Lyme Disease and Hair Loss: What types of hair loss are possible?

What types of hair loss are possible?

Lyme disease is an infectious disease caused by bacteria known as Borrelia. These bacteria are typically spread by ticks, such as the one I photographed here.  Most people develop a rash at the site of the tick bite (often shaped like a "bull's eye" as it spreads). Not everyone develops the rash. If untreated, patients with Lyme disease can develop neurological problems, heart problems and arthritis many years later. About 300,000 people in the United states are affected yearly by Lyme disease.

Lyme disease gets transmitted to humans when a specific tick known as the Ixodes tick bites the skin. What's unique about these ticks is that the tick must be attached to the skin for 36-48 hours before the bacteria can be spread. This means that if humans can identify the tick on their skin before the 36 hour mark (and remove it gently with tweezers), it may be possible to prevent the disease.

The frequency of hair loss in patient's with Lyme disease has not been carefully studied. Lyme disease may cause a diffuse hair loss similar to a telogen effluvium. One study from 1999 suggested that telogen effluvium occurred within three months after the outbreak of disease in 13 % of patients with Lyme meningitis and in 56 % of patients with encephalitis. Lyme disease has also been implicated in one subtype of scarring alopecia (Psuedopelade of Brocq) although this remains to be verified in repeat studies. Some researchers have suggested a role for Lyme Disease in patients with Morgellons Disease (a skin disease whereby patients identify fibers within the skin, under the skin or projecting from the skin). Overall, Lyme disease may cause hair loss. A history of a tick bite and spreading bull's eye rash can be helpful early clues in the diagnosis. Antibody tests are available for Lyme disease, but they are not useful in the early stage. They are more helpful in the diagnosis of later stages.  Testing is typically a two-stage process beginning first with a test known as an “ELISA” test. Patients who test positive with the ELISA test then undergo testing using a “Western Blot.”

Reference

Cimperman J, et al.
Wien Klin Wochenschr. 1999.