If you’re noticing more hair shedding when you brush or finding sparse spots on your scalp, you might wonder if this is another part of living with multiple sclerosis (MS). Given this autoimmune condition’s wide variety of symptoms, it’s understandable to suspect thinning hair may be one of them.

Unexpected hair loss — known as alopecia — isn’t a symptom of MS. But, losing hair can be a side effect of certain treatments for MS and other common medications you may be taking.

In addition, being diagnosed with MS — and worrying about how this condition will affect your life — can be a traumatic experience. This emotional stress may also cause hair loss. In fact, hair loss itself can be distressing and affect one’s mental well-being.

Understanding possible connections between MS and hair loss may help you determine the source of your thinning hair, find ways to address it, and improve your quality of life. Here are five things to know about MS and hair loss.

1. Hair Thinning Can Be a Side Effect of Disease-Modifying Therapies

Certain categories of medications are known to sometimes cause hair thinning or hair loss as a side effect. For example, hair loss can occur with certain disease-modifying therapies (DMTs) approved by the U.S. Food and Drug Administration (FDA) to treat relapsing MS.

Although researchers have reported that interferon-beta medications and other DMTs have led to hair loss, teriflunomide (Aubagio) seems to be most commonly associated with hair thinning. “Thinking about starting Aubagio. Heard Aubagio has many side effects — diarrhea, headaches, hair thinning, and more,” wrote one MyMSTeam member.

One large review study noted that among 8,759 people taking DMTs who developed alopecia, teriflunomide was the cause of hair loss in 42 percent of people. Another small study reported that 10 percent to 14 percent of 38 people taking teriflunomide for MS experienced hair thinning.

The good news is that this hair thinning usually isn’t severe, doesn’t last long, and doesn’t require you to stop taking the medication. One MyMSTeam member wrote, “I’m on Aubagio and have been for two years. I did have some hair thinning, but not so that anyone could notice. It only lasted a couple months and started at about month three.”

Although DMTs like these may play a role in hair loss, another medication, condition, or lifestyle issue might also be the culprit. Don’t stop taking or change your dosage of a DMT — or any medication — without first talking to your neurologist.

2. Other Medications Used for Multiple Sclerosis May Cause Hair Loss

Medications that weaken the immune system — called immunosuppressives — may also lead to problems with hair thinning or loss. These treatments calm the overactive immune system that causes inflammation (the typical sign of relapse) or treat MS symptoms. Some of these drugs are routinely used to treat MS but aren’t approved specifically for MS.

These medications are believed to damage hair follicles, leading to hair loss and hair thinning. Immunosuppressive agents are also used for chemotherapy to treat cancer. For instance, mitoxantrone, a cancer drug sometimes used off-label to treat MS, is also known to cause hair loss, but hair typically grows back once treatment ends.

3. Drugs for Another Condition Could Cause Hair Loss

Certain medications in your MS treatment plan could cause hair loss or thinning, but another common medication might also be the reason. Many people with MS experience depression or related mood disorders. Certain antidepressant medications can cause hair loss within the first three months of starting treatment. Hair regrowth usually occurs within a few months after stopping treatment.

Many other common medications can result in hair loss or thinning to varying degrees, such as:

• Blood pressure or heart condition medications
• Anti-seizure medications
• Anticoagulants (blood thinners)
• Acne medications
• Thyroid disorder medications
• Parkinson’s disease medications

The related hair loss is typically not permanent. Often, hair growth will resume once the medication is stopped or when treatment ends.

4. Your Hair Loss Might Stem From Another Health Condition

Multiple sclerosis doesn’t cause hair loss or thinning, but other autoimmune conditions can, such as alopecia areata. Although researchers have explored a possible link between alopecia areata and MS, so far, there’s no real evidence that alopecia is more common in people with MS.

Other medical conditions that can cause hair loss include:

• Thyroid disorders
• Scalp infections
• Other autoimmune diseases, such as lupus and rheumatoid arthritis
• Some hormonal disorders, such as polycystic ovarian syndrome
• Trichotillomania (a condition in which a person compulsively pulls out their hair)

5. Talk to Your Doctor About Other Potential Causes of Hair Loss

Thinning hair can accompany the natural process of aging, especially because of hormone changes. According to the Mayo Clinic, certain hair loss patterns are genetic (run in families), such as male-pattern baldness.

Other factors that could lead to hair loss include:

• Stress
• Poor nutrition or significant weight loss
• Traction alopecia (hair loss caused by tight hairstyles)

Never stop taking a disease-modifying therapy or other MS medication without first speaking to your neurology provider. This is because stopping on your own could trigger a relapse. Your doctor can help you figure out the reason behind your hair loss and how to best treat it.

Whatever the cause, significant hair loss can be traumatic. It’s important to speak with your healthcare provider if your hair loss is worsening, follows a specific pattern, or is concerning to you. Hair loss could be a side effect of your MS treatment but, given the wide range of other contributing factors, your DMT may not be to blame after all.

Talk With Others Who Understand

On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.

Are you living with MS and experiencing hair loss? Let others know in the comments below.