Can Diabetes Cause Hair Loss?

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There are many reasons you may experience hair loss, including stress, vitamin or mineral deficiency, hormones, or medications. Diabetes is among these possible causes.

According to the American Academy of Dermatology, the average human sheds about 50-100 hairs per day, which is considered normal. Losing hair is part of the hair lifecycle. As one hair is lost, another is replaced.

Excessive hair shedding can occur during times of stress or after pregnancy. It is important to note, however, that this is not the same as hair loss. Hair loss, referred to as alopecia, occurs when something stops the hair from growing. Hair loss can occur in patches and may not return until the trigger is fixed.

Diabetes can cause hair loss when blood sugars are out of range. Diabetes can also be associated with an immune system disorder called alopecia areata, which can cause hair loss.

Hair loss can be distressing, especially if you do not know the cause or how to treat it. Find out how diabetes and hair loss are related and what treatment options are available.

woman holding brush hair loss

Chalisa Thammapatanakul / EyeEm / Getty Images

Causes

Hair loss in diabetes may be hereditary and related to other immune system disorders, such as thyroid disease or alopecia areata. Other causes of hair loss in diabetes can be related to poor circulation, medication side effects, inadequate blood sugar control, and nutrient deficiencies. For the best treatment options, it is important to determine the cause.

Immune System Disorder

People with diabetes are at increased risk of developing other immune system disorders. Sometimes people with diabetes can also have thyroid disorders. An issue with the thyroid can cause hair loss because disruptions in the thyroid hormone can affect the hair cycle and lead to hair thinning or hair loss.

If you have diabetes and suspect you have a thyroid issue due to weight loss, weight gain, fatigue, or nervousness, your physician should evaluate you.

Another type of autoimmune disease that is associated with diabetes is called alopecia areata. This occurs when the immune system attacks the hair follicles, leading to patches of hair loss on the scalp and other parts of the body. An accumulation of infiltrating immune cells typically characterizes it.

The amount of hair loss will depend on how many hair follicles are attacked. While the disease can cause an attack on the hair follicles, it rarely destroys them; therefore, hair can grow back, especially if you have not lost much hair.

Some people may be genetically predisposed to hair loss. This appears to be more common in those with other autoimmune diseases such as type 1 diabetes, rheumatoid arthritis, asthma, hay fever, atopic dermatitis, thyroid disease, vitiligo, or Down syndrome.

Poor Circulation

Insulin resistance, vascular impairment, and poor circulation are symptoms that can be a result of chronically high blood sugar or hyperglycemia. Chronic hyperglycemia can decrease the oxygen and nutrient supply, resulting in vascular impairment.

This can cause hair thinning, hair fragility, spareness of hair, or decreased hair growth speed. Insulin resistance could produce microvascular impairment, thus playing a role in the pathophysiology of androgenic alopecia.

Researchers found that type 2 diabetes was associated with an increased risk of severe central scalp hair loss in Black women. Researchers concluded that people with type 2 diabetes should be followed closely for central scalp hair loss so that appropriate treatment can be offered.

Medication Side Effects

Certain types of medications can cause hair loss by disrupting the hair cycle. Sometimes it can be difficult to pinpoint the cause, especially if a person is on multiple medications.

For example, certain types of cancer treatment such as chemotherapy and radiation can cause hair loss. Typically, when hair loss occurs due to certain medications, the hair will grow back when medication use stops.

Other types of medications that can cause hair loss include:     

  • Arthritis medications
  • Antidepressants
  • Medications for gout
  • Cholesterol-lowering medications, including certain statins
  • High blood pressure medications (ACE inhibitors)
  • Anticoagulants (blood thinners)
  • Acne treatment medications
  • Antifungals
  • Antiarrhythmias
  • Anticonvulsants
  • Psoriasis medicines
  • Steroids

Elevated Blood Sugar

Hyperglycemia (elevated blood sugar) occurs when sugar remains in the blood and cannot be taken into the cells for energy. This can occur because of lack of insulin, insulin resistance, or a combination of both. Over time, damage to the microvascular and macrovascular vessels can occur.

For example, if blood vessels in the legs are damaged, hair follicles below the knees can also be damaged due to a lack of blood flow, which disrupts the flow of oxygen and nutrients and, as a result, affects the hair growth cycle.

This can be a sign of peripheral arterial disease (PAD). People with PAD may also have intermittent claudication, wounds that heal very slowly, or numbness and tingling in the legs or feet.

Elevated blood sugar from hormonal imbalances can also affect hair growth and hair loss. For example, when cortisol (the stress hormone) levels are high, the cells become resistant to insulin. Instead of sugar being taken out of the bloodstream, it remains in the blood.

Over time, excess cortisol can disrupt the hair follicle, leading to hair growth disorders such as androgenetic alopecia, alopecia areata, and telogen effluvium.

Symptoms

There are many different types of hair loss. How it falls out will depend on why it is falling out. For example, if you have type 1 diabetes and your hair starts to fall out in patches on your scalp or various parts of the body, you may have alopecia areata. This may occur in a single episode, or it may have remission and recurrence.

Other types of hair loss may occur on the scalp or other parts of the body. For a proper diagnosis, it is important to differentiate how quickly the hair is falling out and where, so that you can give your physician an accurate picture.

People with diabetes are also at increased risk of skin-related symptoms, such as dry, itchy skin and other types of skin-related disorders. When blood sugars are elevated, people with diabetes are at increased risk of developing infections. Folliculitis is a type of bacterial skin infection that affects the hair follicles.

Diagnosis

Diagnosis is contingent upon several variables, including how your hair loss presents—Is it on your scalp, your legs, or elsewhere? Does it fall out in patches or clumps?

There can often be a sex-specific hair loss trait, which causes hair to fall out in patterns termed male and female.

Other factors may include:

  • Race     
  • Medications      
  • Other health conditions      
  • Pregnancy      
  • Stress level
  • If you have experienced trauma
  • Differentiating between sudden or gradual hair loss

Your physician may do bloodwork to determine if you have any vitamin and mineral deficiencies. A dermatologist may also use a dermascope to diagnose the cause of hair loss. Additionally, they will examine your nails.

Considerations

If you have diabetes, you are at increased risk to develop other immune system disorders such as thyroid problems or alopecia areata. Some studies suggest that insulin resistance can be a marker for hair loss. Therefore, it could be possible for people with prediabetes to experience hair loss.

Prediabetes, also described as impaired glucose tolerance or impaired fasting glucose, is considered a precursor of type 2 diabetes. Prediabetes does not typically cause symptoms, but without intervention, it can progress to type 2 diabetes.

Several factors can increase your risk of prediabetes, such as a family history of diabetes, age, excess weight (especially in the abdomen), high blood pressure and/or cholesterol, and sedentary behavior, among others.

If you are experiencing hair loss and have some of these other risk factors, you may want to be examined by your physician to see if you have impaired glucose tolerance. Getting control of your blood sugar promptly can help prevent type 2 diabetes and get your hair loss under control.

Treatment

It is important to note that not one treatment works for everyone. Treatment options will depend on the reason for hair loss and the type of hair loss you are experiencing. In most instances, hair can grow back once the intervention is started.

Managing Blood Sugar

If you are someone with diabetes and have been experiencing elevated blood sugars, getting your blood sugars within the normal range may help you slow down hair loss and even help with hair regrowth.

Because elevated blood sugar is associated with vascular disruption, poor circulation, and hormonal imbalances, maintaining your blood sugars within your normal range can help keep your hair cycle regular.

Your normal blood sugar range will depend on your age, if you experience hypoglycemia often, how long you have had diabetes. and your life expectancy.

Typically, blood sugars should be 80-130 mg/dL after fasting for eight or more hours and less than 180 mg/dL two hours after a meal. These targets should be individualized with your healthcare professional.

If your blood sugars are at goal and you are reaching your target numbers that you have created with your healthcare team, yet you are still losing your hair, you should contact your medical team. There could be a different medical or nutritional reason as to why you are losing hair.

Medication

Certain medications are known to help treat hair loss and help hair regrow. The American Academy of Dermatology lists different types of medicines that can help with hair loss types. The type of
medication prescribed will depend on your age and the risks of side effects:

  • Corticosteroid creams and injections: Injections are typically for adults and not children. Creams can be applied to the patches in both children and adults. Injections seem to be more effective in adults, while creams seem to work better in children.
  • Rogaine (minoxidil): Helps to keep hair growth stimulated and is helpful for the scalp, beard, and eyebrows. This may also be an option for children.
  • Anthralin: Another type of topical medication that is typically used with Minoxidil. This can cause skin irritation.

Lifestyle Modification: Diet, Supplements, Exercise

In individuals with nutrient deficiencies, such as vitamin D or iron deficiency, supplementing or changing dietary patterns to include nutrient-rich foods may help with hair loss. It is important to note that over-supplementing is not the answer.

In fact, supplementing with too much of certain vitamins and minerals can be harmful, especially if you do not have a deficiency. For example, getting too much vitamin A and E have actually been linked to hair loss. Because these vitamins are fat-soluble, they can cause toxicity if taken in excess.

It is always a good idea to use food first to see if there is any effect on hair. If you find that dietary interventions are not helpful, you may want to be tested for nutrient deficiencies.

Nutrient deficiencies may warrant dietary supplementation, but supplementation recommendations should always be guided by a professional, as supplements are not regulated and too much of certain vitamins can be harmful.

Essential vitamins and minerals important in hair health include iron, zinc, biotin, niacin, fatty acids, selenium, vitamin D, and amino acids.

A well-balanced diet that contains ample amounts of fruit, vegetables, healthy fats, whole grains, and a variety of protein sources can usually provide recommended daily amounts of vitamins and minerals. In instances where there is an actual deficiency, supplementation supervised by a medical professional may be warranted.

Iron

Iron deficiency has been correlated to hair loss by mechanisms of action that are not clearly understood. Some studies indicate that those who have low iron levels also have experienced some hair loss.

People with severe iron deficiency need to be evaluated by a doctor for iron replacement. Those who are vegan may need dietary counseling to optimize iron absorption and iron intake to prevent deficiency. Foods rich in iron include animal proteins, seafood, legumes, nuts, seeds, leafy greens like spinach, and whole grains.

Zinc

Zinc deficiency is uncommon; however, it can cause hair loss in severe cases. Some studies have shown that people with zinc deficiency, when treated, were able to reverse their hair loss. Zinc deficiency may occur due to various reasons, including malabsorption issues, genetic disorders, and certain medications.

Foods naturally rich in zinc include red meat; poultry; shellfish like oysters, crab, and lobster; whole grains; dairy products; and fortified cereals.

Zinc from plant-based foods is not as readily absorbed as animal products. People who follow a vegan or vegetarian meal plan may need to have zinc levels assessed. You should not supplement with zinc without a medical professional. Over-supplementing with zinc can cause a copper deficiency.

Fatty Acids

Essential fatty acids (omega-3 and omega-6 fatty acids) must be ingested through the diet as the body cannot make them. Some studies have shown that a deficiency can cause hair loss on the scalp and eyebrows.

Eating a diet rich in fatty acids may be associated with increased hair growth; therefore, it is important to eat enough fat. Foods rich in omega 3 and 6 include fatty fish, walnuts, chia seeds, flaxseed, sunflower seeds, pumpkin seeds, and canola oil.      

Selenium

Although the research is scarce, many companies market selenium supplementation for hair growth. Most diets are adequate in selenium, and deficiencies are rare. Selenium toxicity is possible, therefore eating foods rich in selenium versus supplementing is recommended.

The amount of selenium a food contains will depend on the soil it is in. One Brazil nut can provide all your selenium needs for the day. Other food sources of selenium include fish, meat, poultry, grains, legumes, and dairy.

Vitamin D

Some studies have shown that people with alopecia areata can have low levels of vitamin D. As vitamin D is largely obtained from sunlight, it is known as the sunshine vitamin.

During the winter months, it can be harder to obtain adequate amounts of vitamin D. Because vitamin D is found in a limited number of foods, supplementation may be warranted for low blood levels or deficiency.

Foods rich in vitamin D include salmon, trout, mackerel, tuna, fish liver oils, fortified milk and milk alternatives, egg yolks, fortified cereals, and orange juice.

Biotin

Lack of biotin or a biotin deficiency has been associated with hair loss, brittle nails, and dry skin. Deficiency is rare but can be associated with enzyme deficiency, excessive antibiotic use, consuming too many raw egg whites, alcoholism, and antiepileptic use.

It might sound plausible that taking biotin or using biotin-containing products can help with hair loss. However, while supplementation with biotin has been shown to have efficacy in treating brittle nails, there is insufficient research for supplementing biotin for hair loss without a biotin deficiency.

If you do not have a deficiency, you should be able to get enough from food. Foods rich in biotin include spinach, oats, egg yolks, and wheat germ.

Amino Acids

Amino acids are the building blocks of protein, and protein is an important component to hair growth and strength. Hair follicles are mostly made of protein; therefore, it makes sense that a lack of protein could cause hair loss.

If you have diabetes and have been told to follow a very low-calorie diet, you may not be eating enough protein. Insufficient calorie intake can reduce your intake of key nutrients, such as vitamins, minerals, and protein. This can result in hair loss.

It is important to get adequate amounts of protein daily. The average adult needs about 0.8 grams of protein per kilogram of body weight. One kilogram equals 2.2 pounds, so if you weigh 170 pounds that would mean that you need about 62 grams of protein.

Foods that are rich in protein include chicken, fish, turkey, eggs, cheese, yogurt, tofu, edamame, legumes, nuts, seeds, and nut butters, to name a few.

Exercise

Exercise has so many health benefits including improving insulin sensitivity, which can improve glucose control. It is important for people with diabetes, especially those taking glucose-lowering medications such as insulin, to test blood sugar often to prevent hypoglycemia.

Coping

There are many treatment options for hair loss. However, if you have significant hair loss, it may take time to grow back. In this case, your dermatologist may recommend that you purchase a wig for the time being.

Wigs or hair replacement may be an option to consider, especially if your hair loss has impacted your daily life and affected your self-esteem. Some dermatologists may recommend a hair prosthesis, a wig that is custom made to ensure a perfect fit. There are many options to choose from.

If you are experiencing hair loss on other parts of your body, you would benefit from meeting with a board-certified dermatologist to develop a plan. They must see you so that you can understand the best remedy.

For example, if you lose hair in your nose, they may recommend applying an antibiotic ointment to your nose to protect you from foreign particles, such as dust, germs, and small airborne particles.

If your hair loss is related to stress, it is important to figure out how to manage your stress. Consider reaching out to a mental health professional.

You may also participate in mindfulness activities, such as deep breathing, yoga, or meditation. Journaling, writing down your feelings, walking, exercising, and listening to music are other types of stress-relieving activities.

Connecting with others who are experiencing the same thing you are is another important way to boost self-esteem and prevent loneliness.

The American Academy of Dermatology recommends connecting with someone from the National Alopecia Areata Foundation. If this is not the type of hair loss you are experiencing, you can ask your dermatologist for another appropriate foundation. 

A Word From Verywell

Dealing with diabetes requires daily self-management and can get tiring. Adding hair loss to your diagnosis may feel overwhelming, but be assured, there are ways to slow down hair loss, prevent it, and stimulate hair growth.

If you are having trouble managing your diabetes and keeping your blood sugars within the normal range, consider meeting with a registered dietitian or certified diabetes care and education specialist. These professionals can provide you with education and help you overcome barriers.

A few dietary, exercise, and behavior changes, such as moving more, can go a long way to improving blood glucose control and optimizing nutrient needs. People with diabetes who maintain good blood glucose control can protect themselves from diabetes complications and can live a full, healthy, and energized life.

Certain nutrients may help with hair loss and hair regrowth. If you have an actual deficiency in one of these nutrients, supplementing may be necessary. However, most of the time, simply adding more foods rich in these nutrients can be beneficial, possibly for hair, but also for overall health.

If you feel like your hair loss has happened suddenly or excessively and you are not sure why, you may need to meet with a dermatologist specializing in hair loss. Once they figure out the reason for the hair loss, they can tailor a treatment plan to suit your needs.

Most of the time, there are remedies. It may just take some time to figure out. Remember that you are not alone.

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18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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