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Mast Cells and Hair Loss! Really?!

Updated: Feb 17

We all lose some hair every day. This is normal and since new hair replaces the lost ones, normal hair shedding is not noticeable. However, if you are experiencing excessive and noticeable hair loss, it can be frustrating and even embarrassing.

Recent research suggests that your mast cells may play a role in hair loss. Targeting mast cell activation and histamine intolerance may be the missing link you need for addressing hair loss. In this article, I want to discuss the connection between your mast cells and hair loss. Let’s get into it.

What Is Hair Loss

According to the American Academy of Dermatology Association, healthy hair shedding is between 50 and 100 hairs a day (1). The average person has about 100,000 hairs on their head, so this daily hair loss isn’t noticeable. As new hair replaces the lost ones, you should not notice a difference, unless you have a hair loss issue.

Though it is more common in older adults and men, hair loss or alopecia can occur in anyone, even children. You may develop hair loss gradually over time or suddenly and unexpectedly. Hair loss can be temporary, for example, due to stress, hormonal fluctuations, or medical treatments like chemotherapy, but may also be permanent.

Symptoms of Hair Loss

Signs and symptoms of hair loss may include:

  • Widening part that becomes more noticeable over time

  • Receding hairline

  • Bald patches that can grow in size over time

  • Loose hair and shedding more than normal when brushing or combing

  • Clogged drains from losing hair in the shower

  • Burning scalp

  • Pain or itching if hair loss is from an underlying hair condition

Types and Causes of Hair Loss

There are several types of hair loss you may develop for a variety of reasons, including:

  • Androgenic alopecia: Androgenic alopecia is a hereditary hair loss that affects up to 50% of the population and can cause male pattern baldness and female pattern baldness. Some people may not experience symptoms until middle age, while others may notice hair loss as young adults, teenagers, or even as children (2).

  • Alopecia aerate: Alopecia areata is an autoimmune condition that causes bald patches on the scalp and hair loss on the eyebrows, eyelashes, and other areas (3).

  • Anagen effluvium: Anagen effluvium is rapid hair loss from chemotherapy, radiation, or other medical treatments. This is usually a temporary hair loss that regrows after treatment (4).

  • Telogen effluvium: Telogen effluvium is also a sudden hair loss that usually occurs after a traumatic event, serious illness, extreme stress, physical shock, or emotional shock. It may occur due to pregnancy, childbirth, menopause, or other hormonal shifts. It may also develop due to malnutrition, endocrine disorders, and some medications (5).

  • Tinea capitis: Tinea capitis is a ringworm that affects your scalp and may cause small, clay, itchy bald patches. It can be addressed with antifungal treatment (6).

  • Traction alopecia: Traction alopecia may develop because of pressure or tension on the hair from ponytails, braids, and other hair styles (7).

  • Other causes: Lichen planus, certain types of lupus, and other health issues may also lead to hair loss (8, 9). As you will learn later in this article, mast cells and mast cell activation may also play a role in hair loss.

What Are Mast Cells

Your mast cells are white blood cells found in your connective tissues, including your digestive tract, skin, respiratory tract, urinary tract, reproductive organs, surrounding your nerves, and near your blood vessels and lymph vessels. They store histamine and other inflammatory mast cell mediators, which they can release when encountering allergens, chemical toxins, pathogens and other stressors. Though your mast cells are necessary for a healthy body, overactive mast cells may increase the risk of mast cell disorders, including mast cell activation syndrome (MCAS). This may lead to widespread symptoms and health issues, including hives, itching, eczema, skin issues, headaches, migraines, fatigue, nervous system symptoms, digestive issues, and bladder problems (10, 11, 12, 13).

Mast Cells and Hair Loss: The Connection

New research suggests that your mast cells may play a role in various forms of hair loss. This means that targeting mast cells may also help the prevention and treatment of hair loss.

A 2018 review published in Skin Appendage Disorders has found that stress and immune dysfunction may play a role in autoimmune hair loss, including alopecia areata and lichen planopilaris (14). Immune privilege refers to the dynamic process that helps to maintain various processes that help to recognize and fight foreign antigens through immune-mediated inflammation. However, the collapse of the hair follicle immune privilege can lead to pro-inflammatory cytokine release, mast cell degranulation, perifollicular (around the hair follicle) inflammation, and scarring hair loss. According to the review, stress may play a role in triggering this inflammatory response and mast cell degranulation.

A 2010 review published in the Journal of Inflammatory Research, has found that inflammation may play a role in male pattern hair loss (MPHL) and female pattern hair loss (FPHL) (15). Researchers found mast cell infiltration and severe inflammation in over one-third of tissues samples taken from MPHL. One study included in the review found the presence of perifollicular inflammation in 71% of MPHL and FPPL samples. Results suggest that targeting inflammation and mast cells may be helpful when addressing hair loss.

A 2017 study published in the International Journal of Trichology has also found that mast cells and mast cell degranulation may play a role in telogen effluvium hair loss (16). Researchers looked at scalp biopsies to look at the mast cell count in telogen effluvium, androgenic alopecia, and alopecia areata. They found that mast cell counts were significantly higher and may play a role in stress-induced telogen effluvium compared to the other hair loss groups.

However, other research suggests that mast cells may play a role in other forms of hair loss as well. A 2014 study published in PLoS One has found that pro-inflammatory activities and perifollicular mast cell degranulation may play a role in alopecia areata (17). A 2003 study published in the Journal of Cutaneous Pathology and a 2015 study published in Actas Dermo-Sifiliograficas both suggest that mast cells may play a role in scarring alopecia (18, 19).

Researchers noted mastocytosis, a buildup of mast cells, in the skin around the blood vessels, hair follicles, nerve endings, and muscle cells, and that the release of mast cell mediators may be involved in the pathogenesis and scar formation in scarring alopecia. A 2020 review published in the Journal of Biomedical Science has found that mast cell activity may be linked to androgenic alopecia, cicatricial alopecia, and other hair loss disorders (20).

This suggests that targeting mast cells should be considered when addressing alopecia or other forms of hair loss. A 2018 review published in the Journal of Investigative Dermatology Symposium Proceedings has found that antihistamines targeting mast cell histamine release may help hair growth in alopecia areata (21). A 2021 review published in Dermatology and Therapy has also found that antihistamines may help hair growth in androgenic alopecia (22). A 2021 study published in the Journal of the American Academy of Nutrition has found that antihistamines combined with cryotherapy and corticosteroids may benefit alopecia areata (23).

Research is ongoing to fully understand the role of targeting mast cell activation in hair loss. However, it's important to note that antihistamines may only put a bandaid on the problem. Antihistamines may also decrease your body’s ability to make the enzyme breaking down histamine and lower your body’s capability to deal with excess histamine. Antihistamines may also come with unwanted side effects. Supporting your body through diet, lifestyle, and supplementation may help to reduce mast cell activation and histamine intolerance naturally and reduce hair loss as a result.

Recommendations for Mast Cells and Hair Loss

Addressing mast cell activation and histamine intolerance may be an effective way to tackle hair loss naturally. Here is what I recommend:

Follow a Low-Histamine Diet

Follow an anti-inflammatory, low-histamine diet. Avoid inflammatory foods, such as refined sugar, gluten, refined oil, artificial ingredients, heavily processed foods, and junk food. Avoid high-histamine foods and foods that trigger histamine release, act as diamine oxidase or DAO enzyme blockers, or increase histamine levels. You can find a list of foods to be careful with in this article. Follow a diet rich in low-histamine, anti-inflammatory, nutrient-dense whole foods, such as greens, vegetables, herbs, fruits, eggs, pasture-raised poultry, grass-fed beef, and wild-caught fresh fish.

Reduce Your Histamine Bucket

Lifestyle and environmental factors may also trigger mast cell activation and add to your histamine bucket. Avoid medications, chemicals, environmental toxins, heavy metals, and other irritants that may trigger mast cell activation. Lower your stress and anxiety. Exercise and move your body regularly. Improve your sleep.

Try Topical Melatonin

Melatonin is most known for its sleep-supporting abilities. But did you know that melatonin can also support your hair health and reduce hair loss? I’ve covered the mast cell-stabilizing benefits of melatonin in this article. As a mast cell stabilizer, melatonin may help to reduce the risk of hair loss related to mast cell activation. Moreover, you may also benefit from topical melatonin. A 2012 study published in the International Journal of Trichology has found topical melatonin may help to improve the symptoms of androgenetic alopecia in females by reducing hair loss (24). Melatonin lotion may be helpful for female hair loss and other scalp symptoms, such as burning scalp.

Try Some Natural Topicals for Hair Loss and Hair Health

According to a 2021 study published in Scientific Reports, massaging coconut oil on your scalp may support your scalp microbiome, scalp health, and hair growth (25). According to a 2015 study published in Skinmed rosemary oil applied to the skin may also support hair growth (26). A 2017 study published in BMC Complementary Medicine and Therapies has found that geranium oil may boost circulation and hair growth (27).

Try Some Supplements for Hair Loss and Hair Health

A 2015 study published in the Journal of Cosmetic Dermatology has found that omega-3 fatty acids and antioxidants may help with hair loss in women (28). A 2015 study published in the Journal of Medicinal Food has found that red ginseng extract may promote hair growth (29). A 2012 study published in the Journal of Clinical and Aesthetic Dermatology has found that supplementing with biotin may also help addressing temporary hair thinning and hair loss (30).

Next Steps

Are you experiencing hair loss or other symptoms of mast cell activation or histamine intolerance? Working with a healthcare practitioner knowledgeable about histamine intolerance and MCAS is the best way to get to the root cause of your symptoms and to create an individualized treatment plan. I welcome you to start a functional medicine consultation with me for further personalized guidance to improve your health. You may book your consultation here. Check out my Histamine Intolerance Course here. Learn on your own time, from anywhere. Get an inside look at the most helpful functional medicine tests for pinpointing imbalances, ways to identify and manage the most common (and sometimes surprising) mast cell triggers, and learn what to eat, what to avoid, and why.


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