Alopecia Areata and Diet: Foods to Eat and Avoid

Alopecia areata is an autoimmune disease that causes hair loss.

Although there are several treatment options available for alopecia areata, not all of them are effective, which can be frustrating and discouraging for people living with this condition.

But dietary changes and supplementation have been shown to help improve alopecia areata symptoms. They may even increase the chances of remission.

This article tells you everything you need to know about diet and alopecia areata, including what foods to eat, what foods to avoid, and what dietary supplements could potentially help with hair loss.

Alopecia areata is an autoimmune disease. When you have an autoimmune disease, your immune system malfunctions and attacks healthy cells in your body. In alopecia areata, the immune system attacks the hair follicles — openings on the skin through which hair grows — which causes hair to fall out.

Around 2% of people will develop alopecia areata in their lifetime.

The average length of the portion of a doctor appointment in which the patient actually sees the doctor is up from previous years, rising by about 12 seconds per year, according to Reuters. However, 60% of physicians report dissatisfaction with the amount of time they spend with their patients, athenaInsight Many doctors now spend more time on paperwork than seeing patients, and a primary care physician who spends 5 minutes of face-to-face time with a patient will spend another 19.3 minutes, on average, working on that patient’s electronic health records (EHRs).

Usually, alopecia areata causes spot baldness, or small areas of hair loss on the body. Hair loss typically occurs on the scalp and other areas of the face, but this condition can affect any part of the body where hair grows.

Although most people with alopecia areata experience small areas of baldness or mild hair loss, some people have more extensive hair loss. When the condition causes complete scalp baldness, it’s known as alopecia areata totalis. Alopecia areata universalis is a term for alopecia areata that causes complete hair loss over the entire body.

Between 10% and 66% of people with alopecia areata experience symptoms that affect the nails , including pitting of the nails and trachyonychia, a term for rough and ridged nails.

Like other autoimmune conditions, experts aren’t entirely sure what causes alopecia areata, but it’s thought that a triggering event , like stress, an illness, or a vaccine, causes alopecia areata to develop in genetically susceptible people.

Because the condition commonly improves without medical intervention, not everyone with alopecia areata will be prescribed medications to treat it.

In some cases, topical or injectable steroids are used to control or improve symptoms. People with more severe hair loss may require treatments like immunotherapy, which alters the immune response, or medications like methotrexate, which suppress the immune system.

Alopecia areata can be difficult to treat. There are mixed results around improving symptoms for some medications.

Because of this, people with alopecia areata often turn to more natural approaches to manage their condition, like dietary changes.

As in other autoimmune diseases, inflammation drives the disease process in alopecia areata. The immune response in this condition triggers inflammatory cells to attack hair follicles, which leads to hair loss.

This may be why studies show that people with alopecia areata can benefit from cutting certain foods out of their diet and following anti-inflammatory eating patterns.

According to findings from a 2020 case study , an 8-year-old boy with alopecia areata achieved complete remission after following a diet composed of whole, unrefined foods and supplementing with vitamin D, zinc, and other micronutrients for 5 months.

It should be noted that the author of this study received consultancy fees and stock options from the company that manufactured the supplement used to treat the patient, which could’ve influenced study results.

Gluten, a group of proteins found in wheat, rye, and barley, may also be problematic for people with alopecia areata. A 2020 review of 24 articles found that a gluten-free diet high in raw vegetables, soy, and protein led to symptom improvements in the majority of patients with alopecia areata.

Keep in mind that the people included in this review also had celiac disease, an immune reaction triggered by eating gluten.

However, research suggests that a gluten-free diet may also benefit people with alopecia areata who don’t have celiac disease. This is because gluten may exacerbate inflammatory skin diseases.

However, there’s a lack of research investigating the effects of different diets on alopecia areata. Even though other diets, like an anti-inflammatory eating program, would likely benefit people with this condition, there’s currently no evidence that any one diet is more beneficial than others.

That said, anti-inflammatory diets like the Mediterranean diet have been shown to be helpful for people with inflammatory skin conditions like psoriasis and experts suggest that these eating patterns could have similar benefits for those with alopecia areata.

In addition to possible improvement of alopecia areata symptoms, anti-inflammatory diets rich in nutrient-dense foods offer a variety of other health benefits.

For example, diets high in anti-inflammatory foods like fruits, vegetables, and seafood can help protect against chronic diseases like heart disease, obesity, and type 2 diabetes.

If you have alopecia areata, a diet rich in the following foods may improve your symptoms and provide additional protective benefits.

• Vegetables: broccoli, sweet potatoes, butternut squash, garlic, cauliflower, spinach, carrots, asparagus, peppers
• Fruits: citrus fruits, cherries, apples, berries, peaches, pears, pineapple, grapes
• Healthy fats: olive oil, avocados, nuts, seeds, nut butter, coconut oil, unsweetened coconut
• Whole grains: brown rice, rolled oats, farro, quinoa, brown rice pasta, barley
• Legumes: chickpeas, lentils, black beans
• Protein sources: seafood, eggs, chicken, tofu, turkey, beef
• Spices, herbs, and seasonings: rosemary, turmeric, basil, sage, cinnamon, ginger

Many of these foods — the fruits and vegetables in particular — are high in antioxidant and anti-inflammatory compounds that help regulate inflammation, protect against cellular damage, and promote immune health.

Because it’s an inflammatory condition, people with alopecia areata should avoid foods and drinks known to contribute to inflammation . These include ultra-processed foods, fried foods, and food and drink with added sugars.

Additionally, gluten-containing products and dairy may make alopecia areata symptoms worse in people who are sensitive to these foods. If you’re interested in developing a diet to treat your alopecia areata, it’s best to work with a health professional like a registered dietitian whenever possible.

A dietitian may recommend trying what’s called an elimination diet, where you remove foods from your daily diet and then slowly reintroduce them to try and identify what may be causing your symptoms and worsening condition.

In general, though, people with alopecia areata may benefit from cutting out the following foods and drinks.

• Added sugars: table sugar, sweetened drinks like soda, cookies, ice cream, pastries, candy, sugary cereals, sweetened yogurts
• Fast food: fried chicken, French fries, hamburgers, chicken nuggets, pizza
• Refined grains: white bread, white pasta, instant noodles, bagels, etc.
• Ultra-processed snack foods and meals: chips, some frozen dinners, sugary granola bars, boxed mac and cheese
• Processed meat products: bacon, lunch meats, sausage, hot dogs
• Gluten-containing foods: breads, tortillas, wraps, cakes, crackers, and other items containing gluten

There’s no conclusive evidence linking diet and alopecia areata, but you can try different things to see if making changes to your diet helps with your symptoms. For optimal nutrition, it’s recommended that you work with a professional dietitian or a medical professional before you make any major dietary changes.

People with alopecia areata are more likely to have low blood levels of several nutrients, which could contribute to or worsen symptoms.

A 2017 review found that people with alopecia areata had lower blood levels of vitamin D, zinc, and folate compared to people without the condition.

A 2019 study that included 200 people, found that those with alopecia areata had significantly lower vitamin D levels compared to healthy controls. Also, it was shown that lower vitamin D levels were associated with more severe alopecia areata symptoms.

Not only is vitamin D critical for healthy immune function, but it also plays an important role in hair growth and hair follicle health.

Zinc, another essential nutrient for hair health and immune function, is also commonly low in people with alopecia areata. Studies show that people with alopecia areata who have low zinc levels are more likely to have severe symptoms.

In addition to zinc and vitamin D, there are a number of other nutrients that play important roles in hair and immune health. Anti-inflammatory supplements such as fish oil could be helpful for inflammatory skin conditions, too.

If you’re concerned about nutrient deficiencies and want to start taking supplements to help manage your alopecia areata, it’s important to work with a healthcare professional who can give you personalized suggestions based on your specific health history.

A healthcare professional can run blood tests to assess your nutrient levels. They can then recommend appropriate supplements and doses that are most likely to improve your symptoms and overall health based on the blood test results.

It’s possible to overdose on certain supplements such as vitamin D and zinc, which is another reason working with a healthcare professional is recommended.