A REALLY Bad Hair Day!

Alopecia is a common skin disease that results in the loss of hair on the scalp (and possibly elsewhere on the body). It typically begins with a small, round, and smooth patch on the scalp and can progress to complete baldness or total loss of body hair. Alopecia affects roughly 2% of the general population and 4.7 million people in the United States. It is a very unpredictable disease, as the hair can grow back or fall out at any given time, and the disease course varies for each individual.

A review of the medical literature does NOT reveal any scientific research studies regarding an association between FM and hair loss; and only very limited anecdotal information can be found after conducting a broader Internet search. Despite this, hair loss in general is frequently reported as a secondary symptom of FM, though whether it is the result of other complications or directly related to the condition itself is not well-understood. For example, both stress and sleep disturbances are commonly associated with FM; however, hair loss is commonly linked to all three.

In a survey of 185 healthetreatment.com members who reported a diagnosis of FM, 4.5% reported suffering from Alopecia. Most users reported mild to moderate hair loss, with a few reporting severe and very severe hair loss. These findings should be taken with caution, however, as the number of subjects reporting hair loss was small (17) and it is unclear if their hair loss is directly related to FM or to some other underlying medical condition.

According to the website of Dr. Jacob Teitelbaum, an expert on FM, hair loss is common among sufferers, though he cites no statistics to support this claim. For general hair thinning, Dr. Teitelbaum recommends treating

1. nutritional deficiencies; and
2. an underactive thyroid (even if thyroid labs appear normal).

Low iron is a key nutrient for hair growth, and standard testing misses most cases of iron deficiency. In fact, despite the fact that most physicians consider a ferritin blood test (the best measure of iron deficiency or excess) over 12 to show adequate iron, a recent study in patients with chronic illness and even mild anemia (a description fitting most people with CFS) showed that a ferritin under 100 was diagnostic of iron deficiency!

In addition, for those with Restless Leg Syndrome (RLS) and a ferritin under 60, iron can be more effective than the medication Requip, and can eliminate RLS as well as your iron levels optimize.

There are no pharmaceutical treatments for Alopecia that are currently approved by the US Food and Drug Administration (FDA), however many doctors may try to use a medication “off-label” (i.e., for a purpose other than what it is FDA-approved, which is legal under most circumstances). For individuals with mild and patchy Alopecia, several treatment options are available.

• Cortisone injections: A common treatment that is utilized is to inject the steroid known as cortisone into the bare patches of skin. This is typically done by a dermatologist once per month. If any new growth occurs as a result, it is generally visible within four weeks.
• Minoxidil: Another treatment that is sometimes used is to apply a mixture of 5% minoxidil to the affected areas two times per day. Minoxidil is the active ingredient in current hair loss products such as Rogaine.
• Anthralin: Anthralin cream or ointment, which is commonly used to treat psoriasis, is applied to the bare patches once per day and washed off after a period of time (typically 30 minutes to an hour later). New hair growth – if it results – will occur in eight to 12 weeks.

In addition to conventional medical therapies, a number of natural remedies have demonstrated effectiveness in treating Alopecia. Evidence from one study showed that lavender oil (combined with essential oils of thyme, rosemary, and cedarwood) improved hair growth in 44% of Alopecia sufferers who were treated over a 7 month period (Hay et al., 1998). This study evaluated 86 patients with Alopecia and randomly assigned them into two groups: the “active” group were instructed to massage essential oils – including thyme, rosemary, lavender, and cedarwood – into their scalp daily. These oils were contained in a carrier oil mixture of jojoba and grapeseed. The “control” group was instructed to use only carrier oils for their daily massage. Using photographic evaluation, dermatologists independently reviewed the images of the subjects’ hair loss and found that 19 patients (44%) in the active group showed improvement, versus only six (15%) in the control group.

Other natural products, including zinc, biotin, coenzyme-Q10, and saw palmetto, among others, have been evaluated as treatment options for Alopecia, but none have demonstrated effectiveness to date.

In FM patients, as in any chronic illness, a very common cause of unusual hair loss is a condition called “Telogen Effluvium.” This is when the normal cycles of natural growing and falling out of the hair follicles become jolted out of their usual random phase due to illness. In this condition, a severe physical stress – such as pneumonia or a flare up – can produce unusual hair loss which doesn’t begin until 3-9 months later. This type of hair loss is reversible, although it can take 3-9 months. It often grows in more quickly than this, but it’s better to be pleasantly surprised than to feel disappointment and abandon the needed medication too quickly.

Treatment of Alopecia is not entirely effective but options do exist. Steroid therapy, immune therapy, nutritional therapy, thyroid functioning evaluation, and natural therapies with essential oils may be of benefit to those of us who suffer from hair loss.

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