Living with type 1 diabetes involves a lot of daily management, from monitoring blood glucose levels to preventing long-term complications. But one unexpected concern for many people is hair loss or thinning. Surprised?

Many factors may contribute to premature hair loss, including genetics, lifestyle, and various health conditions. Some research suggests that there may be a connection between these hair issues and type 1 diabetes.

In this article, we’ll break down this relationship and explore potential reasons why you may be experiencing hair loss. We’ll also discuss strategies for preventing and treating hair loss.

Understanding Type 1 Diabetes

Type 1 diabetes is an autoimmune condition where the body’s immune system mistakenly attacks the cells in the pancreas that make insulin. These cells, called beta cells, are crucial for breaking down blood sugar after you eat. When a person’s beta cells are destroyed, their body can’t make enough insulin, leading to high blood glucose (sugar) levels.

Even though type 1 diabetes mainly affects blood glucose regulation, its symptoms occur all over the body. Common symptoms of type 1 diabetes include:

• Hunger
• Weight loss
• Fatigue and irritability
• Blurry vision
• Extreme thirst and frequent urination

Type 1 diabetes may also affect the integumentary system, which includes the skin, hair, and nails. A significant rate of hair loss may indicate persistently high blood sugar in someone with diabetes.

The Link Between Type 1 Diabetes and Hair Loss

Some research shows that individuals with type 1 diabetes may experience hair loss or thinning. This is not a well-established symptom of type 1 diabetes, and it's unclear what the rate of hair loss is in people with diabetes. Several theories may explain increased or early hair loss in individuals who have type 1 diabetes.

How Diabetes Affects Hair Follicles

According to an older study published in the Journal of Adolescent Health Care, the structure and size of the hair follicles of male and female children with diabetes appeared different under a microscope compared to the hair follicles of children without diabetes. Children with diabetes had reduced diameter of the hair shaft — so-called thinner hair — compared to those without diabetes. The reasons for this were not understood, however, it was thought to be caused by poor nutrition and high blood sugar over time.

Autoimmune Activity and Comorbidities

Type 1 diabetes is an autoimmune condition, and autoimmune disorders can sometimes affect hair follicles directly. One autoimmune hair follicle condition is called alopecia areata, which causes hair loss, most often in small round patches. It is common for individuals with type 1 diabetes to experience comorbidities (multiple medical conditions at once), including alopecia areata.

In fact, there is a syndrome called autoimmune polyendocrine syndrome type 1 that occurs with other multiple autoimmune diseases in children, including type 1 diabetes and alopecia areata, along with thyroid disease.

Another common comorbidity associated with both type 1 and type 2 diabetes is polycystic ovary syndrome (PCOS). PCOS is a hormonal condition that affects females of reproductive age and can lead to a variety of symptoms, including irregular periods, excessive facial and body hair, acne, and hair loss.

Poor Circulation

Diabetes causes issues with blood vessels over time. When a person experiences high blood sugar levels for a prolonged period, their veins and arteries can become damaged. On the scalp, this can lead to reduced blood flow. Hair follicles need blood to supply nutrients. Without these nutrients, hair growth can stop and hair follicles can die, leading to hair loss.

Hormonal Imbalance

Changes in hormone levels are very common in diabetes. Because the body doesn’t produce insulin naturally in type 1 diabetes, a person’s insulin levels can drop low or rise high depending on the dosages of their medications and the amount of sugar they consume.

Another hormone affected in diabetes is cortisol, a stress hormone. These and other hormones regulate hair growth, and an imbalance can disrupt the hair growth cycle, leading to thinning or shedding.

Stress

Managing type 1 diabetes on top of other daily life challenges can be very stressful. According to Diabetes UK, 1 out of every 6 people living with type 1 diabetes struggles with anxiety symptoms. Increased long-term stress levels are associated with hair loss conditions such as telogen effluvium. In this condition, the hair prematurely enters the resting phase and falls out while being combed or washed.

One theory for the relationship between stress and hair loss is related to cortisol. High cortisol levels, often resulting from stress, decrease the formation and speed up the breakdown of proteins essential for hair follicle activity.

Nutritional Deficiencies

Managing diabetes often means following strict dietary rules, which can sometimes lead to a person not getting enough nutrients and becoming malnourished. Deficiencies in many essential vitamins and minerals, such as iron, zinc, riboflavin, folate, and biotin, can contribute to hair loss.

Although these factors may suggest a potential link between type 1 diabetes and hair loss, most people with diabetes won’t experience significant hair loss issues. The severity of hair loss is different in everyone and may be related to many other factors such as family history.

Prevention and Management of Hair Loss in Type 1 Diabetes

Hair loss on top of type 1 diabetes can be upsetting, but there are several strategies to help prevent or treat it:

• Maintaining optimal blood sugar levels
• Improving scalp health
• Ensuring proper nutrition
• Managing stress effectively
• Getting medical help

Maintain Optimal Blood Sugar Levels

Treating your diabetes through medication and lifestyle changes is the most effective way to worsening symptoms or complications of type 1 diabetes. Consistently monitoring and controlling blood sugar levels can reduce the risk of complications, including hair loss associated with poor circulation. Work closely with your endocrinologist (a doctor who specializes in treating hormone-related conditions) to help develop or adjust your diabetes management plan for blood sugar control.

Promote Scalp Health

Practicing good scalp hygiene and using gentle, nourishing hair care products can help maintain a healthy environment for hair growth. Avoid harsh dyes, chemicals, too many heat products, tight hairstyles, and excessive brushing or combing.

Address Nutrition

Nutrition plays a huge role in hair health. Ensure you are eating a diet rich in vitamins and nutrients, including proteins and healthy fats. Speak to a registered dietitian if it will help you eat a nutritious diet. Get routine bloodwork done annually or as recommended by your primary care doctor to ensure you’re not deficient in any major vitamins. If you are, ask your doctor about supplements, such as the B vitamins.

Read about diabetes-friendly snacks.

Manage Stress

It’s easier said than done, but if you think stress may be causing your hair loss, do everything you can to regain control over your mental health. Incorporate stress-reduction techniques such as mindfulness, regular exercise, and relaxation therapies into your routine to minimize the impact stress has on your physical health.

Seek Medical Advice

If you have any scalp symptoms, such as itchiness or flakiness, see a dermatologist to make sure you aren’t struggling with another condition such as scalp eczema, psoriasis, or seborrheic dermatitis. If you’re experiencing significant hair loss or thinning, consult a dermatologist and mention it to your endocrinologist. They may assess your condition, help you discover the underlying cause, and recommend appropriate hair loss treatment.

After trying to address the underlying cause, your treatment plan may also include topical and oral medications, such as finasteride and minoxidil; supplements such as zinc or biotin; or other interventions.

Find Your Team

On myT1Dteam, the social network for people with type 1 diabetes and their loved ones, more than 2,700 members come together to ask questions, give advice, and share their stories with others who understand life with type 1 diabetes.

Have you or a loved one experienced diabetes-associated hair loss? How do you cope with this and other symptoms of type 1 diabetes? Share your experience in the comments below, or start a conversation by posting on your Activities page.