Multiple Sclerosis (MS) is a chronic condition where the body’s immune system mistakenly attacks the central nervous system, damaging the protective covering of nerve fibers called myelin. Living with a chronic condition often involves navigating unexpected physical changes, and for many people with MS, hair thinning or loss becomes a concern. When changes to hair health occur after a diagnosis or the start of treatment, it is understandable to question whether the underlying disease is the cause. This article investigates the relationship between MS and hair loss, distinguishing between the effects of the disease itself and other related factors.
Multiple Sclerosis and Hair Loss: The Direct Connection
Multiple Sclerosis itself is not classified as a direct cause of hair loss. The disease process primarily involves demyelination and nerve damage within the brain and spinal cord, which are components of the central nervous system. Hair follicles, the structures responsible for hair growth, are located in the skin and are not typically targeted by the autoimmune response that defines MS.
The immune-mediated attack that defines MS focuses on myelin and does not extend to the tissues governing the hair growth cycle. Therefore, any hair changes occurring around the time of diagnosis or during the disease course are generally due to secondary factors.
Medication Side Effects and Hair Thinning
The most common connection between MS and hair loss comes from the medications used to manage the disease. Disease-Modifying Therapies (DMTs) alter the immune system’s activity to reduce relapse frequency and slow progression, which can sometimes affect the hair growth cycle. This drug-induced shedding often manifests as Telogen Effluvium, a temporary condition where many hairs prematurely enter the resting phase.
One oral DMT, teriflunomide, is particularly noted for this side effect, with clinical data indicating that 10 to 14 percent of patients may experience temporary hair thinning. This medication accounts for a significant percentage of reported alopecia cases linked to MS drugs in post-market surveillance. Other DMTs, including some interferon therapies, have also been associated with hair thinning in a subset of patients.
High-dose corticosteroids are frequently used to treat acute MS relapses by rapidly suppressing inflammation. These anti-inflammatory drugs can also disrupt the normal hair growth cycle, leading to temporary shedding. More intensive treatments, such as hematopoietic stem cell transplantation (HSCT) used for severe MS, are known to cause near-total, though often temporary, hair loss. Hair loss caused by medication is usually reversible, with regrowth often beginning once the body adjusts to the drug or after treatment concludes.
Other Common Causes of Hair Loss in MS Patients
Hair loss in individuals with MS is often linked to co-occurring conditions or systemic stressors that accompany a chronic illness. Autoimmune disorders tend to cluster together, meaning a person with MS has a higher likelihood of developing another autoimmune condition that directly causes hair loss. Thyroid dysfunction, particularly hypothyroidism caused by Hashimoto’s thyroiditis, is common in the MS population and is a well-established cause of diffuse hair thinning.
Another autoimmune condition, Alopecia Areata, involves the immune system attacking hair follicles, leading to patchy hair loss. Its presence as a secondary autoimmune disorder may explain some cases of shedding. Chronic stress and anxiety from managing MS can also trigger Telogen Effluvium independent of medication side effects.
Nutritional deficiencies can also contribute to hair issues, as certain vitamins and minerals are vital for healthy hair production. Deficiencies in iron and Vitamin D are sometimes observed in MS patients, and inadequate levels of these nutrients can negatively impact hair follicle function. Consulting with a healthcare provider can help determine whether the hair loss is due to medication, a nutritional imbalance, or a separate co-occurring medical condition.