Updated November 28, 2020
Hair loss is a good example of how the skin problems of cats are different from dogs. It’s got a lot to do with their special grooming behaviour.
The Overgrooming Myth
When cats have itchy skin they don’t scratch the same way dogs do. More commonly, they just lick the area more. This damages the hair shafts, which break, and bald spots appear.
From the outside, the skin often looks normal. Once upon a time, at this point, vets would say, “your cat is overgrooming”. Boom. In one word, it’s suddenly the cat’s fault.
But it gets worse. I once heard an eminent vet say that prednisolone has calming effects on cats and that’s why it works on ‘overgrooming’. Well, prednisolone is actually an anti-inflammatory steroid. Despite the fact that ‘pred’ could only be working by suppressing an itch, some vets were willing to invent new properties for the drug rather than accept the reality.
So what is the reality?
Why Cats Lose Hair
Hair loss has at least three causes:
- Diseases causing itch such as allergy or fleas
- Diseases causing the hair to break or fall out
- Diseases causing overgrooming
As you can see, I don’t deny the existence of psychological overgrooming. It just needs it to be considered last. The reason is simple: the first two will get better with specific treatment. Overgrooming is a diagnosis of exclusion and often ends up being hard to treat.
The mystery photo shows hair loss between the back legs of our elderly patient Purdy. It would have been so easy to call it psychological or hormonal.
If we call a cat an overgroomer, we’re in danger of giving up on them before we start. We need to consider all three causes. Lets start with the itch.
What Causes Itchy Skin In Cats
Itchy skin in cats is usually caused by either:
- Flea bite
- Environmental allergy
- Food allergy
- Mites (rarely)
Now have a look at the picture at the start. It shows the most common patterns seen for these three causes in 502 cats (reference below). The colours indicate the percentage of cats in each group that were affected in that area.
- light blue is 0-20%
- blue is 20-40%
- yellow is 40-60%
- orange is 60-80%.
Several observations spring out straight away:
- Hair loss on the lower back and tail is most often flea-related
- Hair loss on the belly happens with everything
- Hair loss on the front and back legs: probably not food
- Facial problems happen with everything but head & neck problems are more common for food
- Nothing is true 100% of the time
Point 5 means that although patterns are useful to tell us what to try first, we can’t use them for a diagnosis.
So although Purdy does have hair loss on the belly, here’s why she didn’t have these diseases:
- She gets treated every month with Revolution for fleas
- Environmental allergies such as to dust mites, pollens and grasses almost never start in old age
- Food allergies are usually a lot more severe and widespread
- The lesions aren’t typical for mites
So what about the second cause of hair loss?
What Causes The Hair To Fall Out?
Not many diseases cause spontaneous alopecia. A fungal infection called ringworm (pictured under ultraviolet light) is most common. However, Purdy just doesn’t fit the age or pattern for ringworm, and the skin changes aren’t consistent either.
Hair can also fall out with mites (very rare, wrong spot) and breed-related ‘disorders’. Pictured is my disorder of a Devon Rex, Grendel. All the rex breeds have hair that grows poorly and so most of them will have bald patches at times. That’s just the way they are.
So, by exclusion, it seems like Purdy will be overgrooming after all.
What Causes Overgrooming?
Causes of true overgrooming include anything that might affect your cat’s emotional well-being. That can be:
- a house move
- new baby
- another cat or dog
- health problems
You can read more examples at our page on Stress and anxiety in cats.
In this case, Purdy’s problem was caused by hyperthyroidism. She was brought to me for the hair loss, but I noticed she wasn’t right in other ways and ordered a blood test.
Thyroid disease makes cats edgy and highly strung. Once we controlled her thyroid problem, she relaxed and the hair grew back.
Do Hormones Cause Hair Loss in Cats?
Hormonal causes come up online as the top cause for feline alopecia. Well, Google if you’re listening, the right answer is: almost never. Purdy’s example is an unusual way to recognise thyroid problems. I also see hair thinning with untreated diabetes, but that’s the least of these cats’ problems. And as for the major cause in older dogs, Cushing’s disease in cats is too rare to mention.
Hair Loss Treatment in Cats
So to finish, let’s get practical and imagine you’ve got a cat with bald spots. You now know it can be caused by a lot of things. What do you do?
First, get a checkup with your vet. I’ve only discussed the common, typical causes of hair loss but your vet knows a lot more.
Then, if your vet doesn’t find something, they will probably advise a similar pathway to the one I used above:
- Rule out parasites with an appropriate treatment
- Rule out food allergy via a diet trial
- Investigate environmental allergy (may require a treatment trial)
- Perform blood and urine testing if not done before
- Consider psychological causes
After this, if you’re not getting improvement, talk to your vet. There are always other ideas such as ringworm culture or biopsy, or you may be recommended referral to a specialist.
Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.
Hobi, S., Linek, M., Marignac, G., Olivry, T., Beco, L., Nett, C., … & Koebrich, S. (2011). Clinical characteristics and causes of pruritus in cats: a multicentre study on feline hypersensitivity‐associated dermatoses. Veterinary dermatology, 22(5), 406-413.
Hi my 3 year old cat started to over groom a few months after a move, and has continued to do so for more than 6 months now. He has numerous bald patches on his side, legs and belly and sometimes licks until they scab. He’s been to the vet twice and they have diagnosed him with anxiety, we tried anxiety meds, calming treats, and the calming diffuser with no results. We also tried a body suit, but then he focused on the areas that were not covered like the legs and arms. I work from home so he always has company and treats and toys don’t seem to distract him from grooming. Is there anything I can do here to help?
Hi Nikky-Ann. Given that anxiety is such a tricky diagnosis, I would start also considering physical causes of the problem such as an itch from an undetected allergy. It’s mentioned in this article.
Hi there, very helpful article, I’m writing from Türkiye btw, I have a cat in my street that I look after, he is a black cat, yesterday he was not around and last night he turned back to my street and he is having a hard time walking, his back and legs and hurt when I pet them and he is also loosing patches of hair on his shoulders and sides, we do not have the means to take him to the vet and the municipality vets will not being him back to us and just put him in a shelter and if he is not adopted he’s gonna be euthanized, could you help with some things we can try to help her at home or buy at a pet store? Thanks in advance
Hi Kim. You can buy a treatment for mites and fleas, but it sounds like he has another serious problem that really does need a vet to have a look.
Help! My 9 year old cat started scratching about 3 months ago. I gave him frontline. The itching was getting worse and leading to some hairless patches. Since then we’ve been to the vet 2xs. We did 1 full round of steroids and started with revolution. He was good until we started to ween off the steroid and then back to square 1. It has even gotten worse and now hairless patches on his thigh, backs of back legs, front legs. He’s had another revolution treatment but won’t take anymore meds, no matter how I try to sneak them in.
His fur looks clumpy, he looks like he’s lost weight, he isn’t interested in what foods he used to really love (which I had been hiding his meds in).
He’s a pretty aggressive cat at the vet which makes bringing him very difficult but I’m at a loss and I’m scared and sad for him.
Hi Erica. It certainly sounds like a difficult case. Have you considered a referral to a veterinary dermatologist? Revolution is normally very effective against fleas as long as every dog and cat in the house is treated. There’s possibly another cause, of which the common ones are listed on this page. Consider also food allergy in an older animal with this history.
I have 5 cats all adults and senior I noticed my senior cat was going bald on her belly and a little on her back legs chalked it up to age until I just started noticing her daughter which was born 2012 is much more bald in hind legs up towards her hip and I have ruled out fleas as they’re indoor cats only I have them on purina one instinct chicken flavour dry food her skin is pink not sores I really don’t have the money for all kinds of test I just don’t want to risk a sickness that can potentially cause her to die without proper veterinary care any suggestions?
Hi Caroline. The article is the best advice I can give you, and to add that although you are right that it definitely reduces the risk, you can’t rule out fleas by cats being indoors. A good treatment trial is the best way, but a quick test would be to give your cats a big pat and ruffle up on a clean white sheet and then look very carefully for the tiny specks of flea dirt afterwards.
Hello!
I was wondering how you can rule out mites or allergies without needing a vet? They are super expensive and we can’t afford to do all these treatments. Also I checked your chart and the only balding patch our cat every gets is under her front leg and then she bites the back of her legs until they bleed (it stains the floors and sheets everywhere). We’ve taken her to the vet for it but every time she starts biting again right away and bleeding again. I want to help her as much as I can but can’t afford to keep going to the vet over and over. What do I do?
Hi Katrina. It’s a good idea to rule out external parasites very early. You will find a list of suitable flea and mite products for cats on this page.
Hello!
Your website was very helpful, thank you for all the great information. I had a cat, her name was Bobbie, and she had hyperthyroidism for seven years before she passed. I am well aware of the symptoms that go along with it. My new kitten Dorey has all of the same symptoms plus she is over grooming the insides of her legs. Our vet says she is too young and won’t test for hypothyroidism? Is that true and, if so, at what age do I have to wait? If she is not eating her fur, she is eating food or treats?
Thank you for your help!
Hi Kimberley. Your vet is correct that hyperthyroidism is a very unlikely disease in a kitten. However, a routine blood test generally includes a total T4, so it’s easy to screen for regardless. The problem is much more likely to be a skin disease at this age, such as allergy.
Hi!
We have an 10ish yo (we think.) street cat rescue. Immediately we noticed she had food allergies as runny smelly poop and bad gas. We combated that and found a raw food that worked. But for around 3 months now she has had balding patches on her rear sides (top of legs) and she’s developed reoccurring cystitis. We have been giving her Metacam (we are in the UK) when she experiences her UTI but are aware this isn’t good for her long term. No changes in environment, she doesn’t *love* our other 2 cats but is generally very happy and friendly and enjoys her life. She’s overweight but not overfed. We are willing to ask and pay for any tests at this point to try and determine the cause/s. Any ideas on what to test for and or change? We have recently changed her food again (poops seem fine so far, it’s been 5 days). Getting desperate to help our girl.
Thanks!
Hi Sam. As the article suggests, balding patches are usually caused either by allergy to food or environmental factors, but especially to external parasites. Therefore, these need to be ruled out first, but once you’ve done that, in your case, it would be sensible to double down on the food aspect, as you have already shown there is an element of this. To do so requires the use of a prescription elimination diet for a trial period to see if it helps. The only problem with this is that it will contradict the treatment of cystitis, the cornerstone of which is the use of wet, not dry diets. There are other methods you can find at the link as well. Good luck.
My cat licks his lower belly raw. Eve been to the vet several times, he has been on a hydrolzed food diet for about a month, has been getting steroids, and he’s been in a cone for about a month, but when the cone comes if he still goes for his belly. I don’t think he’s been checked for hyperthyroidism. Kinda at the end of my rope.
Hi J. A blood test is a good idea but don’t hold out too much hope – it would be a long shot. There’s also a drug called Atopica you can read about at the link but it does add to cost and needs to be planned well. But don’t stress too much if your cat seems otherwise healthy and happy.
Thanks – Atopica that is actually the plan after he gets through his steroids, which is basically almost done. I would just let it go and not stress as you suggested, but it can get quite bad, infected and oozing, which just seems like a bad situation. Hopefully the atopica will be effective.
HI, We recently added a new cat to our household (6 months old); he seems to get along for the most part with our 1+ year old cat. However he keeps licking her in the spaces in between her eye and ears, which has caused her fur loss, including “eye brow” whiskers in that area. We try to stop him from licking her there but cannot be around all the time. Any advice to prevent him from licking her constantly in those spots? She doesn’t seem to mind it but we are worried about the fur loss. Is there some topical aid we could use that is safe for her but would discourage him from licking her there?
Hi Stef. Sorry that’s a very unusual one and I can’t think of a way to stop it. I guess if it’s causing no harm other than hair loss, I would tolerate it.
Hello Andrew,
We have a 2,5 years old sterilized house cat, called Sandy. Sandy was adopted roughly 1,5 years ago, we were told, she is allergic to lamb meat, otherwise healthy. She used to have severe psychological issues, but nowadays she does much better. She seems to be happy and relaxed.
She has always had a small bald patch on one or both of her back legs, but we noticed, that the patches have grown greatly. On one back leg its about 4x8cm. Her skin looks and feels normal. She also has a small bald patch on one of her front legs. I saw her chewing and licking the hair. During the daytime she doesn´t groom her back leg.
She also has other issues. She has always been chubby and bloated, even tough we give her the correct amount of food. Her poop has always been very soft almost liquid like. We have been testing different hypoallergenic foods. Due to the changes in her diet, her poop is more solid, but still very soft. Hardly ever poop shaped. Sandy grooms her privates several times after using the toilet. The skin and the hair around her privates is usually vet and sometimes pink.
Her front legs are well developed, her back legs seem to be weak, underdeveloped.
Can allergy still be the underlying cause of her symptoms?
Thank you,
Bogi and Sandy
Hi Bogi. The signs could certainly be caused by an allergy, but it’s also worth checking that the food allergy trial you undertook was strict enough – there is a link in the text to my views on feline elimination diets. The leg weakness sounds like a separate issue though.
Hi thanks for replying, it’s not the first time, his grooming of stomach has been ongoing 6 months +, the vet examined thyroid and said it was OK, although no blood test taken. I forgot to mention he is on Meloxicam for past 3yrs for arthritis.
My 20 year old male cat is licking his stomach and side of hind legs raw. Vet said it could be stress or allergy. I’ve tried feliway diffuser, flea treatment, changed his litter and food type. Used hibiscrub from vet on legs which has helped, but his stomach is still pink and no fur.
Hi Lisa. They may be right, but I would also think about an underlying health condition if this is the first time it has happened. For example, in this article there is a cat who had thyroid disease and did the same thing. Alternatively, you may need a systemic treatment like prednisolone.
Hi thanks for replying, it’s not the first time, his grooming of stomach has been ongoing 6 months +, the vet examined thyroid and said it was OK, although no blood test taken. I forgot to mention he is on Meloxicam for past 3yrs for arthritis.
Hi Andrew,
My one cat has about a 1 inch bald patch on his tail and has been there for about one month which occurred following a fight with one of our other cats. I thought the fur would fill back in however it hasn’t, and has since been replaced with dry scaly skin. I have been trying to schedule an appointment with our vet however they’ve been very busy currently. Are there any treatments out there that I can use to try to help promote increased hair growth in his tail? This is the only bald patch that he has. It’s also very obvious as he is an all black cat.
Hi Allie. Sorry, without a diagnosis the best you could do would be to apply a good flea control.
Hey Andrew,
I’m at a loss and could use your help. My 8 y.o. male cat (not sure of his breed) is getting bald patches on his middle and lower belly, on his “ankles?” and on the Carpal pads.
I took him to the vet about a month ago and they gave him a steroid shot and said he is overall healthy and that it could be anxiety or psychological.
We haven’t changed his food, litter, or environment. His demeanor is normal and hasn’t changed in the slightest. He isn’t lethargic and still plays! It’s just very bazaar and we aren’t sure what’s wrong with him. We first noticed the balding about 4 months ago and have tried OTC anti-fungal spray as well as a vest to help prevent the licking. His urination and bowel movements are regular and don’t seem out of the ordinary and still eats and drinks. We have no other cats, animals or children.
Any advice would be so helpful!
Hi Jenna. As you can tell from the article, I only consider hair loss in cats to be psychological when the other more common causes have been ruled out. Firstly, always use a veterinary grade flea control, not one from the supermarket. Then, sometimes what your vet has done with a steroid trial (I use tablets or drops) is not a bad idea, and then a food trial.
Hi Andrew,
My 1 yr old Rex Cornish female completely lost hair on the back of her neck and the top of her head.
I had changed her food for a chicken and rice one because she was gaining weight… But the breeder told me that she may be allergic to chicken food. I have returned to the salmon food. As I read your article, Rexes race do have problems with hair loss. So should I worry about the fact my Rex become to have bald spot? Can I do something to make it regrowth? Or like Grendel, it can genetic and permanent hair loss?
Thank you
Hi Nathalie. Rex breeds have highly variable hair coverage from individual to individual, and it also changes with the seasons (I assume that you are entering summer which is typically the worst time). If the skin looks normal and there is no excessive scratching or licking, I would not be too concerned about allergy. As much as I cannot be sure without taking a look, it sounds normal to me.
Hi Andrew,
I think our cat has a patch of ringworm, it was a tiny spot that seemed like it was normal for him, a bit of uneven hair growth or something, but it suddenly got bigger. It’s on his shoulder blade area. The patch appears sore, though the other owner doesn’t seem to think its an issue requiring a vet visit. If we were to treat him for ringworm without a formal diagnosis is this dangerous? He is currently taking 2.5mg Felimazole twice daily for a thyroid condition. Thanks for your consideration and advice.
Hi Alison. It’s very unlikely to be ringworm at his age unless you’ve recently been handling kittens. Given that he is on anti-thyroid medication, it’s possible that this is a side effect, although we usually see the skin sores on the head. Regardless of cause, it’s more likely to be a bacterial infection than fungal (which are also rarely sore). By the way, I have a problem with using anti fungal creams on anything but very small areas in cats due to the inevitable ingestion that will occur.
Good Evening, what do you suggest to treat dandruff?
My 3 1/2 year old Burmese is an inside cat and has terrible dandruff. Her diet consists of Royal Canin, Neutered Young Female biscuits, raw chicken wings and beef cubes.
Thanks for any advice you can give.
Hi Alice. Dandruff usually has the same causes as hair loss, with particular emphasis on parasites. Therefore I would start with using Revolution and then see your vet for the other options.
However, severe dandruff in cats (click the link to read more) is special in that it can also be caused by a LACK of grooming. Since you have a breed prone to dental problems, it’s worth considering even at such a young age.