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Does Mixed Connective Tissue Disease Cause Hair Loss?

Mixed connective tissue disease (MCTD) has clinical features of autoimmune connective tissues diseases such as scleroderma, systemic lupus erythematosus (SLE), polymyositis and rheumatoid arthritis and is also known as overlap syndrome. Hair loss or alopecia is a common complaint made by patients with autoimmune connective tissue diseases. Therefore, mixed connective tissue disease patients also complain hair loss especially those who have the autoimmune connective tissue diseases (AICTD). Hair loss is seen commonly with systemic lupus erythematosus, dermatomyositis and scleroderma. Telogen hair loss, scarring alopecia and diffuse thinning or fragility of hair is the common types of alopecia that is associated with AICTD. Less commonly anagen effluvium and alopecia areata can be present with AICTD. Drugs that are used in the treatment can also cause hair loss.

Hair loss is seen commonly with systemic lupus erythematosus, dermatomyositis and scleroderma. Telogen hair loss, scarring alopecia and diffuse thinning or fragility of hair is the common types of alopecia that is associated with AICTD. Less commonly anagen effluvium and alopecia areata can be present with AICTD. Drugs that are used to treat connective tissue diseases can cause hair loss as well.

Alopecia is a characteristic feature in systemic lupus erythematosus, scarring alopecia is seen with discoid lupus erythematosus dermatomyositis alopecia is a characteristic diffuse, violaceous, scaly, non-scarring and symptomatic hair loss. The alopecia type in Sjogren syndrome, MCT), and scleroderma is not clearly identified. It is important to diagnose alopecia early and necessary interventions and treatment is done early to prevent permanent hair loss.

Mixed connective tissue disease (MCTD) has clinical features of autoimmune connective tissues diseases such as scleroderma, systemic lupus erythematosus (SLE), polymyositis and rheumatoid arthritis and is also known as overlap syndrome. Hair loss or alopecia is a common complaint made by patients with autoimmune connective tissue diseases. Therefore, mixed connective tissue disease patients also complain hair loss especially those who have the autoimmune connective tissue diseases (AICTD).

Types Of Alopecia

There are different types of alopecia, we will talk about some common types and the types that are associated with connective tissues diseases.

Scarring Alopecia. This causes permanent loss of hair. The causes are inflammatory conditions such as folliculitis, cellulitis, acne and other skin disorders such as some forms of lupus erythematosus, lichen planus. There are two types, primary scarring alopecia where the hair follicle is destroyed due to an inflammatory reaction and it is replaced with scar tissue. Secondary alopecia is due to external injuries such as burns, radiation or infections. Most cases of scarring alopecia occur with small patches of hair loss which expands with time. In some cases, the hair loss is gradual and not noticeable, and in some case the hair loss is rapid and associated with itching and burning pain.

Telogen Effluvium. A temporary hair thinning is seen over the scalp. This occurs because of the changes in the growth cycle of the hair, where many hair follicles enter the resting phase at the same time which causes the hair loss and subsequent hair thinning.

Anagen Effluvium. Anagen effluvium is hair loss during the growth stage of the hair cycle. This may lead to non-scarring alopecia.

Alopecia Areata. Acute onset patchy hair loss seen in children and young adults. In about 90% of patients the hair comes back within a few years, but in some people, this can lead to total baldness. The exact reason of alopecia areata is not known but believed to be caused when the immune system targets the hair follicles and interfere with the normal hair growth and formation. Biopsies from skin affected shows immune cells which are not present in normal circumstances. Some cases are seen where several family members are affected by alopecia areata and maybe it is a familial condition. It is associated with autoimmune conditions such as rheumatoid arthritis, lupus, vitiligo, ulcerative colitis, thyroid disease and allergic conditions.

Androgenic Alopecia. This affects both males and females and it is a genetic condition. Men who have this condition is called male pattern baldness and hair loss begins very early like in teenage age or in early 20’s. A receding hairline is seen and the gradually hair loss is seen in the crown and in the frontal scalp. Women who have this is called female pattern baldness and they notice thinning of hair in their 40’s and hair loss most at the crown area.

Involutional Alopecia. This is natural process of hair loss. With aging gradually the hair becomes thin, hair follicles go into resting phase and the remaining hair becomes fewer in number and shorter.

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Does Mixed Connective Tissue Disease Cause Hair Loss?