For many in the Black community, hair is an essential part of identity, making any change – especially thinning or loss – a significant concern. If you’re living with HIV, you may wonder: Is the virus itself attacking your hair, or is your treatment to blame? The truth is complex.

While HIV may not directly cause alopecia, its impact on your overall immune health, coupled with specific Antiretroviral Therapy (ART) side effects, can undoubtedly lead to unwelcome changes in your tresses. Let’s break down the facts and discuss how to maintain your crown’s health while managing your condition.

What’s happening in your body

When you have HIV, the virus attacks and destroys the CD4 cells (T-lymphocytes), which are essential for the immune system’s ability to fight off infections and maintain normal functioning, as explained by the Mayo Clinic. As the virus multiplies and spreads throughout your body, it weakens your immune system, making you more vulnerable to opportunistic infections.

Without proper treatment, HIV can progress to acquired immunodeficiency syndrome (AIDS), which is the most advanced stage of the disease. So how does the virus affect your body?

  • HIV enters the body often through body fluids in blood, semen or vaginal discharge.
  • The HIV then targets and infects the CD4 cells. Also known as CD4 cells, T lymphocytes are a type of white blood cell that plays a crucial role in coordinating the body’s response to infections, per MedLine Plus.
  • HIV then replicates and spreads throughout the body.
  • As the virus progresses, it destroys CD4 cells, significantly weakening the immune system’s ability to function.
  • With fewer CD4 cells, the body’s immune system cannot effectively guard against secondary infections.
  • With weakened immune systems and left untreated, the virus progresses to AIDs, which can make you highly susceptible to serious illnesses, according to the Cleveland Clinic.

Generally, hair growth relies on a healthy immune system and proper nutrient absorption. When the body’s immune system is significantly weakened, secondary infections may cause hair follicles to shift into a resting phase, causing hair to shed more than usual. For instance, studies have shown that secondary syphilis may cause alopecia areata or vitiligo. Alopecia areata is an autoimmune disease that affects the body’s hair follicles, causing patchy hair loss.

Common causes

Living with HIV can lead to hair loss, primarily through two common mechanisms. Firstly, the emotional burden of managing a chronic illness like HIV can cause significant stress. This stress can trigger a condition known as telogen effluvium, a temporary form of hair loss, as studies reveal.

Dr. Justus Rabach, MD, MBChB, supports this connection, noting that “A study published in The Harvard Gazette suggests that elevated stress hormones indeed hurt hair follicle stem cells.”

Secondly, a weakened immune system (a hallmark of HIV) makes an individual susceptible to secondary infections, which can also contribute to hair loss.

Specific Causes

There are other specific causes of hair loss, including HIV treatment.

  • Antiretroviral Therapy (ART): ART is a combination of medications used to treat and manage HIV. The procedure works by blocking HIV from replicating itself. This helps to keep your immune system healthy, as explained by the Cleveland Clinic.

Some ART medications, like protease inhibitors, used to treat HIV, can cause hair loss, though this is a rare side effect, per Open Forum Infectious Diseases.

  • Nutritional Deficiencies: HIV can impair the body’s ability to absorb essential nutrients, such as biotin and folate, which are crucial for healthy hair growth, a review published in Dermatology and Therapy notes.
  • Aging and Genetics: Sometimes, hair loss may not be linked to HIV, but rather due to age or genetic factors.

HIV hair loss diagnosis and treatment

To better understand your condition before your consultation, your healthcare professional will conduct a specialized diagnostic evaluation. This provides them with the very details they require to make informed decisions and receive guidance regarding proper medication courses.

Specific diagnosis/treatment

Your medical expert may first conduct a physical examination and inquire about your diet, hair care routine and medical and family history. The purpose of reviewing the latter is to determine if genetic factors contribute to your condition.

The following tests might be done:

  • Blood test: This medical procedure enables healthcare professionals to identify underlying conditions that contribute to hair loss.
  • Scalp biopsy: Your healthcare expert can scrape samples from your skin or pluck hair from your scalp to examine the hair roots under a microscope and determine whether an infection is causing hair loss.
  • Pull test: To determine the stage of the shedding process, your medical team might gently pull out several hairs to see how many come out.

When your medical team has successfully determined the root cause of your condition, they might suggest a suitable medication plan to help manage your situation. But for some conditions like alopecia areata, hair may regrow without medication within a year.

Available medication options include minoxidil (Rogaine) and finasteride (Propecia). Minoxidil is an over-the-counter topical solution that can promote hair growth and help retain existing hair, the Mayo Clinic explains. Finasteride, however, is a prescription primarily for men that can be taken daily as a pill. This option helps to slow hair loss by inhibiting a hormone that damages hair follicles, another report from the Mayo Clinic notes.

Surgical options are also available to manage hair loss. Hair transplant surgery is a surgical procedure that involves relocating hair from denser areas of the scalp to areas of balding. This procedure helps to restore hair effectively, according to the Cleveland Clinic.

What happens to your hair if you have HIV?

The effect of HIV on your hair often depends on the stage and management of the disease. In many well-managed cases, individuals living with HIV, especially those on effective antiretroviral therapy (ART), may not experience any noticeable hair changes.

However, if HIV progresses to advanced stages or during periods of severe immune suppression, changes are more likely. The hair may become significantly thinner, or you could experience hair loss in patches. This can be attributed to related factors such as nutritional deficiencies, stress or secondary infections. Early detection, maintaining proper nutrition and consistent, effective HIV treatment and management are crucial steps that can significantly reduce the risk and severity of HIV-related hair loss.

What can’t you do if you have HIV?

With proper medication and adherence to strict health guidelines, HIV should not limit your lifestyle. Still, there are precautions that you should stick to:

  • It is highly recommended that you adhere to your medication. If you are on ART medication, do not skip doses, since it can weaken your immune system and worsen symptoms, including hair loss.
  • Do not engage in unprotected sex, especially with multiple partners or sharing needles due to drug abuse. This can help prevent the spread of the virus and protect others from infection.
  • Do not take any other medication apart from the ones prescribed by your healthcare professional. Always consult with your medical team, as medication can interact with HIV medications, leading to severe complications.

When to see a doctor about HIV hair loss

It is essential to consult your healthcare provider if you notice significant changes in your hair health. Specifically, you should seek medical attention if you experience sudden or severe hair loss that is noticeably different from your normal shedding. Additionally, make an appointment if you observe signs of nutritional deficiency, as this can be a key contributor to hair thinning, or if your HIV symptoms are worsening.

Reviewing your current medications is also vital, as some treatments may have hair loss as a side effect. Early diagnosis and detection of the cause are crucial, as they can help prevent permanent hair damage and may reveal other underlying health issues that require attention.

Bottom line

HIV does not directly cause hair loss. However, the virus, its treatment and other medical conditions all play a significant role. Therefore, maintaining a healthy lifestyle, managing stress and working with your healthcare provider can help keep your hair and overall health in good shape.

Frequently Asked Questions

What are the seven warning signs of HIV?

Fever, headache, muscle aches and joint pain, swollen lymph glands, weight loss, sore throat and painful mouth sores. These symptoms are usually noticeable during the early stages of infection, acute HIV, and can resemble the flu. Do not confuse the symptoms with those of the flu. If you suspect exposure, get tested as soon as possible.

Does HIV affect your feet?

Yes, HIV can affect your feet. This commonly leads to peripheral neuropathy, which causes numbness of the feet, shooting pain and muscular weakness. These painful experiences are often caused by nerve damage resulting from the virus itself or as a side effect of certain medications. If you notice these symptoms, report them to your healthcare provider.

Citations

Mayo Clinic. HIV/AIDS – Symptoms and causes. Mayo Clinic. Published February 9, 2024. https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524

MedLine Plus. CD4 Lymphocyte Count: MedlinePlus Lab Test Information. medlineplus.gov. Published November 30, 2020. https://medlineplus.gov/lab-tests/cd4-lymphocyte-count/

Cleveland Clinic. HIV & AIDS: Causes, symptoms, treatment & prevention. Cleveland Clinic. Published June 6, 2022. https://my.clevelandclinic.org/health/diseases/4251-hiv-aids

Baohua Y, Xuan L, Lan B. Alopecia areata and vitiligo as primary presentations in a young male with human immunodeficiency virus. Indian Journal of Dermatology. 2014;59(2):209-209. doi:https://doi.org/10.4103/0019-5154.127710

Hughes EC, Saleh D. Telogen Effluvium. Nih.gov. Published July 3, 2019. https://www.ncbi.nlm.nih.gov/books/NBK430848/

Lau J. Researchers discover how chronic stress leads to hair loss. Harvard Gazette. Published March 31, 2021. https://news.harvard.edu/gazette/story/2021/03/researchers-discover-how-chronic-stress-leads-to-hair-loss/

Cleveland Clinic. What Is Antiretroviral Therapy? Cleveland Clinic. Published September 18, 2023. https://my.clevelandclinic.org/health/treatments/antiretroviral-therapy

El Zein S, Tabaja H, Kanj A, Richmond D, Veltman J. Alopecia After Switch to Tenofovir Alafenamide in 6 African American Women. Open Forum Infectious Diseases. 2019;6(7). doi:https://doi.org/10.1093/ofid/ofz278

Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatology and therapy. 2019;9(1):51-70. doi:https://doi.org/10.1007/s13555-018-0278-6

Mayo Clinic. Hair loss – Diagnosis and treatment – Mayo Clinic. Mayoclinic.org. Published 2019. https://www.mayoclinic.org/diseases-conditions/hair-loss/diagnosis-treatment/drc-20372932

Mayo Clinic. Finasteride (Oral Route) Description and Brand Names – Mayo Clinic. www.mayoclinic.org. Published 2025. https://www.mayoclinic.org/drugs-supplements/finasteride-oral-route/description/drg-20063819

Cleveland Clinic. Hair Transplant: How Does It Work, Success Rates. Cleveland Clinic. Published 2021. https://my.clevelandclinic.org/health/treatments/21519-hair-transplant