Ankylosing spondylitis, a type of arthritis, is an autoimmune condition, and different types of hair loss have been associated with abnormal immune responses.

However, when it comes to this chronic inflammatory arthritis, there’s no evidence to suggest that it causes hair loss. Even so, there are reports of people experiencing hair loss due to ankylosing spondylitis. 

And that leads to the question: what causes ankylosing spondylitis hair loss? Mainly, it’s a result of drug-induced alopecia. However, the stress of the condition can also cause hair loss. 

Depending on the kind of medication you’re on, it’s even possible to experience different types of hair loss. In this guide, you’ll learn more about ankylosing spondylitis hair loss and what might be done about it. 

Can Ankylosing Spondylitis Cause Hair Loss?

A 2022 study published in the International Journal of Rheumatic Diseases found no link between hair loss and ankylosing spondylitis. Ankylosing spondylitis patients weren’t at an increased risk of hair loss either, according to the researchers. 

It was a nationwide study of 3640 Taiwanese patients with this inflammatory disease. And it also included 14,560 people without the disease as a control group. While the study had certain limitations, its results are still significant and meaningful. 

Another important thing that the same researchers concluded was that inflammation caused by ankylosing spondylitis also doesn’t seem to cause hair loss. Inflammation is something that in other autoimmune conditions (like lupus) causes hair loss. But that’s not the case here. 

Still, this disease can result in hair loss, but it’s more so in an indirect manner. And it’s mainly because of the medication prescribed to manage this condition. 

What Causes  Ankylosing Spondylitis Hair Loss?

The main cause of ankylosing spondylitis hair loss is the disease-modifying anti-rheumatic drugs (DMARDs) prescribed to treat it. However, stress can also play a role. 

Let’s take a closer look at each of these factors. 

Medication 

Disease-modifying anti-rheumatic drugs (DMARDs) are a class of drugs prescribed for the treatment of rheumatoid arthritis. While rheumatoid arthritis is different from ankylosing spondylitis, both are rheumatic conditions – diseases affecting bones, muscles, joints, tendons, and ligaments. 

Additionally, DMARDs are prescribed for both since both are inflammatory and autoimmune conditions. With these drugs, the immune systems and inflammatory processes in the body are suppressed. As a result, it helps with pain and stiffness.

However, one side effect of DMARDs is hair loss. An example of it is methotrexate, which targets and stops the growth of hair follicles, causing hair loss. According to the Arthritis Foundation, methotrexate causes hair loss in 1-3% of people. 

Other disease-modifying anti-rheumatic drugs used for ankylosing spondylitis have also been reported to cause hair loss. Among others, it includes: 

• leflunomide (brand name Arava)
• etanercept (brand name Enbrel)
• adalimumab (brand name Humira) 

Here, it should be noted that DMARDs also include the medication known as “tumour necrosis factor (TNF) inhibitors” (Humira and Enbrel are included in this class of drugs).  

And curiously enough, one side effect of TNF inhibitors is that they can induce a type of autoimmune disease known as alopecia areata. That also causes hair loss in the form of oval-shaped patches. 

Stress

Having a chronic condition like ankylosing spondylitis can be quite stressful. And that can also trigger a type of hair loss known as telogen effluvium.

Here, you should also note that chronic stress can also affect your immune system. And that can make you more vulnerable to illnesses, which can also cause hair loss. 

Is Ankylosing Spondylitis Hair Loss Permanent?

According to DermNet, drug-induced alopecia is usually reversible. So, it is possible to grow your hair back. 

However, it only reverses after you’ve discontinued the drug. This does not mean that you should stop taking medication if you’ve noticed hair fall. 

Make sure to consult your doctor about it. They may change your medication.  

Other than that, alopecia areata and telogen effluvium are also usually reversible. 

What’s The Treatment For Ankylosing Spondylitis Hair Loss? 

The treatment will depend on the cause of your hair loss. As mentioned above, if it’s drug-induced, your doctor might change your treatment plan (don’t discontinue any medication without consultation). 

And if the hair loss is stress-induced, there are different things you can do for that as well. For one, you’ll have to look for ways to manage stress. This can include exercise, deep breathing, healthy eating, guided meditation, yoga, etc.

Other treatments for telogen effluvium also include minoxidil and supplements (which you may or may not need, so consult your doctor first).  

You might also be recommended laser therapy or platelet-rich plasma injections. Or a surgical intervention like a hair transplant if you have permanent hair loss. But in any case, you should first talk to a board-certified doctor. 

Conclusion 

Ankylosing spondylitis can be a difficult condition to live with. There is no cure for it, but its symptoms can be managed with different treatments. 

Unfortunately, one of the side effects of some treatments can be hair loss. The stress of dealing with the autoimmune condition can also add to hair loss. 

Still, it may be possible to manage it. And you might be able to grow your hair back as well. But if you have ankylosing spondylitis and are experiencing hair loss, make sure to get in touch with a doctor for an accurate diagnosis and an effective treatment plan. 

Reviewed and Approved by Trichologist Yaprak Yazan