Does Diabetes Cause Hair Loss?

If you have diabetes and notice you’re losing an abnormal amount of hair, it is possible that high blood sugar levels are a cause. Diabetes can affect every part of the body, including the blood vessels that supply your hair follicles, potentially leading to excessive hair loss. Diabetes is also linked to a number of other risk factors for hair loss, including autoimmune conditions and hormonal imbalances.

Seeing some stray hairs in your brush every day is to be expected. Adults typically lose about 50 to 100 strands a day. This is known as hair shedding.

“Our hair all goes through a natural shedding cycle,” says Samantha Venkatesh, MD, a dermatologist with Rush Medical Group in Chicago.

Hair loss, on the other hand, occurs when something prevents your hair from growing. Hair loss can be temporary or permanent, and there are a large number of potential causes, some of which are associated with diabetes complications and treatment.

Researchers aren't certain that diabetes and high blood sugar levels directly cause hair loss, says Dr. Venkatesh. But type 1 and type 2 diabetes are both associated with a variety of known hair loss risk factors.

Poor Blood Circulation

Hair follicles need oxygen-rich blood flow to grow. Chronic high blood sugar levels, known as hyperglycemia, can damage blood vessels and compromise the oxygen and nutrient supply to hair follicles. This, in turn, may disrupt hair growth and lead to shedding.

“If there is less blood flow to the scalp, this, in theory, could decrease the ability for hair to grow,” says Venkatesh.

The Diabetes-Autoimmune Relationship

People with type 1 diabetes often have other autoimmune conditions, and both alopecia areata and Hashimoto’s thyroiditis are associated with hair loss.

There may be a scientific connection to prediabetes and type 2 diabetes and alopecia areata too. In one study of people with alopecia areata, people were 62 percent more likely to have prediabetes compared with a control group.

Researchers suspect there may be common inflammatory responses in the body between the two conditions, though more research is needed.

Venkatesh says that centrifugal cicatricial alopecia (CCCA), a type of rare, scarring hair loss, also has a known association with diabetes.

Diabetes Medications

GLP-1 agonists are one class of medications that help manage blood sugar in people with type 2 diabetes. Semaglutide, also known by its brand name Ozempic, is widely prescribed and has generated many reports of hair loss.

“I have seen hair loss in patients who are on these medications,” says Hannah B. Kopelman, DO, a hair restoration surgeon and dermatologist at Kopelman Hair Restoration in New York City.

GLP-1 hair loss may be caused by the rapid weight loss these medications can spark — not the drugs. People who achieve dramatic weight loss using other means also sometimes experience temporary hair loss.

Dr. Kopelman says that hair grows back on its own, and people who take these meds may have a better head of hair in the long run.

“When the body is in a healthier state with more controlled insulin, I’ve seen people’s hair become thicker and grow better,” says Kopelman.

While GLP-1 hair loss may not be a significant concern, there are other drugs that are known to cause hair loss, some of which are often prescribed to people with diabetes. Many people with diabetes take medications for hypertension, high cholesterol, gout, thyroid disease, and depression which carry a risk of temporary or permanent hair loss.

Thyroid Issues

People with diabetes have a higher risk of developing both hyperthyroidism and hypothyroidism.

These thyroid conditions are strongly associated with hair loss. According to a one study, 33 percent of people with hypothyroidism and 50 percent of people with hyperthyroidism may experience excessive hair shedding.

Iron Deficiency

There is a link between higher A1C levels and iron deficiency,

and iron deficiency can directly contribute to hair loss. The mineral plays a role in producing hemoglobin, which is the protein in red blood cells that delivers oxygen to the cells throughout your body.

Polycystic Ovarian Syndrome (PCOS)

PCOS, a hormonal disorder that impacts women of reproductive age, shares a common risk factor with type 2 diabetes — insulin resistance — and the two conditions often coexist.

PCOS can cause the body to produce an excess of testosterone, and a common side effect of that is thinning hair.

Stress

Managing a chronic condition can be a lot to handle, and stress is linked to hair loss too.

“Stress can definitely contribute to hair shedding,” says Venkatesh.

There are many ways to help slow or stop the progression of hair loss.

See a Healthcare Professional Right Away

Speaking to a doctor, ideally a board-certified dermatologist, can help you determine if the hair loss you notice falls into the range of normal, or if there may be an underlying health issue. If you have bald patches or an unexplained reduction in hair density, early screening tests may help identify the root cause and get preventive measures quickly in place.

Treatments can take 6 to 12 months to work. “If we can catch it earlier, then we can be more helpful with treatment,” says Venkatesh. Kopelman concurs: “Addressing it sooner can also help you preserve the hair you have and slow down the progression of hair loss.”

Medications

There are many medications approved to treat hair loss. Kopelman typically chooses from three medications, which she says are safe for people with diabetes:

minoxidil (Rogaine) for both men and women
finasteride (Propecia) for male pattern baldness
dutasteride (Avodart) for male hair loss

Topical minoxidil, available as a foam or a liquid in varying concentrations, is available as a prescription and over the counter. Minoxidil also comes in a pill as a therapy for hypertension, but some doctors prescribe it off-label to help with hair loss.

“Minoxidil helps with hormonal hair loss, and it also increases blood flow to increase the growth of hair and the diameter of hair,” says Venkatesh.

Venkatesh recommends the 5 percent minoxidil for both men and women. It will need to be applied on the scalp once a day for women and twice a day for men for at least six months before improvements are seen.

Dietary Supplements

Many people with diabetes have nutritional deficiencies.

It’s possible that a lack of essential vitamins and minerals may cause changes in hair structure and affect hair regrowth.

Metformin can also cause vitamin B12 deficiency, which can lead to hair loss,

and low vitamin D levels, which are common in people with types 1 and 2 diabetes, may also contribute to hair loss.

It is possible that dietary supplements could help address these deficiencies. Kopelman says that she will run labs to check vitamin D, B12, zinc, and iron levels in her patients.

There are also supplements specifically designed for hair growth, but they are not strictly controlled by the U.S. Food and Drug Administration.

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