Autoimmune conditions and hair loss: what to know

Alopecia areata is an autoimmune condition in which immune activity targets hair follicles. It often presents with smooth, clearly defined patches, although broader scalp or body-hair loss can occur. Hair loss can also have non-autoimmune explanations, so shedding alone cannot identify the cause.

Smooth round patches, changes in the eyebrows or eyelashes, and small nail dents can accompany alopecia areata. Diffuse shedding after illness, major stress, or a medication change may fit telogen effluvium instead. Scaling, broken hairs, tenderness, or inflamed areas raise different possibilities, including infection or inflammatory scalp disease.

A clinician examines the scalp and hair shafts and reviews the timing of loss, health conditions, medicines, diet, styling practices, and family history. Blood tests may be selected when symptoms suggest thyroid disease, anaemia, a nutritional deficiency, or another systemic problem; they are not automatically needed for every person.

Photograph the same scalp areas in similar lighting and note whether loss is patchy, widening along a part, concentrated at the hairline, or spread across the scalp. Record recent illness, new medicines, tight hairstyles, scalp symptoms, and loss of hair elsewhere. This history can make an appointment more productive.

Use gentle hair care while the cause is being assessed: avoid repeated traction, harsh chemical processing, and vigorous brushing of fragile hair. Do not start high-dose supplements solely for shedding, because excess amounts of some nutrients can worsen hair loss or interfere with tests.

Book a dermatology assessment for new patches, ongoing shedding, eyebrow or eyelash loss, visible scalp inflammation, or uncertainty about the cause. Seek prompt care when hair loss comes with a painful, hot, swollen, crusted, or draining scalp, or when you feel systemically unwell. Scarring, shiny skin, and loss of follicle openings also merit timely assessment because some inflammatory disorders can damage follicles.

Ask which features support an autoimmune diagnosis, whether the follicles appear scarred, and whether examination alone is sufficient. You can also ask what treatment is intended to do, how progress will be judged, which side effects need reporting, and whether your other medicines or health conditions affect the choices.