When I was younger, everyone wanted Farrah Fawcett’s hairstyle. Jennifer Aniston popularized “The Rachel” haircut on the hit show Friends. And we’re all seeing men sporting “man buns” alongside women. Hair is a big deal in our culture.
Hair has figured prominently in history, too. The Bible tells us that Samson garnered his strength from his long hair, and lost that strength when Delilah cut it off. Priests and monks used to shave the crowns of their head to show a lack of vanity and symbolize their vow of chastity. Over the centuries, different cultures have upheld norms about hair: for example, the Mohawk hairstyle that we’ve all seen stems from Pawnee Native American nation of the Midwest. People in some African tribes shave their heads as, for example, a sign of mourning or marital status.
We value our hair. Who doesn’t view a head full of lush, shiny hair as a symbol of health, success, and confidence? Our hair is tied closely to our identity. We talk about “good” and “bad” hair days. And when we walk out of that salon with our hair freshly styled, it feels like we’re on top of the world.
Hair-loss statistics
According to the American Hair Loss Association, by the age of 35, two-thirds of men will have some degree of hair loss; by age 50, about 85% of men will have significant thinning of their hair. Hair loss is prevalent in women, too — they make up 40% of hair-loss sufferers. Thanks to society’s pressure to be attractive, hair loss can have a major negative effect on quality of life. Hair loss can be devastating, leading to loss of confidence, poor self-image, and even depression.
Alopecia areata
There are many causes of hair loss, including thyroid issues, hormonal changes, scalp infections, certain medications, chemotherapy, and radiation. However, one cause of hair loss that is related specifically to Type 1 diabetes is called alopecia areata. This condition is an autoimmune disease in which the immune system attacks hair follicles, leading to patches of hair loss on the scalp and on other parts of the body.
Alopecia areata may have a hereditary component, too, and often occurs in families where members have other autoimmune diseases, including Type 1 diabetes, rheumatoid arthritis, thyroid disease, lupus, or Addison’s disease.
The course of alopecia areata is such that hair can grow back, but it may fall out again. Some people lose all the hair on their scalp and other parts of the body; fortunately, there is always the possibility of hair regrowth. In addition, hair may grow back white, with a gradual return to the hair’s natural color.
There is no cure for alopecia areata, nor is there a specific medicine used to treat it. However, medications used for other conditions might be helpful in promoting hair regrowth. Corticosteroids (injections or ointments), anthralin, topical minoxidil, topical immunotherapy (which involves applying chemicals to the scalp), and psoralen with ultraviolet A light therapy are options.
Very-low-calorie diets
Very-low-calorie diets (VLCDs) are diets that involve consuming fewer than 1000 calories per day. They’re generally followed for a limited amount of time. If you have diabetes and have tried or are trying to lose weight, very-low-calorie diets can seem very appealing, as they practically promise big results, quickly.
There are a lot of drawbacks to these diets, however, which means that if you’re considering trying one of them, you should discuss the pros and cons with your dietitian or health-care provider. Side effects of these diets or any diet that promotes rapid weight loss may include irregular heartbeat, constipation, fatigue, and hair loss. Hair loss occurs due to a lack of nutrition, including protein, iron, and vitamin C — it’s hard to get all the nutrients you need when you subsist on 1000 or fewer calories each day. Once your weight stabilizes, hair should grow back.
Bariatric surgery
It’s fairly common to lose some hair following bariatric surgery (usually about three months post-op). This hair loss is called telogen effluvium and it means that the hair is in its “resting” phase (as opposed to its growth phase, called anagen). Your hair that’s in its telogen phase when you have the surgery is the hair you end up losing several months later.
The stress of surgery, combined with the post-op low-calorie, low-protein intake, are the main reasons for hair loss. In addition, if you have other factors on top of these, such as thyroid disease, a low iron intake, and a predisposition to hair loss (thanks mom and dad!), don’t be surprised at a 5% to 15% hair loss.
The good news is that you can expect your hair to grow back, unless, of course, underlying nutrient deficiencies or thyroid issues aren’t addressed. And as for genetics, well, as they say, you can’t pick your family.
Coping with hair loss
Seeing copious amounts of hair strands in your brush or watching clumps of hair come out in the shower is stressful and can induce anxiety.
Will hair loss from diabetes grow back?
For the most part, hair loss can be dealt with, but it’s important that you know the cause. In some cases, hair loss is permanent. And, as in the case of alopecia areata, hair may grow back all on its own. Make sure you talk with your doctor or ask for a referral to a dermatologist or hair specialist (called a trichologist) to find out why you’re losing hair and what treatments are available.
Common hair loss treatments include:
Medications
Two FDA-approved medications are minoxidil (brand name Rogaine) and finasteride (Propecia, Proscar). Finasteride is only available for men. Both have side effects, and results will vary person to person.
Nutrition
Deficiencies in certain nutrients, such as protein, iron, zinc, biotin, copper, and essential fatty acids can contribute to hair loss. But swallowing handfuls of supplements isn’t necessarily the answer. Biotin is often promoted as a way to promote hair growth, yet research doesn’t prove that taking biotin supplements is overly helpful. A dietitian can help determine if you are lacking in certain nutrients.
Surgery
Hair transplants or restoration surgery may be an option. However, surgery is expensive and may lead to infection and scarring.
Laser treatments
The FDA has approved laser combs, a band, and a helmet that use a low-intensity laser to stimulate hair follicles to grow hair. These devices aren’t covered by insurance and can be costly. Results vary for each person. While they can be helpful, don’t have too high of an expectation of growing long, luscious locks.
Essential oils
Some research hints that certain essential oils, when massaged daily into the scalp may help with hair regrowth. Rosemary, thyme, lavender, and cedarwood oils mixed into a carrier oil like jojoba or grapeseed might be beneficial.
Amy Campbell, MS, RD, LDN, CDE
A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com
