Hair loss was a common side effect of early HIV medications such as AZT, Crixivan, and Atripla. But those medications are less frequently used today. Although some case studies have been reported, modern-day antiretroviral therapy generally doesn’t cause hair loss.

Thinning hair is a natural part of aging and can occur for reasons other than HIV. Here we’ll explore a few conditions that cause hair loss and how they might relate to HIV.

“Telogen” refers to hair that isn’t growing because it’s in the resting state. “Effluvium” is a scientific word that means outflow, or the shedding of hair. Telogen effluvium (TE) occurs when too many hairs stop growing for too long of a period. When new hair finally begins to grow, it pushes the resting hairs out, resulting in shedding.

Very little is known about TE, but people with HIV can be prone to the condition.

HIV and TE

TE can result from an infection, chronic illness, physical or psychological stress, and poor nutrition (especially a protein deficiency). These factors are all also associated with HIV.

Any of these can “shock” a person’s system and result in hair loss. As much as 50 percent of a person’s hair can fall out within two months after the initial shock, with hair coming out in handfuls at times.

Diffuse alopecia occurs when hair from all over the scalp falls out. Alopecia is a condition known to accompany immune disorders. According to a study published in 2006, about 7 percent of people with HIV reported diffuse alopecia.

Acyclovir (Zovirax), a common medication used to treat genital herpes, can cause hair loss. Healthcare providers sometimes prescribe acyclovir to people with HIV. It can be used to treat or prevent herpes of the skin, eyes, nose, and mouth, which can develop along with HIV infection.

Acyclovir is also used to treat leukoplakia, an HIV-related condition that results in hairy, white patches on the tongue or inside the cheek.

The STD syphilis can also result in hair loss.

Today, many people with HIV live long lives. A recent study of HIV-positive adults in Canada and the United States showed that people diagnosed with HIV at the age of 20 may live as long as any other person in these countries.

This means that hormonal symptoms — including male and female baldness — can occur as part of the aging process. Many men are losing hair by the age of 60.

Issues related to the disease itself may be a compounding factor, although little research exists on the topic.

Iron deficiencies can lead to hair loss in premenopausal women. Anyone losing a large amount of blood regularly can develop an iron deficiency and consequently experience hair loss.

A thyroid gland that produces an excess or deficiency of hormones can also contribute to hair shedding.

Most of the time, hair loss caused by any of the problems mentioned above is temporary. It’s important to remember that in the case of TE, hair falls out because new hair is growing in.

In severe cases of hair loss, steroid injections may promote hair growth. Topical creams may also spur growth.

Outside of hair loss that’s caused by natural aging, changing medications and getting proper nutrition can help prevent hair loss.

Although hair loss was once commonly associated with HIV, modern-day HIV medications don’t cause hair loss.

Those with HIV who maintain a healthy lifestyle usually don’t lose their locks. And with the right treatment, people with HIV can live long, healthy lives.

Talk to your healthcare provider about medication or lifestyle modifications if you’re concerned about hair loss.