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Does ALS cause hair loss?

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord. ALS causes the nerves that control voluntary muscle movement to degenerate, leading to muscle weakness, disability, and eventually death due to respiratory failure.

Hair loss is not considered a primary symptom of ALS. However, some people with ALS do experience mild hair thinning and loss as the disease progresses. In this article, we’ll take a detailed look at the relationship between ALS and hair loss. We’ll cover:

– What causes ALS and how it impacts the body
– Whether ALS directly leads to hair loss
– Secondary factors related to ALS that can cause hair thinning
– Tips for maintaining healthy hair with ALS

Understanding the link between ALS and hair loss is important for managing expectations and proactively addressing hair health. While hair loss is not inevitable with ALS, being aware of the potential factors allows patients to minimize thinning and keep their hair looking its best.

What Causes ALS?

ALS is caused by the progressive degeneration and death of motor neurons in the brain, brainstem, and spinal cord. Motor neurons are nerve cells that control the muscles that allow us to move, speak, swallow, and breathe.

In ALS, both upper and lower motor neurons are affected. Upper motor neurons extend from the brain down to the spinal cord, while lower motor neurons run from the spinal cord to the muscles. As motor neurons die, the brain is no longer able to initiate and control muscle movement.

The vast majority of ALS cases (90-95%) are sporadic, meaning the disease occurs randomly without any known cause. An estimated 5-10% of cases are familial ALS and caused by a genetic mutation passed down in families.

Regardless of whether the disease is sporadic or genetic, the hallmark sign of ALS is the progressive degeneration of motor neurons. As motor neurons die, common symptoms include:

– Muscle weakness, twitching, cramping
– Slurred speech and difficulty swallowing
– Impaired breathing
– Fatigue and weight loss

These symptoms reflect the loss of muscle control as communication between the nervous system and muscles declines. ALS does not directly impair the senses, bladder function, or cognition. But in the later stages, these functions can become indirectly compromised as the muscles controlling them weaken.

Does ALS Itself Cause Hair Loss?

Hair loss is not considered a primary symptom of ALS that is directly caused by the disease. ALS damages motor neurons only, so it does not affect the hair follicles themselves.

However, some people with ALS do experience mild thinning or shedding of the hair as the disease progresses. An estimated 15-25% of people with ALS report hair loss.

There are a few factors that may contribute to an increased risk of hair loss in ALS patients:

– **Disease progression** – In the later stages of ALS, malnutrition and muscle wasting become more common as eating and swallowing are impaired. This can lead to vitamin or protein deficiencies that impact hair growth.

– **Medications** – Some ALS medications, like riluzole, may list hair loss as a potential side effect. However, this is rare.

– **Stress** – Coping with an ALS diagnosis causes immense emotional and physical stress, which can influence hormones and exacerbate hair loss.

– **Reduced blood flow** – As muscles weaken, circulation may become compromised. This reduces blood flow and oxygen delivery to the scalp.

– **Respiratory decline** – Impaired breathing limits oxygen intake, which can impair follicle growth.

So while ALS itself does not directly damage the hair follicles, its secondary effects on the body can contribute to thinning hair or worsened male or female pattern baldness in some cases. However, complete hair loss is rare in ALS patients.

Other Causes of Hair Loss in ALS

In addition to the secondary impacts of ALS progression, some of the medications and treatments used to manage symptoms can also cause hair loss as a side effect.

Common culprits include:

– **Radiation therapy** – This may be used to help relieve ALS symptoms, but radiation can damage hair follicles.

– **Immunosuppressants** – Drugs that suppress the immune system may be used in ALS treatment, but they can also disrupt hair growth.

– **Steroids** – Steroids help treat ALS inflammation but increase hair shedding.

– **Diuretics** – Diuretics prescribed for blood pressure can lead to zinc and potassium loss.

– **Antibiotics** – Antibiotics may be needed for illnesses in ALS but can affect follicles.

– **Weight loss drugs** – These supplements support nutrition but can potentially thin hair.

Any medications prescribed to manage pain, cramps, sleep issues, or other ALS symptoms could also cause hair loss for some patients.

Patients taking new medications after an ALS diagnosis should monitor their scalp health and let their doctor know if increased shedding or thinning occurs. Adjustments to dosages or alternative options may be available.

Tips for Healthy Hair with ALS

While some hair thinning is expected over the ALS disease course, proactive hair care can help reduce shedding and maintain fuller locks. Here are some tips for ALS patients:

– **Get plenty of protein** – Eat foods high in protein like eggs, meat, nuts, and fish to nourish hair follicles. Supplements can also help if dietary protein is inadequate.

– **Take biotin and vitamin D** – These supplements support hair growth, especially in nutrient deficient patients. Check with a doctor first regarding appropriate dosing.

– **Use volumizing shampoos and conditioners** – Look for products containing ingredients like keratin and collagen to strengthen strands.

– **Try a deep conditioning hair mask weekly** – Intensive moisturizing masks can reduce breakage and shedding.

– **Avoid heat styling tools** – Limit use of hot tools like blow dryers and straighteners to prevent damage. Let hair air dry when possible.

– **Handle hair gently** – Use a wide-tooth comb and avoid tightly pulling hair back. Tight ponytails or braids can lead to excessive traction alopecia.

– **Ask about medications for hair loss** – Minoxidil or finasteride may be options to help encourage growth, depending on the cause. Discuss with a dermatologist.

– **Consider a shorter haircut** – Shorter styles with layers can create the illusion of fuller hair.

– **Use color sparingly** – If dyeing hair, opt for semi-permanent and gentle options done by a professional. Limit processing that can dry out strands.

While ALS patients may notice some increased hair shedding, staying on top of hair care and working closely with healthcare providers can help maintain a healthy head of hair for as long as possible. Being open about hair changes allows the treatment team to explore ways to minimize shedding and thinning during the ALS journey.

The Takeaway

ALS is a progressive neurodegenerative disease that leads to loss of muscle control, eventually impairing speech, swallowing, breathing, and more in its late stages.

Hair loss is not a primary symptom directly caused by ALS. The disease does not damage the hair follicles themselves. However, some secondary impacts of ALS can contribute to hair thinning for some patients, including:

– Malnutrition and muscle wasting as the disease advances
– Medications used to treat ALS symptoms
– Vitamin/mineral deficiencies from reduced nutrient intake
– High stress levels
– Circulation changes and reduced oxygen intake

While about 15-25% of ALS patients notice mild hair shedding, complete baldness related to the disease is very rare. Being proactive with nutrient intake, using gentle hair care practices, and working closely with healthcare providers allows patients to maximize hair health and minimize thinning.

With attention to overall wellness and scalp care, most ALS patients can maintain their hair relatively well throughout the majority of their disease course. While some increased loss is expected over time, ALS on its own does not directly trigger complete hair loss or baldness. Monitoring for changes and focusing on scalp health allows patients to keep their hair looking and feeling its best.

Frequently Asked Questions

Does ALS cause you to lose your hair?

ALS does not directly cause significant hair loss or complete baldness. Some mild shedding can occur as the disease progresses due to secondary factors like malnutrition, medications, and thinning of hair strands. But the ALS disease process does not damage the hair follicles themselves.

Why does ALS cause hair loss?

ALS does not directly impact the hair follicles or cause substantial hair loss. Mild shedding is sometimes seen due to secondary effects of ALS, like declining nutrient intake, circulation changes, medication side effects, and stress. But hair loss is not a primary symptom.

What nutrient deficiency causes hair loss in ALS?

ALS patients are at risk of several nutrient deficiencies that can worsen hair loss, including low protein, zinc, vitamins D and B12, and iron. Following a nutrient-dense diet or adding supplements can help provide hair-supporting nutrients that may become deficient.

What percentage of ALS patients experience hair loss?

Estimates suggest 15-25% of ALS patients report some degree of hair thinning or shedding. However, the amount of loss varies, and complete baldness related to ALS is rare. Patients may see gradual thinning as the disease progresses.

Do ALS patients lose hair due to medications?

Some medications used to manage ALS symptoms can potentially cause hair loss as a side effect, like immunosuppressants, steroids, diuretics, and antibiotics. Patients starting new medications should monitor for increased shedding and discuss options with their doctor.


While ALS itself does not directly trigger complete hair loss, some increased shedding can occur as the disease advances. Staying on top of hair care, nutrition, and working closely with your healthcare team allows ALS patients to maximize their hair health and maintain their locks for as long as possible. Monitoring for changes and being proactive are key to minimizing hair thinning over the course of ALS.