Rheumatoid Arthritis Hair Loss — What’s Really Going On and What to Try

Hair thinning while you’re managing rheumatoid arthritis (RA) feels unfair. You didn’t sign up for extra side effects. The two main reasons for hair loss in RA are the disease itself — inflammation that can push hair into a shedding phase — and certain drugs used to treat RA. Knowing which is at play changes how you act.

Common causes and what they look like

Inflammation from RA can cause diffuse thinning. That means more hair falling everywhere, not a few bald patches. This is similar to telogen effluvium — hair moves prematurely from growth to shedding. On the drug side, some DMARDs (disease-modifying antirheumatic drugs) and older meds can trigger hair loss. Sulfasalazine, methotrexate, and leflunomide have been reported to cause shedding in some people. Steroids can thin hair over time for others. Stress, low thyroid function, iron deficiency, and sudden weight change also cause similar patterns, so it’s worth checking labs rather than assuming RA is the only reason.

Practical steps you can take now

1) Talk to your rheumatologist. If hair loss started after a drug change, ask whether an alternative is possible. Don’t stop medicines on your own — flaring RA can make hair loss worse.

2) Get basic tests. A simple workup often includes thyroid function, ferritin (iron stores), vitamin D, and basic blood counts. Fixing low iron or thyroid issues can stop shedding fast.

3) Try gentle hair care. Use a mild shampoo, avoid tight styles and heat tools, and skip harsh chemical treatments while shedding is active. Be gentle when brushing wet hair — use a wide-tooth comb.

4) Consider topical minoxidil. Many dermatologists recommend it for diffuse drug-related hair loss. It won’t work overnight, but it can speed up regrowth once the trigger is removed or controlled.

5) Explore advanced options if needed. Platelet-rich plasma (PRP) and low-level laser therapy have helped people with medication-triggered alopecia. Discuss risks and costs with a dermatologist before booking treatments.

6) Address nutrition and stress. Aim for enough protein, correct iron and vitamin D levels, and reasonable sleep. Stress-management—simple breathing, short walks, or counseling—helps because stress itself prolongs shedding.

7) When to see a dermatologist. If hair falls out in clumps, you see scarring, or the issue doesn’t improve after 3–6 months, get a specialist consult. A dermatologist can do scalp exams, biopsies, or change topical therapy plans.

Hair loss with RA is often reversible, especially when you find and treat the trigger. Start with clear tests and a chat with your rheumatologist, use gentle care, and consider proven topical or clinic-based treatments if shedding continues. Small steps can bring noticeable improvement over months.