Hair loss on Legs: Causes and Studies


Hair loss on Legs Causes and Studies, this article is a collection of facts based on recent scientific data relating to hair loss on the legs. This condition affects mostly middle - older aged men, but can also be seen in women. Some people may even have hair loss in other parts of the body like the arms. The scientific term for hair loss on the legs is Anterolateral leg alopecia, and it is more common than you think, affecting over 30 percent of males.

Appearance


Anterolateral leg alopecia usually presents on the front and sides of the legs, or just below the knees with clear boundaries divided by smooth skin and normal leg hair, it is not very well studied in medical literature, or in any dermatology textbooks. The Below image shows a 32-year-old patient with signs of leg alopecia, note the clearly defined borders, and smaller hairs present in the circumscribed area.

hair loss legs

Causes of Hair Loss on the Legs


  • An androgen deficiency is seen as the primary cause, this is a male sex hormone, namely: testosterone which is produced in the testes and fuels the male sex¬†characteristics.
  • Friction with trousers, or wearing socks has also been linked to this condition.
  • Peripheral vascular disease has also been linked to hair loss (this is due to reduced blood circulation to the lower limbs). Since the average man's hair coverage varies, most men are unaffected by the mild symptoms it displays. Peripheral artery disease, in particular atherosclerosis which leads to fatty deposits inside the arterial walls and thus narrowing of the arteries which carry blood supply to the legs.
  • Rashes: Eczema has been known to target the front of the ankles, this could also lead to scaly skin, we should also highlight dermatitis which causes skin to become itchy which may cause blisters and hair loss
  • Thyroid disease:
  • Both hypothyroidism (underactive) and hyperthyroidism (overactive) thyroid disease can cause loss of hair.
In most of these cases the hair follicles are unable to cope due to lack of nutrients.

If you would like a good article about what causes hair loss in men, Read this: Why is my hair thinning: Mens Edition.

Case studies


In a few patient studies published by Gupta and Shaw which studies 3 men showing symptoms of Anterolateral Leg Alopecia.

Case 1


A 42-year-old man is examined, showing signs of hair loss on the leg, he alleges the condition was present for almost 20 years but has not gotten any worse.The man was of average health and was not taking any medication. Hair loss was present on both legs from above the ankles to just below the knees. He did not suffer from hair loss on the scalp and the pulse in the leg was normal.

Case 2


A 38-year-old Caucasian man in perfect health shows signs of hair loss on the Leg with no other symptoms, he also had no family history of the disease. Hair loss was present in both anterior (front) and lateral (side) areas of the leg with smaller patches on the thigh, a punch-biopsy (removing a small piece of skin) revealed lack of hair follicles.

Case 3


A 49-year-old man approached the doctor with reports of lack of hair on his legs for more than 20 years, the patient had no other health concerns. The Alopecia shape was well defined and nearly covering the entire area, he also had small patches of normal hair inside the affected area.

Treatment for Anterolateral Leg Alopecia



Treatment
This involves treating the underlining cause, if, for example, the cause is related to the thyroid, or poor circulation; these would need to be addressed in order to see improvements. Since it is rather benign in nature, and progression is not widely seen it should not be seen as a serious health problem, with this said hair transplants are not really an option for this condition. Sometimes hair loss will resolve spontaneously. As long as there is no damage to the hair follicles themselves, it is possible for the hair to regrow.


Why Am I Losing Hair on My Ankles?


This is a common question and is often overlooked but its cause can be rather bothersome. According to studies, loss of hair on the ankles is caused by dropping testosterone levels. This is important to the early development of the male body, it also maintains bone mass, controls fat distribution, and regulates muscle mass. Some of the testosterone our body creates is converted into Dihydrotestosterone (DHT), too much of this hormone can reduce hair growth on your legs and ankles.

A second cause linked to hair loss on the ankles is poor circulation since it reduces blood flow to the affected hair follicles. In General, hairs need blood, oxygen and nutrients otherwise they will die. Poor circulation is usually a symptom of other conditions like obesity, diabetes, or even high blood pressure so it is important to check with your doctor if you have any numbness, fatigue, swelling in the feet.

Symptoms of poor circulation in the legs
  • Numbness in the legs (tingling in the hands, feet, or toes)
  • Edema or Swelling in the feet, legs
  • Slow-growing toenails
  • Pain in the legs while walking
  • Changes in Skin Colour
  • Limb Coldness



Hair loss on legs from Jeans


Acquired alopecia may present on the lower legs due to tight-fitting jeans, socks, or footwear. There are very few published articles about this phenomenon. This condition goes by many names including:

  • Non-scarring leg alopecia
  • Friction alopecia
  • Non-scarring leg alopecia
  • Traction alopecia


Hair loss on the legs continues for many years, even though the source of friction (tight jeans, socks) are removed. It is likely that many men don't approach doctors about the condition, and therefore it is not well defined or studied. Many men develop this condition, but it is harmless and does not cause any inflammation, or scarring.

For some men, their appearance may be quiet alarming, since they may have a well-defined line of hair loss on their lower legs or around the ankles which may cause self-consciousness.

Scarring vs Non-scarring Alopecia


Alopecia can be classified as either scarring or non-scarring. Most cases seen by doctors are non-scarring which is caused by tinea capitis or alopecia areata. Scarring Alopecia is rarer, and is usually caused by discoid lupus erythematosus. The form of alopecia that causes hair loss on the legs is usually frictional in nature, some doctors refer to this as traction alopecia.

Hair loss on legs from Diabetes


People suffering from diabetes are more likely to develop alopecia areata, which causes the immune system to attack the hair follicles. You might notice hair loss on the scalp, legs, or even arms. Patients with diabetes often have poor blood flow to extremities, and this can lead to hair loss on the legs, and arms. Living with diabetes causes stress and this is another factor that contributes to thinning hair.

Hair loss on Legs with Age


Androgen hormones are the primary reason for the physical changes we see in hair. These are "male hormones", but women produce a smaller amount as well. This is the reason men develop beards since they produce more androgen. Our leg hair also changes as the years go by, when we are children it appears as fine, short hairs known as vellus hairs.

Once our hormones peak after puberty leg hairs become vibrant and strong, and with age, both men and women start to lose their leg hair. Leg hairs peak between the age of 20 - 45, and gradually become hairless once we are 65. The hair on the legs grows according to a cycle, it grows for a period then it stops and falls out. The hair follicles can become dormant, and later produce a hair again. This explains why unlike your scalp, you never need to cut the hairs on your legs.

Conclusion


Anterolateral Leg Alopecia is more bothersome than it is serious, few clinical investigations have been conducted and studies are not well described. Maybe in a few years, there will be a heightened awareness of the cause, but until then it remains a subtle annoyance. If however, it is related to circulation you may wish to speak to a doctor, there are numerous serious implications including Peripheral artery disease, blood clots, or even diabetes which need expert medical advise.

If you would like a good article about what causes hair loss in men, Read this: Why is my hair thinning: Mens Edition.

References:

Frictional alopecia of the distal legs: case series and review
https://cloudfront.escholarship.org/dist/prd/content/qt9hz9t0df/qt9hz9t0df.pdf

Diagnosing and Treating Hair Loss
https://www.aafp.org/afp/2009/0815/p356.html

Secrets of Your Skin & Hair: Bono



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