If you have noticed that you are losing hair on your legs, you may assume it is happening because you’re getting older. If you don’t feel any different or notice other symptoms, it is easy to brush off hair loss on the lower legs without considering the possibility of a more serious underlying issue.
Even without detectable symptoms, you may have developed a condition known as peripheral artery disease (PAD), which most commonly impacts the arteries in the legs. With PAD, the arteries become hardened when plaque attaches to the artery walls, narrowing the passageway. This plaque buildup is known as atherosclerosis, and it inhibits blood flow to your legs.
Most people do not notice symptoms of PAD until atherosclerosis is advanced, causing significantly restricted blood flow to the legs, feet, and ankles. Because the lower extremities lack adequate amounts of oxygen-rich blood, they cannot function as they should. This is when you’ll notice signs like toenails that grow slowly, wounds that take longer than usual to heal, and hair loss on your lower legs.
Although some people may not view losing hair on the calves, shins, or legs as a problem, it is important to know that it may indicate a larger health issue.
What Can Cause You to Start Losing Hair on the Legs?
As people age, they may lose hair on their legs for a variety of reasons. Hair loss can occur on your legs just as it can on your head, and, similarly, genetics can play a role in this issue. If baldness runs in the family, you could also experience hair loss on other parts of your body, such as your legs. This rings true for both men and women.
Some hair loss conditions, such as alopecia areata, are caused by a faulty immune system. With alopecia areata, for example, the immune system confuses hair cells as foreign invaders and attacks them. Hair loss of the legs is called anterolateral leg alopecia. This condition isn’t caused by one particular health issue, instead, it is a catchall term for any sort of hair loss on the legs. For example, PAD can cause anterolateral leg alopecia, as can genetics and rubbing the legs together too often.
Besides PAD, other conditions that may lead to hair loss on your lower legs include diabetes, poor circulation, thyroid conditions, fungal infection, folliculitis in severe stages, hormone changes, and pituitary gland disorders.
You can also suffer from hair loss if your body is deficient in certain nutrients, such as iron, vitamin D, or zinc. Steroid use can lead to loss of hair on the legs for males and sometimes females. Since the causes of leg hair loss are so numerous, it’s important to take all your symptoms into account to get an accurate diagnosis. If you have other signs of PAD, you should seek out further evaluation from a medical professional.
How Does PAD Cause Hair Loss on the Legs?
Hair follicles require nutrients to keep them healthy and to allow your hair to grow. Those nutrients are carried through the bloodstream. When people have PAD, their arteries are narrowed by plaque buildup. This makes it difficult for adequate blood and oxygen to provide nourishment to the muscles, tissue, and other parts of the leg, including the hair follicles.
When the hair follicles don’t receive enough nutrition, the hair will stop growing. You may notice patches of hair loss on the legs. This may coincide with other symptoms, such as leg pain or numbness in the legs.
PAD is a progressive disease that can start with mild symptoms or none at all. Early detection and diagnosis of symptoms like leg pain and hair loss on the legs can help prevent the progression of the disease.
Prevalence of Hair Loss on Legs for Men and Women
Both men and women can experience anterolateral leg alopecia, which may be a sign of PAD, but it appears to affect men more than women. As many as 35% of men1 are thought to develop this condition over their lifetime. In most cases, the hair loss is on the lower legs. People affected by this condition may find themselves asking, “Why am I losing hair on my lower legs?” They may reach out to a dermatologist, believing that losing hair on the calves could be a skin issue and nothing else.
This could be the case, but it’s important to check for PAD regardless of your gender. In the past, PAD was thought to affect men more often than women,2 but recent studies show that women are affected as often as men.
If you have any PAD risk factors, such as diabetes, high cholesterol, high blood pressure, or a smoking habit, make sure to tell your physician or a vascular doctor about these risk factors. You should also tell your doctor whether or not you are experiencing additional symptoms of PAD, such as slowed toenail growth, skin discoloration, and cramping in the legs while walking or jogging. These can all signal a lack of adequate blood flow to your legs.
Diagnosing Hair Loss on Shins, Calves, and Feet
If you see your primary care physician due to hair loss on the lower legs, you may be referred to a vascular doctor for additional testing to diagnose or rule out peripheral artery disease. At USA Vascular Centers, our board-certified vascular doctors can conduct two tests to determine if your anterolateral leg alopecia could be caused by PAD.
An ankle-brachial index (ABI) test measures the blood pressure in your ankle and the blood pressure in your arm and then compares the two. Our vascular doctors are experts at diagnosing PAD, and they will be able to tell whether or not the test indicates restricted blood flow in your peripheral arteries.
Or, one of our doctors may choose to conduct an angiogram. During this minimally invasive procedure, contrast dye is injected into the veins to locate blockages in the arteries. Before your appointment, it can be helpful to write down a list of symptoms you’re experiencing and the medications you’re taking so that you are prepared for the visit. Wear comfortable clothing and drink plenty of water beforehand.
Treatment for PAD
If you have PAD risk factors and hair loss on the lower legs, making lifestyle changes such as quitting smoking and beginning an exercise plan can help keep the disease from advancing quickly. However, while lifestyle changes are important and can help slow the course of PAD, advanced PAD requires treatment to help restore blood flow and improve a patient’s quality of life.
USA Vascular Centers offers various minimally invasive treatment options for PAD including, angioplasty, atherectomy, and stent placement. During an angioplasty, the doctor threads a catheter through a blood vessel and inflates a tiny balloon, compressing the plaque and widening the artery. A stent placement uses the same procedure as an angioplasty but with the added step of leaving a small mesh stent in the artery to keep it propped open. An atherectomy involves using a tiny blade to remove plaque from a narrowed artery.
These outpatient procedures do not require a hospital stay — you can recover in the comfort of your own home. You may also need to take medication to reduce the chance of blood clots. For optimal results after your procedure, follow all of your vascular doctor’s instructions for recovery.
Will My Leg Hair Grow Back After Treatment
If your hair loss on the legs is unrelated to PAD, you may find that your hair grows back after you participate in the recommended treatment for your condition. For hair loss caused by atherosclerosis and PAD, undergoing an angioplasty, atherectomy, or stent placement may increase the blood flow in your legs. This, in turn, can result in the regrowth of hair on your legs, but it also may not. If you have further questions about hair regrowth after treatment, consult one of our vascular doctors.
Schedule a Consultation with USA Vascular Today
If you have noticed that the hair on your legs isn’t growing like it used to, our vascular specialists are here to help. We’re committed to answering your questions and improving your quality of life. Give us a call at 888.773.2193 or schedule a consultation with our leading vascular specialists who can determine if vascular treatment is right for you.
Reviewed by Dr. Aaron Shiloh, a board-certified interventional radiologist with decades of experience performing minimally invasive treatment for PAD and other vascular conditions. Dr. Shiloh was awarded a fellowship from the Society of Interventional Radiology, a prestigious distinction that only the top 10% of doctors in his field have earned.
 Siah Wei, Tee, and Matthew J. Harries. “Anterolateral Leg Alopecia: Common but Commonly Ignored.” International Journal of Trichology, Hair Research Society of India, April-June 2014, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154156/. Accessed 22 January 2022.
 Schramm, Kristofer, and Paul J. Rochon. “Gender Differences in Peripheral Vascular Disease.” Seminars in Interventional Radiology, Thieme Medical Publishers, March 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5886764/. Accessed 23 January 2022.