“I never thought I’d lose my hair from psoriatic disease!” one MyPsoriasisTeam member said. Hair loss, also called alopecia, can be another challenging symptom that comes with the scaly plaques of psoriasis or the joint pain of psoriatic arthritis (PsA).

Here’s what you need to know if you’re living with psoriasis or PsA and hair loss. As with any psoriasis symptom, talk to your dermatologist if you notice new or worsening hair loss. They can determine the cause and work with you to find the best way of managing it.

MyPsoriasisTeam Members on Hair Loss

Several MyPsoriasisTeam members have experienced hair loss — particularly from scalp psoriasis. “My hair was progressively thinning out,” wrote one member, “and then it started falling out in clumps at the plaque psoriasis places on my scalp.”

This can come on quickly, as it did for one member who wrote, “All of a sudden, I’m losing massive amounts of hair.”

Sometimes, people lose their hair only when they tug on it with a brush or comb. As one member explained, “My hair was falling out ‘big time’ every time I combed it. I always had thick hair, but there was so much hair loss that on the back of my head, you could see a large area of my scalp.”

Sometimes, people lose a significant amount of hair, which can lead to difficult choices. “My hair is falling out like crazy. I might shave my head due to scalp psoriasis,” one member lamented. Another wrote, “My hair has been falling out since March, and the thickness of my hair is down by 50 percent.”

Can Psoriasis Cause Baldness?

Hair loss from psoriasis can show up in a variety of ways. One study found that for about half of the people with psoriasis, it’s acute (short term). Hair loss shows up as part of psoriasis flares and goes away when the flare-ups pass. Others experience it chronically (long term), having hair loss regardless of whether or not their psoriasis is flaring.

Most of the time, hair loss occurs when a person already has psoriasis plaques or lesions. Although some experience more widespread hair loss, the majority of people with psoriasis experience only temporary hair loss and will regrow their hair once the psoriasis is under control. Psoriasis on the scalp can lead to scarring, so caring for your scalp safely is important. Hair may not grow back in areas that have been scarred. This is rare, but it can occur.

People with PsA can also experience hair loss if they have scalp symptoms. In fact, having scalp psoriasis is considered a risk factor for developing PsA.

What Can Cause Hair Loss in Psoriasis or Psoriatic Arthritis?

There are several ways that psoriasis or PsA may result in hair loss. In addition to scalp plaques, hair loss can also be related to treatments or damaging your scalp by scratching the skin.

Inflammation and Plaques

Psoriasis is an inflammatory condition affecting the immune system. Scalp psoriasis can affect both the skin cells and hair follicles. This can cause the follicles to weaken and make the hair they produce brittle. Although brittle hair may not necessarily fall out, it usually breaks more easily than healthy hair does. Simply brushing brittle hair or pulling it back into a tight hairstyle may cause breakage.

The inflammation from psoriasis causes plaques to build up on the skin. If you don’t remove these scales carefully, they can break off hair in the affected area.

Scratching the Itch

Psoriasis plaques are often itchy. This itchiness can be accompanied by dry skin, flaking, and dandruff, which can make the problem worse. Many people with psoriasis find themselves scratching their scalp, even if they don’t intend to. This scratching can break weak hair, causing even more hair loss.

Stress

For some people, stress is a trigger for plaque psoriasis or PsA symptoms. Because hair loss can cause stress, people can find themselves in a negative loop — stress can worsen symptoms, which can lead to hair loss, which can cause more stress, and so on. Finding healthy ways to manage the stress that causes and is caused by psoriasis or PsA could be key to minimizing or preventing hair loss.

Medications

Some of the oral medications or injected medications used to treat psoriatic disease — such as biologics — can cause hair loss as a side effect. If you start losing your hair after taking a new medication, talk to your rheumatologist or dermatologist about its side effects. With your doctor’s guidance, you may choose to try a different medication.

Managing Hair Loss

Following are some steps you can take to prevent or reduce hair loss associated with psoriasis, PsA, or scalp psoriasis.

Find an Effective Treatment

Talk to your dermatology team about getting a medicated shampoo or other topical scalp treatment (like a topical steroid cream or lotion) for the affected area or your whole head. These can help get your psoriasis under control, which can help stop or minimize hair loss. Shampoos for scalp psoriasis can have a variety of effective ingredients, including coal tar, salicylic acid, and corticosteroids.

Remove Scales Gently

Don’t pick at the plaques on your scalp. Instead, start by making sure your shampoo has a scale softener. Use the shampoo as directed, then see if you can gently peel any scaly patches off your scalp. You may need to let the shampoo soak in or use it multiple times before you can remove the plaques without taking hair along with it.

Compounded solutions with 5 percent salicylic acid can be applied topically to affected areas of the scalp for several hours before rinsing it out with shampoo.

Keep Your Fingernails Short

Keeping your nails short can minimize the damage you do to your hair while applying your shampoo or topical treatment. It can also help minimize damage if you accidentally scratch your scalp or if you scratch while you’re asleep.

Use a Hydrating Conditioner With Each Wash

A moisturizing conditioner can prevent some of the dryness you might experience on your scalp, minimizing itching and, therefore, hair loss. Test your conditioner, along with all of your hair care products, to make sure it’s not adding to your scalp difficulties.

Minimize Heat Exposure

Let your hair air-dry, and don’t use a curling iron, a flat iron, or other heated styling implements while managing scalp psoriasis. Doing so will help your scalp heal faster and help you lose the least possible amount of hair while it’s healing.

Talk to Your Doctor

If you’re experiencing hair loss related to psoriatic disease, talk to your health care provider right away. They can provide medical advice and help you find an effective treatment option, so you can reduce the amount of discomfort and hair loss that you experience.

Find Your Team

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 125,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Are you struggling with hair loss due to psoriatic disease? Have you found a way to treat your scalp psoriasis and related hair loss and you’d like to share it? Add your thoughts or tips in the comments below or by posting on your Activities page.