Loss of Hair in Cats

Alopecia is the medical term for hair loss in cats. This is a common problem for cats and can have a variety of possible causes. In many cases, there is more than one contributing cause, making the problem frustrating for pet parents to figure out and eliminate.

Some types of cat hair loss involve the hair falling out spontaneously, while others are caused by cats overgrooming, biting, or scratching themselves. Occasionally, alopecia is nothing to worry about, such as the small areas of hair loss many cats develop in the area between their ears and eyes. Other times, it can be a symptom of serious underlying disease.

Cat alopecia can be broken down into two types:

• Congenital alopecia occurs most often in newborn kittens or young cats, and it does not cause them to be itchy. This is usually related to your cat’s breed or genetics.

• Acquired alopecia occurs in cats that are born with normal hair coats and lose hair because of an underlying systemic illness or skin disease. It can occur at any age and there are many possible causes, ranging from an infection with parasites like mites, to an allergy, or a metabolic disease like hyperthyroidism. These cats may or may not be itchy, depending on the underlying cause.

Other Symptoms to Check For With Hair Loss in Cats

Cats with alopecia can have patches of hair loss in one area of the body or in multiple areas. The locations vary based on the underlying cause of hair loss. Cat alopecia may be inflammatory or non-inflammatory, meaning that the skin may appear red and irritated, or it may appear normal.

Cats with inflammatory alopecia may show a number of symptoms:

• Be obviously itchy and seem to lick, bite, gnaw, and scratch at their skin more than normal.

• Experience an increase in hairballs.

• Have other skin abnormalities such as redness, bumps, scabs, sores, or crusts.

It is important to note that just because you don’t see signs of itchiness, that doesn’t mean your cat is not itchy. Often, cats hide those behaviors, only to gnaw and scratch when they are hidden from view.

If there is an underlying systemic disease affecting your cat, you may see these signs:

• Changes in appetite

• Vomiting and/or diarrhea

• Changes in energy level

• Increased thirst and urination

• Enlarged abdomen or a pot-belly appearance

Cats with allergies may also experience additional symptoms:

• Conjunctivitis

• Inflammation of the ears

Causes of Hair Loss on a Cat

There are multiple causes of congenital alopecia. 

• Alopecia universalis is a condition in which the cat is born without hair. While hairlessness is a feature of some breeds (e.g., Sphinx, Elf, Delf cats), there is a genetic mutation that makes this type of alopecia possible in any cat breed.

• Hereditary hypotrichosis is when a cat is born with a thin coat of hair, then loses it over time. This is more commonly seen in Siamese, Devon Rex, Birman, and Burmese cats.

• Follicular dysplasia takes place when cats are born with a full coat of hair that thins over time. Cornish Rex breeds are predisposed to this.

There are many potential causes of acquired alopecia in cats, and the problem may be the result of one or more of the following:

• Infection caused by bacteria (most commonly Staphylococcus), yeast (usually Malassezia), ringworm, or parasites (e.g., Demodex, Cheyletiella, Notoedres, or Otodectes mites).

• Allergies to fleas, food, or environmental allergens.

• Discomfort caused by another disease, such as inflammation in the bladder, kidneys, gastrointestinal system, or anal sacs.

• Endocrine disease like hyperthyroidism (common) or Cushing’s disease (rare in cats).

• Recent metabolic stress, such as pregnancy, nursing, or fever.

• Cancers, including cutaneous lymphoma, thymoma, pancreatic carcinoma, and bile duct carcinoma.

• An immune-mediated disease, like alopecia areata (extremely rare).

• Psychogenic alopecia, a behavioral issue in which the cat overgrooms due to compulsion and anxiety. 

How Veterinarians Diagnose Cat Hair Loss

It is important to take appropriate steps to identify the underlying cause of your cat’s alopecia. The first step in diagnosis is a detailed history. Details like the age of your cat and whether it’s on prescription flea prevention, seems itchy, experiences seasonal skin issues, or has had any recent stressors helps your vet determine the proper plan of treatment.  

The next step is a physical exam performed by your veterinarian. The location of the cat’s alopecia is often a clue for what the underlying cause may be. For example, the base of the tail and lower back is often affected in cats with flea issues. Anal gland issues can cause irritation around the anus below the tail, and a cat with psychogenic alopecia will not have hair loss on its neck or face.

Your veterinarian will likely perform one or more diagnostic tests:

• Wood’s lamp: This test detects some occurrences of ringworm infection.

• Fungal culture: A veterinarian may perform a ringworm culture in-house or send a sample to an outside laboratory. It can take several days to get these results.

• Cytology: A skin impression or tape sample is viewed under a microscope to determine bacteria or yeast.

• Skin scraping: A scrape can be used to look for parasites, such as mites.

• Skin biopsy: If the appearance of the cat’s skin is unusual or other tests do not provide a diagnosis, a veterinarian may perform a punch biopsy—or surgically remove—a small area of skin for a pathologist to view.

• Bloodwork and urinalysis: These tests may be recommended to evaluate for an endocrine disorder (such as hyperthyroidism) or other underlying systemic diseases.

• Allergy testing: Your veterinarian may recommend an elimination diet trial using prescription food for 8 to 12 weeks to test for a food allergy. The vet may also recommend intradermal allergen testing if other causes of alopecia have been ruled out and the vet thinks your cat could have an environmental allergy.

• Imaging: An ultrasound and/or X-rays may be used to look for signs of cancer.

Psychogenic alopecia is a diagnosis of exclusion, meaning that it can only be definitively diagnosed after other causes have been ruled out. It is more likely if there have been changes to the cat’s environment, like new pets, visiting family members, moving, or other stressors.

Treatment of Hair Loss in Cats

Treatment will depend on the underlying cause of your pet’s hair loss. Use of an Elizabethan collar (e-collar) may be recommended if your pet is licking or biting the skin. The collar helps prevent infection and allows the hair to regrow.

Possible treatments may include:

• Parasiticide treatment (e.g., Revolution, Bravecto, Credelio), which may be prescribed for eight weeks for all pets in the house. This is recommended even if no parasites are found on exam, as cats are excellent groomers and may effectively remove most of the parasites from their hair coat before you see them.

• Topical therapy which may include medicated shampoo, mousse, or ointment.

• Systemic antibiotics and/or antifungals.

• Elimination diet trial for 8 to 12 weeks with a prescription allergy diet or a limited-ingredient diet.

• Medications such as prednisolone, cyclosporine, and/or antihistamines to reduce itch.

• Behavior-modifying medication (such as fluoxetine) and environmental enrichment, including improved access to resources (food, water, litter box), playtime, and interactive toys.

Recovery and Management of Cat Alopecia

Recovery time for cats with alopecia depends on the underlying cause, and it may take weeks to several months. If the underlying cause is identified and appropriate treatment is pursued, your cat’s hair will likely grow back.

Many diagnoses will require long-term management such as year-round flea prevention, prescription cat food, regular use of topical therapies, and/or consistent use of medication. It is important to work closely with your veterinarian and follow instructions for follow-up visits to achieve the best possible outcome.