Rheumatoid arthritis (RA) is an inflammatory condition that occurs when the immune system attacks the body’s own healthy tissues and causes joint pain, swelling, and stiffness. In addition to these more common symptoms, some people with RA also experience scalp problems, including scalp itching, burning, or hair loss.
Scalp issues in RA can have many different causes, either related to RA or another condition, and there are ways to manage these symptoms. As always, be sure to let your doctor know about any new or worsening symptoms. Read on for more about RA and scalp problems.
Sometimes, people with RA feel like their scalp is burning. As one myRAteam member shared, “My scalp is on fire and driving me mad. It feels sore and itchy like my finger joints just before they swell up.” Another member added, “I get really bad scalp pain, too.”
Some members are surprised to learn that others with RA experience the feeling of a burning scalp. “Tonight, my scalp hurts a lot — really sore,” wrote one member, “I’m wondering whether it might be due to neuropathy, or nerve damage, which can happen in RA.”
Some people with RA develop neuropathic pain, which can be present even when RA is in remission.
Some myRAteam members have mentioned several methods they use to manage burning sensations on the scalp. Special shampoos are one of the most popular. As one member wrote, “I buy scalp treatment shampoos like Nioxin. It feels refreshing.”
You may be able to pinpoint specific triggers for your burning scalp — for example, cold weather or certain hair products. If you identify a trigger that’s something you can avoid, try to do so.
However, avoiding triggers will only alleviate symptoms and will not deal with the root cause of the burning. A rheumatologist or dermatologist can identify the cause of your scalp discomfort and recommend treatment for the underlying cause. A biopsy may be helpful to help diagnose the problem.
Other people with RA experience intense itching on their scalps. In some cases, burning or pain and itching go together. Other times, they are experienced separately.
One member asked, “Do any of you suffer from intense itching in your scalp?” Another responded, “I had an itchy scalp for a while. Drove me nuts!”
Another member began a conversation about their scalp itching, asking, “Does anyone else have scalp itch issues? I have had RA for 28 years, and this is new … I’ve had it for a couple months now.”
To explain the itching problem, another member shared that “RA dries your scalp out.” This can be true — research has found that people with RA may have drier skin than others. This includes the skin on the scalp, although it can affect skin anywhere on the body.
More than 400 members of myRAteam report also having psoriasis, an inflammatory skin condition that is autoimmune like RA. In these cases, psoriasis may be to blame for an itchy scalp. As one member shared, “I’ve had RA and psoriasis for several years. I've been struggling with scalp psoriasis now.”
Talk to your rheumatologist or a dermatologist if you suspect another condition like psoriasis may be contributing to your scalp itching. Usually, if there is inflammation, the skin on the scalp will be red or scaly.
Members of myRAteam deal with scalp itching in a few ways. Many of them involve hydrating the scalp. One member shared, “I rub olive oil on my scalp before I shower and shampoo … it works for me!” Another wrote, “I’m going to warm some coconut oil and massage into my RAW scalp today before my shower — I need some serious relief.”
For consistent hydration to keep an itchy scalp at bay, another member recommended “a cool shower, rub conditioner into the scalp, rinse, then gently pat dry with a towel.”
Other members have tried medicated treatments for scalp itching, although some find they dislike the consistency. “Scalpicin helped,” wrote one, “but I hate putting that gunk in my hair.”
One RA treatment may provide relief from an itchy scalp. More than 2,600 members of myRAteam have used tofacitinib (Xeljanz). It is approved by the United States Food and Drug Administration to treat moderate to severe RA. According to an interview with Brian S. Kim, co-director of the Center for the Study of Itch at Washington University, a small study showed that individuals with RA found significant improvement in skin itching when taking the drug. Topical steroids may help alleviate the itch if it is caused by inflammation.
Some myRAteam members report hair loss with other scalp-related symptoms. “Does anyone have hair loss, scalp itching, and burning?” asked one member. Others experience hair loss without scalp discomfort. Another lamented, “I had beautiful, thick hair till last month, then handfuls started to fall out.”
Many members associate hair loss, not with RA in general, but with the medications they take to control their RA. One member mentioned, “I take methotrexate, and my only problem is thinning hair.” Another added, “I, too, have bouts of hair loss, especially when I start a new med or oral steroids.” Yet another agreed: “I had a lot of hair loss while on methotrexate.”
RA medications may be the culprit of some hair loss. Many of the medications sometimes prescribed for the condition — including biologics, corticosteroids, and disease-modifying antirheumatic drugs — can cause hair loss as a potential side effect. Note that not everyone who takes a medication will develop all of the potential side effects or the same side effects. Methotrexate is more likely to cause hair loss than the biologics.
Another potential cause of hair loss is the autoimmune condition alopecia areata, in which the immune system attacks hair follicles. People with RA have an increased risk of developing this form of hair loss.
Lupus, another autoimmune condition that can affect any part of the body, commonly causes hair thinning or loss. More than 1,400 members of myRAteam report having lupus as well as RA.
There are a few ways to handle hair loss related to RA. Your first step is to talk to your rheumatologist or a dermatologist to pinpoint the cause of your hair loss. They may perform a physical exam, order blood tests, and perform a scalp biopsy. From there, they can recommend a strategy for managing your hair loss.
If hair loss is caused by RA medications, your doctor may recommend reducing your dosage or changing medications. Several nutritional supplements may help with hair loss in some cases. Some myRAteam members report improvements to their hair when taking biotin. Others take iron or other nutrients. Always check with your doctor before taking a new supplement. Some supplements may interact with your medications or cause side effects at a certain dosage.
In some cases, members accept hair loss as a tolerable side effect of the medications that are helping to keep their RA symptoms under control.
On myRAteam, the online social network for people with RA and their loved ones, more than 188,000 members come together to ask questions, give advice, and share their experiences with others who understand life with RA.
Are you living with RA and dealing with itching or burning on your scalp or struggling with hair loss? Have you found anything that works to soothe these symptoms? Share your story or tips in the comments below or by posting on myRAteam.