Multiple Sclerosis (MS) is a chronic, progressive disease of the central nervous system where the immune system mistakenly attacks the body’s own tissues. This autoimmune response focuses on the protective myelin sheath around nerve fibers in the brain and spinal cord. The resulting damage disrupts communication pathways, leading to a wide variety of neurological symptoms. Many people diagnosed with MS experience unexpected hair thinning or loss, leading to questions about a direct link to the disease process. This article explores the relationship between MS and hair loss, clarifying that while MS does not directly cause hair loss, related factors often account for the observed changes.
Is Hair Loss a Direct Symptom of Multiple Sclerosis?
Hair loss, or alopecia, is not considered a recognized, primary symptom of Multiple Sclerosis pathology. The disease process of MS is highly specific, targeting the myelin sheath that insulates nerve axons in the central nervous system, which includes the brain and spinal cord. This demyelination causes signal transmission to slow down or stop entirely, manifesting as neurological dysfunction. MS does not directly attack the hair follicles, skin, or other structures responsible for hair growth. Therefore, the physical mechanism of MS, which is focused on neurological inflammation and scarring, does not inherently result in hair shedding or thinning.
Hair Loss as a Side Effect of MS Treatments
The most common and direct link between a diagnosis of MS and hair loss is related to the pharmacological treatments used to manage the disease. Many Disease-Modifying Therapies (DMTs) work by modulating or suppressing the immune system to reduce the frequency and severity of relapses. Unfortunately, some of these powerful medications can inadvertently disrupt the normal hair growth cycle.
Telogen Effluvium
This drug-induced hair thinning is often a condition called telogen effluvium, where a large number of growing hairs prematurely enter the resting phase and then shed. The oral DMT teriflunomide (Aubagio) has a widely recognized association with hair thinning, with reports indicating that 10% to 14% of patients may experience this side effect. Teriflunomide blocks the production of pyrimidine, a building block of DNA, which slows the division of immune cells, but this mechanism can also affect other rapidly dividing cells, including those in the hair follicles.
Other Medications
Other immunosuppressive agents, such as azathioprine and methotrexate, which are sometimes used to treat MS, also carry hair loss as a known side effect due to their generalized effect on cell division. Additionally, high-dose corticosteroids, frequently used for treating acute MS relapses, can temporarily affect the hair follicle’s health, leading to hair shedding. This type of hair loss is generally temporary, with regrowth typically beginning once the body adjusts to the medication or after a short course of treatment concludes.
Underlying Autoimmune Conditions That May Co-Occur with MS
The immune system dysfunction that leads to MS also makes individuals more susceptible to developing other autoimmune diseases, a phenomenon known as comorbidity. This shared genetic predisposition or generalized immune dysregulation means that hair loss may be a symptom of a completely separate, co-occurring condition.
Hashimoto’s Thyroiditis
Thyroid disorders, specifically the autoimmune condition Hashimoto’s thyroiditis, are frequently observed alongside MS. Hashimoto’s disease causes the immune system to attack the thyroid gland, resulting in hypothyroidism, which in turn can lead to diffuse hair loss or thinning.
Alopecia Areata
Alopecia areata, a separate autoimmune disorder where the immune system attacks the hair follicles directly, causing patchy hair loss, can also occur in individuals with MS. While there is no definitive evidence that alopecia areata is more common in MS patients, the underlying autoimmune nature of both diseases suggests a potential shared susceptibility. If hair loss is observed, consulting a healthcare provider is important to test for these coexisting conditions, which require their own specific treatment plans.
Common Primary Symptoms of Multiple Sclerosis
The symptoms that define Multiple Sclerosis are neurological, reflecting the damage to the central nervous system. One of the most frequently reported symptoms is profound fatigue, which is an overwhelming tiredness not relieved by rest.
Sensory and Vision Issues
Sensory disturbances are common, often presenting as numbness, tingling, or a pins-and-needles sensation in the limbs, trunk, or face. Vision problems are often an early indicator of MS, particularly optic neuritis, which causes inflammation of the optic nerve, leading to eye pain and temporary loss or blurring of vision.
Motor and Cognitive Impairment
Motor symptoms include muscle weakness, stiffness, and painful spasms, which can significantly affect balance and a person’s ability to walk. Many individuals also experience cognitive changes, such as difficulties with memory, concentration, and processing information.