Rheumatoid Arthritis, or RA, is an autoimmune disease that usually affects many joints at once.

Though its impact is not only limited to joints, it can also affect our hair.

Hair loss, a common concern, may also be experienced by individuals with Rheumatoid Arthritis.

There is a possible connection between RA and hair loss.

This article will help you to understand the association of RA with hair loss and the factors contributing to it.

So, explore the underlying cause of RA which affects your hair and try the better ways to manage it.

Rheumatoid Arthritis and hair loss

The loss of hair caused by Rheumatoid Arthritis is not common, but there is a possibility that it might occur.

In most cases, RA does not directly cause hair loss

Instead, factors often associated with it, such as certain medications, stress, and other concurrent conditions, can contribute to hair loss.

RA might attack the hair follicles, which causes the loss of hair.

Sometimes, hair falls out when people are experiencing RA with other diseases or conditions. 

Usually, hair fall due to RA rarely happens and may also cause hair thinness.

Medications of RA affecting hair loss

Certain medications commonly used to treat Rheumatoid Arthritis can be more likely to cause hair loss compared to the disease itself.

It mainly comprises Disease-Modifying Antirheumatic Drugs (DMARDs) and biologics.

Let’s know about these medications one by one.

DMARDS

Disease-Modifying Antirheumatic Drugs known as DMARDs are used as the initial treatment approach for RA.

These medications work by reducing the activity of your immune system to manage Rheumatoid Arthritis. 

It is available in many forms. 

Methotrexate and Leflunomide, are possible reasons for affecting hair follicles.

Methotrexate

Damaged hair follicles under microscopic
Damaged hair follicles (under microscopic)

Methotrexate, a commonly used DMARD for Rheumatoid Arthritis, can cause hair loss in 1% to 3% of patients.

Methotrexate’s ability to reduce new cell growth, including hair follicle cells, is responsible for this hair loss.

Folic acid, which is often taken together with Methotrexate, helps to reduce some of its negative effects but does not encourage hair growth.

Taking folic acid, a synthetic version of folate, and a B-complex vitamin can help keep your hair healthy.

Leflunomide (Arava)

Leflunomide, another commonly prescribed DMARD for Rheumatoid Arthritis, has been linked to hair loss in 10% of patients.

This drug is often given along with Methotrexate, and the mechanism of hair loss it produces is similar to that of methotrexate.

Concurrent treatment with Leflunomide and Methotrexate increases the chance of hair loss in people with Rheumatoid Arthritis.

Warning:
Do not take any drugs to cure RA on your own. It is always advised to consult your doctor to get the right prescription according to your specific condition. 

Biologics

Biologics are the drugs used for treating Rheumatoid Arthritis.

They function by lowering inflammation produced by the immune system in the body. 

They achieve this by stopping specific cells and the proteins they make.

Biologics such as Etanercept (Enbrel) and Adalimumab (Humira) can sometimes induce hair loss. 

This side effect, however, is uncommon.

Medical professionals are still determining why biologics might change hair. 

Fact:
It was discovered in 1980s that actively inflamed joints of a person with RA contain certain chemicals and protein such as Cytokines. Researchers have suggested that it can be Cytokines, which is a messenger molecules that can cause hair loss.

It is usually mild if you develop hair loss while taking a biologic.

Your hair growth will return to normal once you stop taking the medicine.

Other autoimmune diseases

Often, hair loss may be observed when a person has one or more disease conditions.

According to research published by the National Health of Medicine, patients with RA are more likely to develop Alopecia Areata.

Alopecia Areata can co-occur with RA, though it is uncommon.

RA medications that do not cause hair loss

Few RA medications do not cause hair loss as a side effect.

You can opt for these medications for RA treatment after consulting your doctor. 

Some examples of these DMARDs are:

  • Tofacitinib
  • Sulfasalazine
  • Hydroxychloroquine Sulfate

Tofacitinib is found to promote hair growth, according to research published by the National Institute of Arthritis and Musculoskeletal and skin diseases.

When to see a doctor

Consult rheumatologist doctor due to hair loss
Consult rheumatologist doctor

It is essential to contact your rheumatologist right away if you face any of the following symptoms:

These symptoms may suggest a significant underlying medical issue requiring immediate medical attention.

Ask your rheumatologist to lower the dosage or suggest other medication if the current one has severe side effects on your hair.

Conclusion

Rheumatoid Arthritis (RA) does not directly affects hair health.

Not all individuals experience hair loss due to RA.

The medications we take to cure RA are majorly associated with hair loss due to side effects.

The most commonly used drugs for cure are Methotrexate and Leflunomide.

If the drugs show any negative effects, you can take folic and B-complex vitamins to improve hair health.

Some drugs, such as Tofacitinib, do not cause hair loss and promote growth.

You can also ask your doctor to prescribe other medications for RA if the current one is not suitable.

It is advised to contact healthcare professionals if sudden patches or excessive hair fall are noticed.

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