Get Thyroid Levels Checked
Since thyroid disease is more common with Sjogren's, get regular TSH tests. Treating hypothyroidism may lessen hair loss.
Ask About Medications
Talk to your doctor about whether hair loss could be a side effect of any medications you take.
Medical Treatments for Sjogren’s Hair Loss
If you develop significant hair shedding or bald patches from Sjogren’s, consult a dermatologist about these medical treatment options:
Corticosteroid Injections
Injections of steroids like triamcinolone directly into bald patches on the scalp can regrow hair in cases of alopecia areata.
Immunosuppressants
Oral medications like methotrexate, cyclosporine and mycophenolate mofetil may regrow hair by suppressing the mistaken immune attack on follicles.
Biologic Drugs
Newer injected biologics like tofacitinib citrate and ruxolitinib selectively inhibit immune cell actions and show promise for treating autoimmune hair loss.
Janus Kinase Inhibitors
Oral JAK inhibitors like baricitinib and ruxolitinib treat alopecia areata by interfering with immune signaling pathways involved in attacking hair follicles.
Topical Immunotherapy
Applying allergy inducing substances like diphencyprone or squaric acid dibutylester topically can promote hair regrowth by altering the local immune response.
Platelet Rich Plasma
Injecting PRP from the patient’s own blood into the scalp may stimulate hair regrowth through growth factor and stem cell effects.
Lifestyle Measures to Cope with Hair Loss
In addition to medical treatment, lifestyle strategies can help cope with the effects of Sjogren’s related hair shedding or thinning:
Camouflage Thinning Hair
Style hair to cover thin areas. Use powders or sprays to thicken appearance of hair.
Consider a New Hairstyle
Shorter cuts like a pixie can make hair look fuller. Highlight cut with face-framing layers.
Talk to Your Stylist
Ask your hairdresser for tips on the most flattering styles and products for your type of hair loss.
Use Volumizing Products
Shampoos, conditioners, mousses and sprays that add fullness can minimize the appearance of thinning hair.
Try Hair Extensions
Extensions can provide fullness and length to disguise hair loss patches or thinning. Clip-ons are non-damaging.
Ask About Hair Transplants
Transplanting follicles from fuller areas of the scalp can restore brows, lashes, hairline or thinning crown.
Consider a Hairpiece
Partial wigs, full wigs, hair toppers or hairpieces offer styling flexibility to cover bald spots or fill in thinning areas.
Coping Emotionally with Hair Loss
Hair loss from Sjogren’s syndrome can negatively impact self-image and emotional wellbeing. Here are some healthy ways to cope with the effects:
Join a Support Group
Connecting with others facing similar hair loss challenges makes you feel less alone.
Focus on Self-Care
Pamper yourself with relaxing baths, soothing music, cozy clothes to boost confidence.
Consider Counseling
A therapist can help develop self-acceptance and coping strategies for hair loss effects.
Practice Affirmations
Positive self-talk focusing on strengths and inner beauty helps counteract negative thoughts.
Express Your Feelings
Talking or journaling about emotions and struggles can help release stress and anxiety.
Boost Your Support Network
Draw close friends and family near for comfort and reassurance when feeling down about hair loss.
The Emotional Stages of Hair Loss
People often experience emotional stages when coping with Sjogren’s related hair loss:
Denial
You pretend not to notice initial thinning hair. You make excuses or avoid looking closely in the mirror.
Anger
You feel frustrated and upset about losing your hair. You may lash out at loved ones.
Bargaining
You try to mentally negotiate for regrowth of your hair. You promise to take better care of your hair.
Depression
You feel profound sadness about your hair loss. You withdraw from socializing and normal activities.
Acceptance
You come to terms with your hair loss situation. You feel ready to move forward and explore solutions.
When to Seek Help for Hair Loss
Consult a dermatologist promptly if you notice:
- Sudden shedding of clumps of hair
- Patchy bald areas on the scalp
- Increased hair loss when brushing/washing
- Hair thinning all over the scalp
Seek medical advice before trying supplements, oils or home remedies for hair loss. A dermatologist can diagnose the cause and provide appropriate treatment.
The Outlook for Sjogren’s Hair Loss
The prognosis for Sjogren’s related hair loss depends on the type and severity:
- Telogen effluvium may spontaneously resolve once triggers like stress or medication changes are removed.
- Alopecia areata patches often regrow within 6 months to 1 year, but may recur.
- With consistent medical treatment, prospects are good for regrowing or maintaining hair.
- Early intervention with immunomodulating drugs offers the best outcome.
While hair loss can be upsetting, most Sjogren’s patients are able to slow shedding and regrow adequate hair with dermatological treatments, lifestyle measures and emotional support.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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