Can Type 2 Diabetes Cause Hair Loss?

Hair is a body part, just like your fingers or toes. Unlike those parts, it constantly grows, and as the hair follicle dies, the hair attached to it will fall out.

A new hair follicle will usually grow back in its place, and sometimes no hair grows back. When this happens, it is hair loss. Anything from aging to stress to certain medical conditions can cause hair loss.

Diabetes is one of those conditions that may cause hair loss. Here’s why that happens, ways to try to prevent hair loss in diabetes, and ways to treat hair loss as it happens.

How Does Type 2 Diabetes Affect Hair Growth?

Hair loss and hair shedding are two different things. Hair shedding is the process where hair follicles die and are replaced by other ones. It is only when the hair follicle does not grow back that hair loss occurs. [1]

Type 2 diabetes is a form of diabetes where the body does not use insulin well enough to process sugar, which is called insulin resistance. Unlike in type 1 diabetes, the pancreas still produces some insulin. Over time, the sugar that is not used builds up in the body, leading to hyperglycemia or high blood sugar. [2]

How does hair loss occur in type 2 diabetes? High blood sugar levels will eventually cause damage to blood vessels, making it harder for oxygen and nutrients to pass through them. Hair follicles need a constant supply of oxygen and nutrients to grow, and since they are replaced so quickly, they need more than other body parts. [3]

If the blood vessels are fully blocked off or so damaged that nothing can get through them, hair follicles will not grow back. Even if they do grow back, they may not work as well, and hair may be thinner, weaker, or not grow as quickly as before. It’s not just the hair on your head that’s affected by this; one study found that hair loss on the legs was a sign of peripheral arterial disease or blood vessel damage in the legs. [4]

Insulin also affects protein levels in the blood and the number of amino acids that are there. Hair is primarily a type of protein called keratin, and hair growth is driven by both protein levels and uses those amino acids to help build hair follicles. Poor insulin management will lead to lower levels of both and thus decrease hair growth. [5]

One other cause of hair loss is not a direct effect of diabetes but the result of treating it. Metformin, one of the drugs used to treat type 2 diabetes, can cause hair loss if taken for a long period of time. There are some reports of more extreme hair loss from taking metformin, but those are extremely rare. [6]

Some ethnic or racial groups may be more at risk of hair loss from diabetes. One study found that black women with type 2 diabetes were more at risk for hair loss than other groups. They were also more likely to lose large patches of scalp hair. [7]

How to Prevent Hair Loss from Diabetes?

If you are concerned with possible hair loss from type 2 diabetes, there are several things that can be done to prevent it. These include:

• Get your diabetes under control. Insulin levels control your blood sugar as well as the proteins and amino acids in the blood. High blood sugar can lead to hair loss, and if there aren’t enough proteins and amino acids in the blood, hair won’t grow. Make sure that you have stable blood sugar levels by sticking to your diet and taking either medications or insulin injections that have been prescribed for you. [8]
• Eat a balanced, nourishing diet. This is already important for managing diabetes, but it can also reduce hair loss. Fruits and vegetables, lean meats and other protein-rich foods, and appropriate levels of carbohydrates will help both your hair and your diabetes. [9]
• Check vitamin levels. You may also want to be tested for biotin and vitamin D levels; if you aren’t getting enough of either of them, it may lead to more hair loss. [10] (A side note: if it hasn’t been shown that someone isn’t consuming enough of certain nutrients that contribute to hair growth, don’t take vitamins or supplements that contain those nutrients. Extra levels of them will not help hair grow back and may actually cause more hair loss. [11])
• Ask for a medication change. If you are on metformin and you think it is contributing to hair loss, see if your doctor is willing to let you try different medications. That being said, if you cannot control your diabetes without taking metformin, there may be no other option.
• Reduce stress in your life. Stress can cause excessive hair loss. [12] Look up relaxation techniques and get support from your family and friends. Try to discover what worries you the most and take steps to address those issues. If life stress seems too much to cope with, seek counselling.

Will Hair Loss from Diabetes Grow Back?

If you’ve already lost hair to the effects of diabetes, you may wonder if it will ever grow back. Whether it will depends on a few different things.

If hair loss was the result of uncontrolled diabetes because of blood flow problems or not enough protein or amino acids in the blood, hair should start to grow back once those problems are addressed. Some hair follicles may be permanently damaged. In those cases, hair may not ever grow back.

If hair loss was the result of a drug like metformin, it might take as many as six months for the hair to grow back after the medication was stopped. In very rare cases, hair loss can continue for years. [13]

Hair loss issues from dietary problems usually can be reversed once the specific problem has been addressed. It may be necessary to take supplements of whatever you were deficient in for a long period of time, even for the rest of your life.

FAQ

Can Insulin Cause Hair Loss?

Insulin does not directly cause hair loss, but if insulin levels are not well managed, damage to blood vessels and abnormal protein levels and amino acids in the blood can eventually lead to hair loss.

Can Diabetics Get Hair Transplants?

Type 2 diabetics are eligible for hair transplants if their condition is well-controlled. Type 1 diabetics are not eligible for hair transplants.

Does Diabetes Cause Itchy Scalp and Dandruff?

Diabetes can cause dandruff and scalp itching because dry skin is a result of the decreased circulation diabetics get. Diabetes can also cause yeast overgrowth on the scalp that leads to dandruff.

Do Medications (like Metformin and Trulicity) Cause Hair Loss?

There is some limited evidence that metformin can cause hair loss when used over a long period of time. However, a link has not been proven.

Final Thoughts

Hair loss for any reason can be embarrassing and frightening. If type 2 diabetes is the cause of that hair loss, it may seem like something that will never go away.

Fortunately, if diabetes is properly managed and brought under control, hair loss from diabetes can be reversed or at least stopped.

References

1. Do you have hair loss or hair shedding? (n.d.). Www.aad.org. https://www.aad.org/public/diseases/hair-loss/insider/shedding
2. American Diabetes Association. (2022). Diabetes Overview – Symptoms, Causes, Treatment. Diabetes.org. https://diabetes.org/diabetes
3. Miranda, J. J., Taype-Rondan, A., Tapia, J. C., Gastanadui-Gonzalez, M. G., & Roman-Carpio, R. (2016). HAIR FOLLICLE CHARACTERISTICS AS EARLY MARKER OF TYPE 2 DIABETES. Medical Hypotheses, 95, 39–44. https://doi.org/10.1016/j.mehy.2016.08.009
4. Miranda, J. J., Taype-Rondan, A., Tapia, J. C., Gastanadui-Gonzalez, M. G., & Roman-Carpio, R. (2016). HAIR FOLLICLE CHARACTERISTICS AS EARLY MARKER OF TYPE 2 DIABETES. Medical Hypotheses, 95, 39–44. https://doi.org/10.1016/j.mehy.2016.08.009
5. Miranda, J. J., Taype-Rondan, A., Tapia, J. C., Gastanadui-Gonzalez, M. G., & Roman-Carpio, R. (2016). HAIR FOLLICLE CHARACTERISTICS AS EARLY MARKER OF TYPE 2 DIABETES. Medical Hypotheses, 95, 39–44. https://doi.org/10.1016/j.mehy.2016.08.009
6. Succurro, E., Palleria, C., Ruffo, M., Serra, R., Arturi, F., & Gallelli, L. (2017). Loss of Eyebrows and Eyelashes During Concomitant Treatment with Sitagliptin and Metformin. Current Drug Safety, 12(1), 10–12. https://doi.org/10.2174/1574886311666161014125536
7. Coogan, P. F., Bethea, T. N., Cozier, Y. C., Bertrand, K. A., Palmer, J. R., Rosenberg, L., & Lenzy, Y. (2019). Association of type 2 diabetes with central-scalp hair loss in a large cohort study of African American women. International Journal of Women’s Dermatology, 5(4), 261–266. https://doi.org/10.1016/j.ijwd.2019.05.010
8. Hu, F. B., Manson, J. E., Stampfer, M. J., Colditz, G., Liu, S., Solomon, C. G., & Willett, W. C. (2001). Diet, Lifestyle, and the Risk of Type 2 Diabetes Mellitus in Women. New England Journal of Medicine, 345(11), 790–797. https://doi.org/10.1056/nejmoa010492
9. Guo, E. L., & Katta, R. (2017). Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatology Practical & Conceptual, 7(1), 1–10. https://doi.org/10.5826/dpc.0701a01
10. Almohanna, H. M., Ahmed, A. A., Tsatalis, J. P., & Tosti, A. (2019). The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatology and Therapy, 9(1), 51–70. https://doi.org/10.1007/s13555-018-0278-6
11. Guo, E. L., & Katta, R. (2017). Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatology Practical & Conceptual, 7(1), 1–10. https://doi.org/10.5826/dpc.0701a01
12. Can stress make you lose your hair? (n.d.). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/expert-answers/stress-and-hair-loss/faq-20057820
13. Information, N. C. for B., Pike, U. S. N. L. of M. 8600 R., MD, B., & Usa, 20894. (2019). What is the structure of hair and how does it grow? In www.ncbi.nlm.nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK546248/