Sarcoidosis is a multisystem (affecting multiple body organs) disorder that’s believed to be autoimmune. It can affect all organs in the body, but it most commonly affects the lungs and lymph nodes.
Less commonly, however, it can affect the skin. It’s known as cutaneous (skin) sarcoidosis, occurring in around 25% of people with sarcoidosis. While there are many symptoms of this type of sarcoidosis, one of them is hair loss.
Sarcoidosis hair loss can occur on the scalp and body, and it can be non-scarring or scarring. A problem with this type of hair loss is that it can easily be mistaken for other kinds of hair loss, delaying diagnosis and treatment.
But with the right treatment, you may be able to stop the hair loss from spreading any further. Depending on the type of hair loss you’re suffering, it may even be possible for you to regrow your hair.
Does Sarcoidosis Cause Hair Loss?
Sarcoidosis can cause diffuse or localised (patchy) hair loss on the scalp and/or body.
It’s an inflammatory condition in which an abnormal immune response leads to the formation of small lumps called granulomas. These granulomas are accumulations of inflammatory cells that have joined together.
Regarding hair loss caused by these granulomas, according to a study published in Actas Dermo-Sifiliográficas, it could be due to:
- A granuloma forming on the hair follicle or,
- A granuloma replacing the follicle
And when it comes to cutaneous sarcoidosis, hair loss isn’t the only symptom. You can also have papules (bumps) and plaques (which can leave scars), nodules, pain, and redness, among other symptoms.
Unfortunately, there is no cure for sarcoidosis. Its exact cause isn’t known either. It’s believed that the inflammation from the abnormal immune response causes this. But there are still others who don’t think that sarcoidosis is even autoimmune.
Regardless, it’s possible to manage this disease with the right treatment. Many people also don’t need treatment as it can go into remission on its own (but it can take months or years).
How Does Sarcoidosis Cause Hair Loss?
Cutaneous sarcoidosis on the scalp is the most commonly reported cause of hair loss in this condition. However, it may also occur due to coexisting autoimmune conditions and stress.
Cutaneous Sarcoidosis
When inflammation due to sarcoidosis affects the skin, it can cause scarring or non-scarring hair loss on the scalp and body. It might be limited to a part of the body or even occur on the entire body.
However, as far as the scalp is concerned, it’s rare for cutaneous sarcoidosis to develop there. But when it does, it can be quite destructive. You may experience the following symptoms:
- Raised hardened plaques (red, brown or purple coloured)
- Papules (skin, brown, red, or purple coloured)
- Depressed ulcers
- Atrophic lesions
- Shiny scalp
- Hyperpigmentation or hypopigmentation
- Redness (erythema)
Because of how it appears, it is possible for scalp sarcoidosis to be misdiagnosed as discoid lupus erythematosus, alopecia areata, follicular mucinosis, lichen planopilaris, necrobiosis lipoidica, folliculitis decalvans, and pseudopelade of Brocq.
It mimics other conditions, which can make diagnosis difficult (especially if only the scalp is involved). For this reason, your doctor will likely do a biopsy (a small piece of tissue removed from the body) to confirm sarcoidosis.
Keep in mind that sarcoidosis hair loss can be both patchy or diffuse (rarely so). And more commonly, it tends to be scarring or cicatricial. It can completely destroy the hair follicle, leading to permanent hair loss.
Other Autoimmune Illnesses
According to a review published in Cureus, the following conditions most commonly coexist with sarcoidosis:
Autoimmune conditions have a tendency to coexist with other autoimmune conditions. And that can also increase your risk of hair loss.
Stress
Sarcoidosis can have a significant impact on your physical and mental health. Living with this condition is not always easy. It can go on for years and each affected organ will present with its own set of symptoms.
Therefore, the emotional stress from this condition may also trigger a type of hair loss known as telogen effluvium. It can cause excess diffuse shedding that starts a few months after the triggering event.
Sarcoidosis Hair Loss Treatment?
The following medications have been used for the treatment of sarcoidosis hair loss:
- Corticosteroids (prednisolone)
- Immunosuppressants (methotrexata, azathioprine, infliximab)
- Antimalarials (hydroxychloroquine)
However, the problem is that these treatments don’t always work. In fact, many researchers report that they don’t work.
They can help stop hair loss from progressing, but they might not be able to grow your hair back. This is especially true if you’ve developed cicatricial alopecia because your hair follicles are permanently damaged.
In the meantime, you should try to have a healthy and active lifestyle. You should also look for ways to manage stress.
Is Sarcoidosis Hair Loss Reversible?
Sarcoidosis hair loss can be reversed if your hair follicles are still intact. If they’ve been destroyed due to scarring alopecia, you won’t be able to grow your hair back.
In any case, you should seek help immediately. Getting treatment in time might limit your hair loss to a small area.
Conclusion
Sarcoidosis hair loss can be very stressful. Because even when it’s patchy, it can involve most of the scalp. So, it can become difficult to hide it.
Unfortunately, this type of hair loss can cause scarring, which can result in permanent hair loss. But if you get early treatment, you may be able to limit the extent of hair loss.
So, if you’re losing your hair, make sure to get in touch with a board-certified medical professional. An effective treatment plan can only be prepared after an accurate diagnosis of your hair loss.
Reviewed and Approved by Trichologist Yaprak Yazan