Is There a Link Between Alopecia and NMO?

Neuromyelitis optica (NMO) is an autoimmune disease. This means it is caused by the immune system mistakenly attacking the body. It typically causes vision issues and weakness, pain, or spasms in the arms and legs. However, one rare side effect of NMO is alopecia.^1,2

What is alopecia?

Alopecia areata is also an autoimmune condition. It happens when the immune system mistakenly attacks hair follicles. Hair follicles are the parts of our skin that grow hair. When these follicles are attacked, it can cause hair loss.^2,3

Hair loss from alopecia typically starts with one patch on the scalp. The patch is usually about the size of a quarter. Other common locations are the beard, eyebrows, or eyelashes. There are usually no signs of rashes or redness at the site. But some people may feel a burning or itching sensation.³

Does it look the same on everyone?

In short, no. The progression of alopecia is different for everyone. Some people may just have their hair regrow in the patch. Others may have new patches form. If there are a lot of patches, they may start to join together. In rare cases, people may lose all the hair on their scalp. In extremely rare cases, people may lose all the hair on their bodies.³

What is the connection between alopecia and NMO?

People with certain autoimmune conditions like NMO are more likely to get alopecia. This includes psoriasis, thyroid disease, vitiligo, and lupus. Scientists do not fully understand these links. We do know that people with autoimmune conditions can be more likely to develop other autoimmune conditions. It is possible that the immune response in one condition is related to the other condition.^2-4

Researchers are not completely certain of the link between alopecia and NMO. But existing research does link NMO to other autoimmune conditions that impact the skin. This could make a connection to alopecia more likely. More research is needed to confirm this link and understand what it means for people with NMO.²

How should you manage alopecia?

For many people, the hair regrows on its own after alopecia. But other patches of hair loss may form in the future. There are treatment options that may help manage alopecia.³

In 2022, the US Food and Drug Administration (FDA) approved the first systemic drug to treat adults with alopecia. It is called Olumiant® (baricitinib). A systemic drug means it treats the entire body instead of just one spot. Olumiant works by preventing the inflammation of the follicles that causes hair loss. There are also drugs like steroids that may help.⁵

OTC treatments

Some research has shown that over-the-counter treatments or supplements may help with alopecia. This is not proven, and these treatments are not regulated by the FDA. These options include:⁶

Taking the measures to protect yourself

If you have alopecia, it is important to protect any patches. Wear sunscreen on these spots or a hat if you are outside. If you have concerns about treatments, talk with your dermatologist. If you believe the alopecia you are experiencing is a side effect of your NMO or are unsure, be sure to talk to your doctor. Research shows that participating in your treatment decisions can increase your satisfaction.^3,7