Eczema is known for causing dry, itchy skin and rashes — but can it also lead to hair loss? For some people, the answer is, unfortunately, yes. Although it’s a lesser-known symptom, alopecia (hair loss) and other scalp issues may be directly linked to eczema. Whether this occurs as a side effect of scratching, prolonged scalp irritation, or for other reasons, it’s important to understand possible connections.

People with eczema also have a higher risk of developing alopecia areata than the general population. This autoimmune condition causes your body to attack hair follicles, leading to bald patches. Some estimates suggest that up to 39 percent of people with alopecia areata also have atopic dermatitis.

Read on to discover how eczema and alopecia may be related, along with strategies for relief.

What Is Eczema?

Eczema is a chronic skin condition that causes your skin barrier to weaken. When the barrier is damaged, your skin is less able to hold in moisture. This leads to symptoms like dry, itchy skin, rashes, swelling, or scales.

Who Gets Eczema?

Eczema is relatively common, especially in children. But people of any age can develop this skin condition. Not everyone has the same type of eczema, but it’s possible to have multiple types. Atopic dermatitis is the most common type, while seborrheic dermatitis is the form of eczema that typically affects the scalp.

In many cases, eczema flares happen after contact with an environmental trigger. Some people have eczema flares due to stress. Others have contact dermatitis, which causes flare-ups after coming into contact with chemicals or physical irritants like smoke, detergents, certain fabrics, or other allergens.

Eczema and Alopecia: What’s the Link?

The most common body sites affected by eczema are the face and the extremities (arms, legs, hands, and feet). But eczema can develop on any part of the body. For some people, it affects the scalp, which may cause hair loss on the head. However, there are many reasons why people with eczema may experience alopecia.

Eczema Flares

When your eczema flares up, it may cause inflammation throughout the body, including your scalp. This can lead to bald patches, hair thinning, or damaged, unhealthy hair.

If you have seborrheic dermatitis, hair loss may be directly related. This condition causes you to produce too much sebum, an oil naturally found in your skin. Seborrheic dermatitis is considered a response to a yeast called Malassezia. When it flares up, it can damage your hair follicles and cause hair loss. Hair lost during eczema flares is typically temporary, which means the hair should start to grow back after treatment or when the flare ends.

Scratching Your Scalp

Eczema flares may cause inflamed, scaly patches to develop on your scalp. In the case of seborrheic dermatitis, itching is caused by scalp inflammation. No matter the cause, when you scratch your scalp, you can injure your hair follicles. This may cause hair loss or hair thinning. Once you treat your eczema and stop scratching, your hair should grow back.

Secondary Infections

Not all itchy, scaly scalp conditions are caused by eczema. Other conditions may cause your scalp to be itchy and dry, including fungal infections.

For instance, tinea capitis is an infection also called scalp ringworm. Symptoms include discolored, swollen patches, severe itchiness, and patchy hair loss. People may be at higher risk of this condition if they have injuries on their scalp, which may occur due to scratching. In severe cases, it may cause scarring, and hair in those areas might not regrow.

An early, accurate diagnosis is essential for treating and managing infections on the scalp. Some bacterial infections can be treated with antibiotics or topical medications. But others, such as tinea capitis, must be treated with oral antifungal drugs.

Temporary Shedding Due To Stress

Stress can lead to a type of hair loss called telogen effluvium. This condition causes hair to fall out several months following a stressful event. Seborrheic dermatitis is a known trigger of telogen effluvium.

Living with any type of eczema can cause you to face both physical and psychological stress. Studies have shown that people with eczema face higher rates of anxiety and depression than those in the general population. This stress could trigger telogen effluvium.

Hair loss caused by telogen effluvium is typically temporary and gets better without treatment about 95 percent of the time.

When To See a Dermatologist

Talk to a dermatologist if you’re experiencing hair loss. They can diagnose the cause of your alopecia and help you start effective treatment and, hopefully, encourage hair regrowth. Be sure to let them know about any family history of eczema, other skin diseases, and hair loss.

If you have scalp pain, rapidly expanding bald patches, scalp crusting or pus, fever, or swollen lymph nodes, reach out to a doctor right away. These could be signs of an infection, which should be addressed immediately. In addition, any hair loss in a child should be brought to a pediatrician’s attention immediately.

Tips for Relief

Your healthcare provider will develop a treatment plan tailored to the underlying cause of your hair loss. Treating the cause should help you manage hair loss and may even help hair regrow.

Treating the Underlying Cause

Depending on the cause of hair loss, treatments may include:

• Atopic dermatitis — Steroid injections, topical steroids, immunosuppressant drugs, and avoiding flare triggers
• Seborrheic dermatitis — Antifungal medications or shampoos, topical corticosteroids, or other medications
• Tinea capitis — Oral antifungal medications or special shampoos that include ingredients such as selenium sulfide
• Alopecia areata — Steroid injections, topical treatments, or newer targeted medications such as Janus kinase (JAK) inhibitors to help calm the immune system
• Stress — Mindfulness therapy, taking time for self-care, and potentially medications to reduce anxiety

Hair Loss Management Tips

Gentle hair care strategies can help you manage hair loss and may even help protect new hair growth.

Keep your scalp moisturized to help prevent and treat dryness and itching. Your doctor will recommend which types of moisturizers to use, but most healthcare providers suggest fragrance-free emollients that aren’t grease based.

Wash your hair with a gentle shampoo that’s fragrance-free, and avoid conditioner if possible. Your dermatologist may recommend over-the-counter or prescription medicated shampoos or other hair products to help calm and heal your scalp. If you need to blow-dry your hair, keep the dryer on a warm setting since hot air can damage your scalp. Avoid hair coloring and perms unless your doctor has specifically cleared you to use these products.

To help ease scalp eczema symptoms, avoid your triggers and try not to scratch the affected areas. Your doctor can help you find eczema treatment options to reduce itching so your skin can heal.

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