Atopic dermatitis (commonly called eczema) has many symptoms. Along with the skin, it can affect the ears, lips, eyes, and other areas. Eczema can also affect the scalp, making some people wonder if it causes hair loss. While the condition may not lead directly to hair loss, there may be some connection.1,2
Understanding hair loss
Hair loss is also called alopecia. There are many potential causes of alopecia. Some are short-term or reversible. Other sources of hair loss are permanent.3
Hair loss also can be sudden or happen gradually over time. It can affect the whole head or just parts. Depending on what is causing it, it can happen at any age, although it is most common in aging adults.3
Common causes of hair loss include:3
- Inherited baldness that occurs with age (androgenic alopecia, also called male- or female-pattern baldness)
- Changes in hormones due to pregnancy, thyroid issues, or menopause
- Autoimmune conditions (such as alopecia areata)
- Drug or supplement side effects
- High stress levels
- Strain on the scalp due to tight hairstyles or scratching
- Damage from hair dyes or treatments
- Radiation therapy to the head
Does atopic dermatitis cause hair loss?
Although it can affect the scalp, especially in young kids, eczema does not directly cause hair loss. However, aggressive scratching as a result of eczema itch can cause damage that leads to hair thinning in areas of long-lasting irritation.1,4
Having a broken skin barrier and inflammation can also increase your risk of getting a skin infection. This type of infection could also affect hair growth.1,4
The effects of itching can be seen on the head and on the body. Long-term scratching can lead to thickened areas of skin called plaques. This process is called lichenification. It is possible for hairs to no longer be able to grow in areas that have thickened. This can lead to patches of hair loss on the body.5
Atopic dermatitis and alopecia areata
Alopecia areata is an autoimmune condition in which the body attacks its own hair follicles by mistake. The amount of hair loss can vary. Some people may have patches of hair loss, while others may lose all hair on their entire body.6
Alopecia areata and atopic dermatitis are different health issues. Experts are not sure exactly what causes alopecia areata. But some research suggests that people with alopecia areata are more likely to have atopic dermatitis or other atopic issues like asthma or allergies. When these occur together, they could lead to hair loss.7
Atopic dermatitis versus seborrheic dermatitis
Atopic dermatitis is actually 1 type of eczema. When people use the term eczema, they are usually talking about atopic dermatitis. However, there is another type of skin inflammation that affects the scalp. This is called seborrheic dermatitis.1,4
Atopic dermatitis is caused by a weakened skin barrier and an overactive immune system. On the other hand, seborrheic dermatitis is caused by an overgrowth of a common fungus called Malassezia yeast. In babies, it is commonly referred to as cradle cap.2,4,8
Like atopic dermatitis, seborrheic dermatitis can cause severe itching and inflammation that can lead to extreme scratching or long-term irritation. This may result in hair loss over time.2,4,8
Treating hair loss
Treating hair loss depends on the underlying cause. Some causes are hard to treat, like age-related hair loss. Others, like hair loss from drug side effects, may be reversible if the drug is stopped.9
Preventing hair loss as a result of eczema itch involves treating and preventing eczema flare-ups. This includes regular skin and scalp moisturizing and using all prescribed drugs and creams as instructed by your doctor.1,10
Moisturizing the scalp can be challenging and messy. Some emollients (heavy, greasy creams) can be left on overnight under a towel. Coconut oil is an example of an emollient that can be put on the scalp for several hours at a time. Some people also use salicylic acid or tar mixtures. Talk with your doctor about what options might be best for you and how to apply them.1
If your hair loss is caused by seborrheic dermatitis or alopecia areata, you may need to take drugs to treat it. Medicated creams or shampoos can help with seborrheic dermatitis. Oral antifungal drugs may be helpful, too.4,7
Alopecia areata can be more challenging to treat. Treatment may involve taking drugs that affect the immune system, like steroids. Targeted immune system drugs like dupilumab may also be helpful in treating atopic dermatitis and alopecia areata that occur together.7,11