What causes a sulfur smell and alopecia?

From the Guidelines

A sulphur smell and hair loss can be caused by several conditions, with alopecia areata being a potential cause of hair loss, although it is not typically associated with a sulphur smell. When considering the potential causes of a sulphur smell and hair loss, it is essential to evaluate the available evidence. According to the British Association of Dermatologists' guidelines for the management of alopecia areata 1, alopecia areata is a condition that can cause considerable psychological and social disability, particularly in cases of extensive or universal hair loss. However, the guidelines do not mention a sulphur smell as a symptom of alopecia areata. Some potential causes of a sulphur smell include:

• Selenium toxicity, which can lead to a garlic-like or sulphurous body odor
• Certain metabolic disorders like trimethylaminuria (fish odor syndrome), which produces a sulphur-like smell
• Fungal infections of the scalp, particularly tinea capitis, can cause both a sulphurous odor and patchy hair loss
• Hormonal imbalances, particularly thyroid disorders, may contribute to both symptoms - hypothyroidism can cause hair loss and affect body odor It is crucial to consult a healthcare provider promptly for proper diagnosis and treatment if you're experiencing these symptoms. They may recommend blood tests to check selenium levels or thyroid function, antifungal medications if a fungal infection is present, or hormone replacement therapy for thyroid issues. Avoid taking selenium supplements unless prescribed, as selenium toxicity often results from supplement overuse. These symptoms can indicate underlying health issues that require medical attention rather than self-treatment.

From the Research

Causes of Hair Loss

• Hair loss can be caused by several systemic diseases, including autoimmune diseases and endocrine diseases 2
• Androgenetic alopecia is a common form of hair loss, typically genetic, and can be treated with minoxidil or oral finasteride for male patients 2, 3
• Other causes of hair loss include telogen effluvium, alopecia areata, tinea capitis, and traction alopecia 3
• Alopecia areata is an inflammatory and T cell-mediated autoimmune reaction against unknown autoantigen of hair follicles, and is often associated with thyroid dysfunction 4

Association with Thyroid Dysfunction

• There is a strong association between alopecia areata and thyroid dysfunction, particularly hypothyroidism and Hashimoto's thyroiditis 4
• Vitamin D deficiency has also been linked to autoimmune thyroid disease, and may play a role in the development of alopecia areata 5

Sulfur Smell

• There is no direct evidence in the provided studies to link a sulfur smell to hair loss
• However, sulfur is an important element in human nutrition, and is involved in many biological processes, including the synthesis of amino acids and antioxidants 6
• Sulfur compounds, such as methylsulfonylmethane (MSM) and dimethylsulfoxide (DMSO), have been used to treat a variety of conditions, including pain syndromes and athletic injuries, but their relationship to hair loss and sulfur smell is unclear 6