How Real Is HIV Hair Loss?

How Real Is HIV Hair Loss?

A positive HIV diagnosis can be world-shattering. The person learning about it may feel hopeless, fearful, and even angry. There is a constant fear of ostracization, discrimination, and having to face judgmental people every day, which can immensely add to the worries of patients with HIV.

Moreover, people who have this infection may also suffer from hair loss, although not directly as a result of the infection. HIV hair loss can cause even more stress, which can become another reason for hair loss.

Let’s find out if there’s anything that a person can do to fight HIV hair loss. And is it possible for patients with HIV to get a hair transplant procedure?

What Is HIV?

HIV (human immunodeficiency virus) is a virus that attacks the CD4+ T-lymphocytes (helper T cells), which is a type of white blood cell. The white blood cells are a part of the body’s immune system. They protect it by warding off various infections and diseases. Since the virus destroys the CD4 cells, the body is unable to trigger an immune response.

This is why for an HIV diagnosis, a person’s CD4 cells are counted in the blood (normally, 500 to 1,400 per mm3 of blood). The human immunodeficiency virus also uses the CD4 cells to make more copies of the virus.

This reduces the body’s ability to fight back effectively against everyday illnesses, such as the common cold. Many people with HIV infection commonly get infected with bacterial pneumonia.

Left untreated, HIV infection causes AIDS (acquired immunodeficiency syndrome). There are different stages of the infection:

  • acute
  • chronic
  • AIDS

Having HIV infection will not always lead to AIDS. Early treatment can prevent the progression of the infection to this stage, where the immune system is extremely damaged.

Through antiretroviral therapy or ART, people who have HIV can live a healthy life for as long as an average person. It can even prevent the transmission of the virus from one person to another. Currently, there is no cure available to treat HIV infection. Those who are HIV positive will have the infection for life.

Causes of HIV

The HIV crossed species from chimpanzees to humans back in the 1800s.

It can be sexually transmitted through bodily fluids, such as blood, semen, anal and vaginal fluids. Unprotected sexual intercourse can transmit HIV from one person to another.

The use of unsterile medical equipment that is contaminated with HIV can also transmit it. Tools used for manicures and pedicures in beauty salons can also transfer the virus to the body.

Symptoms of HIV Infection

Patients with HIV can pass it on to others. However, ART therapy can prevent it. People with HIV may not even know that they have the infection. The symptoms of the infection start manifesting 2 to 6 weeks after. This is the acute infection stage, where the virus is multiplying rapidly.

Since the initial symptoms are similar to that of the flu, many people are unaware that they have the infection. Patients with HIV at this stage may experience the following: 

  • Headache
  • Fatigue
  • Sore throat
  • Fever
  • Muscle ache
  • Mouth ulcers
  • Swollen lymph nodes

Many people wonder, “Is hair loss a sign of HIV?” This doesn’t happen that commonly, which is why you can’t assume that you have HIV simply because you’re losing hair.

After these symptoms go away, patients with HIV may not experience any other symptoms associated with HIV for years. This is the chronic stage of the infection, and it can last for more than a decade.

The virus is replicating at this stage, too but at a slower rate. If the person starts getting ART treatment during this stage, they may remain in it and not have AIDS.

HIV infection has two classifications: HIV-1 infection and HIV-2 infection. HIV-1 infection is more common and can be life-threatening.

Does HIV Cause Hair Loss?

HIV and hair loss have an indirect relation. Medications that are used to treat HIV can cause hair loss as a side effect. This infection can also cause other medical problems, such as iron deficiency anaemia or thyroid dysfunction, which can lead to hair loss. Let’s learn more about the different types of HIV hair loss.

Telogen Effluvium

Learning that you are HIV positive can result in mental and physical stress. Since there is no cure for HIV, it’s hard for patients to cope easily with the knowledge of their infection. They fear stigmatization. So, hair loss can occur as a result of this stress that accompanies the disease.

Telogen effluvium is the name of hair loss that occurs as a result of stress. Chronic illness is one reason for this type of hair loss. You may not immediately lose your hair due to telogen effluvium. In fact, telogen effluvium hair loss can take place months after a stressful event.

However, patients with HIV may be under constant stress. That is why they can continue experiencing telogen effluvium. It can hamper normal hair growth from taking place, resulting in HIV hair loss.

Alopecia Areata

Diffuse alopecia areata, also known as alopecia areata, may also cause HIV hair loss.

Alopecia areata commonly occurs in those people who have immune system disorders. The healthy body cells are under attack by the body’s own immune system.

According to one study, follicular stem cells, present in the hair follicle, become apoptotic (prone to dying) in HIV-1 infection. This can result in alopecia areata. Alopecia areata and HIV are, therefore, correlated.

Medications

This is something that commonly happened in the past as a result of the medications prescribed for HIV. Now, only the prescription of Zovirax (acyclovir) used to treat herpes (in HIV positive patients, in this case) can cause hair loss.

With HIV medications, people with HIV can live longer lives. So, getting the treatment as soon as possible is important. However, bear in mind that in addition to the infection itself, ageing can also result in hair loss over time.

Is HIV Hair Loss Permanent? 

That depends on the cause of the hair loss. If HIV hair loss occurs due to telogen effluvium, it’s reversible. But in rare cases, alopecia areata can result in permanent hair loss. 

As far as the medications are concerned, according to one case study published in the Middle East African Journal of Ophthalmology, acyclovir can result in telogen effluvium and anagen effluvium; the latter can rarely result in permanent hair loss.

While in the case study itself, the patient’s hair loss was reversed as soon as the medication was stopped. So, HIV hair loss can also result from this. 

How Does HIV Affect the Scalp?

People who have HIV find it difficult to fight off everyday infections and illnesses. HIV hair loss can occur as a result of diseases that damage the immune system.

For instance, patients with HIV commonly develop seborrheic dermatitis, which is an autoimmune response. This condition is a form of dermatitis that occurs in those areas of the body where there is more sebaceous glands activity.

This can cause redness, itchiness and flaky scales on the scalp. Inflammation can also occur as a result. Here too, HIV hair loss occurs indirectly. 

Antifungals and steroids are used for treatment. It can be difficult to treat it in patients with HIV. Their weak immune system can lead to repeated skin problems due to any stress.

Can People with HIV Have a Hair Transplant?

HIV hair loss can negatively impact a patient’s life quality, which is why they may want to get restoration surgery.

However, HIV is an infectious disease that weakens the immune system, and in a hair transplant surgery, the surgeon has to make thousands of open cuts on the skin. These cuts are prone to infection during the recovery process.

If an HIV positive patient has an infection after the hair transplant, their body might not be able to fight the infection. The infection can spread quickly across the surgical areas.

This will affect the transplanted hair, and the patient will end up with unsatisfactory and poor results. Infection can also be life-threatening for HIV positive patients.

Therefore, a hair transplant procedure is not recommended for people with HIV. The health of the patient always comes first, so we do not do anything that can put it at risk.

Is Hair Transplant Possible with Undetectable HIV?

It is possible for HIV to go undetected if the person is taking treatment for it. It happens because of the decrease in the viral load. However, an antibody HIV test will result in an HIV positive diagnosis because the antibodies produced are present in the body.

Undetectable HIV means that the patient is still HIV positive. If they stop their medications, their viral load will increase. This possibility can still affect the results of a hair transplant.

The testing kits we use are able to detect HIV even if the patient is undetectable. Unfortunately, this still makes the patient unsuitable for a hair transplant.

Conclusion

There are many other indirect causes of HIV hair loss that stem from the presence of the virus. So, alopecia and HIV can coexist. 

The virus itself doesn’t do anything to the hair follicles, but the weakened immune system makes the patient more susceptible to infections that can affect the scalp or result in an autoimmune response that can damage the follicles. The stress of being positive for this virus can also cause HIV hair loss. 

If the hair loss is temporary, you should consult with your doctor for their treatment. However, if you’re planning to get a hair transplant for permanent hair loss, unfortunately, that’s not recommended because that can put the patient’s safety at risk. To learn about other treatment options, you can consult with our hair transplant surgeons. 

Reviewed and Approved by Dr. Hassan Soueid.

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