Addressing Your Concerns: Does Diabetes Cause Hair Loss?

By age 50, approximately 40% of men and women experience some degree of hair loss due to genetic factors. But could hair loss also be related to diabetes? Research suggests the answer may be yes.

Diabetes affects 1 in 10 people worldwide and contributes to vascular diseases involving the heart, brain, eyes, and skin. By compromising blood flow to the skin, diabetes can impact hair follicles, leading to thin and brittle hair or loss of it altogether. Here, we explore the relationship between diabetes and hair loss and review potential ways to maintain hair growth if you have diabetes.

What is hair loss?

Hair growth is a recurring process that occurs in four stages: growth, regression, rest, and shedding. At any given time, each hair on your body exists in one of these stages. In the shedding stage, hair is shed from the scalp or body, and it is common for a person to lose 50–100 hairs per day.

Hair loss, however, differs from hair shedding. While shedding is a normal part of the hair growth cycle, hair loss is a disorder in which hair regrowth does not occur normally to replace hairs that are shed. As a result, a person may develop hairless patches on their scalp or body.

Is hair loss a symptom of diabetes?

Not everyone who has diabetes will experience hair loss, but research suggests that hair loss and diabetes may be connected.

A study of 5,389 women showed that severe hair loss on the scalp was significantly associated with type 2 diabetes. Those who had diabetes for at least ten years had more than twice the risk of scalp hair loss compared to those without diabetes.

A study of 100 men found that those with a genetic condition called androgenetic alopecia (colloquially called ‘male pattern baldness’ in men) are more likely to have insulin resistance — a feature of type 2 diabetes — compared to men without the condition.

Insulin resistance has also been linked to an autoimmune condition called alopecia areata, characterized by patchy areas of hair loss on the scalp and body. One study showed that people with alopecia areata are more likely to have insulin resistance compared to people without the condition, and the more severe the degree of alopecia, the worse their insulin resistance.

Does diabetes cause hair loss? Exploring the link

Like the body’s organs, hair follicles require sufficient blood flow to function properly. Impaired blood flow restricts hair follicles from receiving the oxygen and nutrients they need, leading to problems such as hair thinning and fragility.

Diabetes is a disease characterized by a lack of insulin production (type 1) or insulin resistance (type 2). Insulin is the hormone responsible for bringing glucose into cells for use as energy. When insulin is absent or ineffective, blood glucose levels rise. Elevated blood sugar (hyperglycemia) causes inflammation that damages small blood vessels supplying hair follicles, impairing their growth.

This mechanism explains why people with diabetes may lose hair on their legs due to peripheral vascular disease, a condition strongly associated with diabetes in which the legs receive poor blood flow due to the buildup of fatty substances.

Hormonal imbalances may also explain how diabetes leads to hair loss. People with diabetes have elevated levels of cortisol. Cortisol, sometimes called the ‘stress hormone,’ reduces the synthesis of substances involved in hair growth. Diabetes is also closely linked to thyroid diseases, which can lead to hair loss in some people due to having too much or too little thyroid hormones.

How to stop hair loss from diabetes

The most important way to decrease and potentially reverse hair loss from diabetes is effectively controlling your blood sugar. By keeping your blood sugar within the normal range, you can slow down the inflammatory damage to your blood vessels responsible for hair loss. Action steps to maintaining optimal blood sugar levels include:

• Taking all your medications as prescribed
• Limiting sugary foods and snacks
• Controlling your food portions
• Getting regular exercise

Since people with diabetes are more prone to nutritional deficiencies, eating a nutrient-rich diet consisting of biotin, B vitamins, and iron may prevent hair loss in people who are deficient. Deficiency in B vitamins (including biotin) and iron have been associated with hair loss, although it is unclear whether supplementation in non-deficient people offers any benefit for hair growth.

Medical options for hair loss

Several medical options exist for people with hair loss. While most of these treatments have been studied in people with androgenetic alopecia or alopecia areata, they may be useful for people with hair loss due to diabetes. These include:

• Topical minoxidil (Rogaine). Minoxidil is thought to work by increasing the dilation of the arteries and promoting circulation around the hair follicles. It may take at least two months to start noticing a difference with minoxidil.
• Oral finasteride. Finasteride blocks the conversion of testosterone to dihydrotestosterone, the hormone responsible for male pattern hair loss. It may take several months for hair to regrow after starting finasteride.
• Corticosteroid creams and injections. Corticosteroids are the most common treatment for mild alopecia areata. Common side effects include skin sloughing and lightening. More severe cases are treated with oral or topical immunotherapies.
• Hair transplant surgery. In this procedure, skin containing healthy hair follicles is removed and planted into an area of hair loss. Most patients begin to see results only after at least six months.
• Low-level laser therapy. Low-intensity light is applied to promote hair follicle development in the growth phase. This therapy is more effective when used in combination with topical minoxidil or oral finasteride.
• Platelet-rich plasma therapy. Plasma containing high concentrations of platelets is injected into the skin, stimulating growth factors that improve blood supply to the hair follicles. Platelet-rich plasma can be used on its own or following hair transplantation for better outcomes.

Lifestyle strategies to reduce hair loss

Besides medical options, there are actions you can take to reduce hair loss if you have diabetes:

• Reduce stress. Managing diabetes can be stressful. Stress is associated with increased cortisol levels, which in turn can cause hair thinning and shedding. Stress reduction techniques such as meditation, exercise, and sleep may be helpful.
• Protect your hair. There are many preventive measures you can take to reduce damage to your hair. Some of these include avoiding hair pulling, excessive brushing, and tight hairbands; using gentle shampoos and conditioners; and limiting bleaching, coloring, and heat styling.
• Try essential oils. One study showed that people with alopecia areata who massaged a mixture of essential oils (thyme, rosemary, lavender, and cedarwood) into their scalp daily achieved significantly greater hair regrowth compared to people who used only a carrier oil. Importantly, essential oils should be diluted in a carrier oil before use to prevent skin irritation.
• Massage your scalp. One study suggests that scalp massages may contribute to hair regrowth among people with androgenetic alopecia. Combining scalp massage with essential oils may provide additional benefits. Scalp massage may also help relieve stress.

While these strategies may benefit your hair, for lasting results, it is important to get to the root of the issue if you have diabetes. Talk to your doctor if your hair loss does not improve or worsens with lifestyle measures, especially if you have other symptoms of diabetes, such as unexplained weight loss, excessive thirst or urination, or tingling and numbness. By catching diabetes early and controlling your blood sugar, you can get ahead of the vascular complications that can lead to hair loss.