Lupus, also known as systemic lupus erythematosus or SLE, is a complicated autoimmune disease that can have a wide range of effects on a person’s health, including thinning hair and hair loss.
While hair loss might not be the most severe of symptoms associated with lupus, it certainly adds a lot to the stress and challenge of managing this condition.
Read on to understand the connection between lupus and hair loss, how it’s treated and how you can support healthy hair regrowth.
What Is Lupus?
Lupus is a complex disease that occurs when your immune system mistakenly identifies healthy tissue and organs as threats. When the immune system fights back against a perceived threat, it also creates inflammation, which means lupus often causes pain and swelling that can affect the joints, skin, kidneys, brain, heart and lungs, among other bodily systems.
Anyone can develop lupus, but it’s most common in women. In fact, according to the Lupus Foundation of America, about 1.5 million Americans have lupus, and 9 out of 10 of lupus patients are women.
On top of that, evidence shows that certain groups are at higher risk for developing lupus, including:
- Women ages 15 to 44
- Certain racial or ethnic groups — including people who are African American, Asian American, Hispanic/Latino, Native American or Pacific Islander.
- People who have a family member with lupus or another autoimmune disease like thyroid disease, rheumatoid arthritis or hay fever, for example.
While systemic lupus erythematosus (SLE) is the most common form of lupus, and it’s most often the type people refer to, three other forms of lupus exist:
- Cutaneous lupus erythematosus: A form of lupus that develops in two-thirds of people who have lupus, affecting the skin
- Drug-induced lupus: A lupus-like disease caused by specific drugs, like some blood pressure medications, anti-seizure medications and antibiotics
- Neonatal lupus: A rare condition that affects infants of women who have lupus
What Causes Lupus?
Unfortunately, autoimmune diseases aren’t well understood, and the exact causes of lupus are unknown. What is known is that autoimmune diseases like lupus run in families and people who have one autoimmune disease are at a higher risk for developing others.
While the exact causes aren't known, experts do think that lupus might be related to hormonal responses to estrogen in the body, and it can develop as a response to certain environmental triggers like toxins, certain medications or infections and sunlight.
As a result, doctors believe that lupus is caused by a complex interplay of genes, hormones, and environmental factors.
Can Lupus Cause Hair Loss?
Yes. While not everyone with lupus experiences hair loss, because lupus has a wide variety of impacts on the body, it can cause hair loss in a variety of ways.
People living with lupus might notice gradual thinning or breakage of the hair along their hairline, or they might notice thinning of the hair all over their heads. Other more serious bouts of inflammation caused by the disease might cause scarring that leads to hair loss.
Hair loss caused by lupus can be temporary or permanent, depending on the underlying cause and its severity.
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The Connection Between Hair Loss and Lupus
Hair loss is not uncommon in people with lupus. Over half of lupus patients experience hair loss at one point or another, although it most often happens in the early stages of the disease and can be one of the early warning signs.
There are different ways that lupus can induce or cause hair loss, though they can all be grouped into two main categories: scarring and non-scarring. Non-scarring forms of hair loss can be reversible and often clear up once the lupus is being treated and managed effectively. With scarring forms of hair loss, hair follicles might be irreversibly damaged, which leads to permanent hair loss.
When hair loss is caused by general systemic lupus, it’s typically due to body-wide inflammation that interferes with the normal functioning of hair follicles. This is a non-scarring alopecia and tends to resolve itself when treatment helps get disease activity under control and into remission.
“Diffuse hair loss that's non-scarring: this is the most common type of hair loss linked to lupus,” explained Dr. Maryann Mikhail, a board-certified dermatologist with Waverly DermSpa. It could lead to a general thinning of hair all over the scalp, but it often leads to the thinning and weakening of hair at the front of the head. Called “lupus hair,” it’s characterized by fragile hair that breaks off easily, leaving short and ragged hair around the hairline.
Discoid Sores and Lesions
Hair loss might also be caused by a type of cutaneous lupus erythematosus called discoid lupus erythematosus or DLE.
“This is a specific form of lupus that affects the face, ears and scalp. It starts with coin-shaped inflammation that eventually scars. It's important to treat this early to stop the progression. Once scarred over, you can't get the hair back,” said Dr. Mikhail.
While it's most common in and around the face and scalp, DLE causes round lesions or sores that can appear anywhere on the body and can also lead to permanent scarring. When these lesions happen on the scalp and scar, they damage the follicles and may cause permanent hair loss.
Medication used to manage lupus, like prednisone and other immunosuppressives, can also lead to hair loss. In this case, your doctor might be able to adjust your treatment plan. Typically, this type of hair loss is reversible and will stop soon after you discontinue the medication.
Telogen effluvium is a type of hair loss that typically happens when the body undergoes a sudden change or shock. In the case of lupus, it often happens when there is a flare-up of the disease or a change in medications.
Dr. Mikhail explained that TE is a stress response hair loss that occurs two to three months after the stress, which for lupus patients means major illnesses or change in medications. "It looks like major shedding that happens quickly,"she said. "Generally, it reverses itself over time.”
So while telogen effluvium can feel drastic and scary, it is a non-scarring form of alopecia that is generally only temporary since the follicles don’t undergo serious damage.
Alopecia areata (or AA) is a form of hair loss that’s generally understood to be caused by an underlying immune disorder and, therefore, could co-occur with lupus. In some cases, lupus might even be misdiagnosed as AA. Alopecia areata is characterized by coin-shaped or patchy hair loss that typically happens on the scalp but could happen anywhere on the body.
Aside from patchy hair loss, another telltale sign of AA is exclamation point hair, which can be observed in the patches of hair loss. These hairs look like exclamation points since they are short and taper inwards toward the scalp when looked at under a microscope.
Different types of alopecia areata can vary in duration and severity, but the good news is that AA is a non-scarring form of hair loss and typically resolves within a year of onset.
When To See A Doctor for Hair Loss
If you’ve already been diagnosed with lupus, your alopecia may or may not be caused by the disease, so it’s important to have a doctor diagnose the underlying cause and undergo the most appropriate treatment.
Bottom line? “Hair loss may be an early sign of lupus before the disease is diagnosed,"said Dr. Ailynne Marie Vergara-Wijangco, board-certified dermatologist and medical advisor at Thank Your Skin. "But many other disorders can cause hair loss, so consult with your doctor if you notice unusual hair thinning or hair loss.”
Related: 6 Times You Should See a Trichologist
How Is Lupus-Related Hair Loss Treated?
Treatment of lupus-related alopecia will depend on the underlying cause.
“The most important thing is to get the lupus under control with treatment and sun protection, including sun protection of the scalp," said Dr. Mikhail. "Lupus treatment ranges from anti-malarial medication, oral prednisone and other immunosuppressants. If there's itching or visible signs of inflammation, we might offer a topical steroid.”
If you’re experiencing a case of telogen effluvium, time and patience are key since it can take several months to see visible signs of hair regrowth. Be gentle with your hair while the natural growth cycles recover, and support healthy hair growth with the tips covered below.
Dr. Mikhal also explained that with discoid lupus, treatment could include topical or injectable steroids in milder cases. Antimalarial medicines, other immunosuppressants or other topicals might be necessary for more severe discoid lesions.
If it’s determined that medication is causing hair loss, work with your doctor to amend your treatment plan where possible.
Can Hair Loss From Lupus Be Reversed?
“In most cases, your hair will grow back when your lupus is treated," said Dr. Vergara-Wijangco. "But some people with lupus develop round (discoid) lesions on the scalp. Because these discoid lesions scar your hair follicles, they do cause permanent hair loss.”
Healthy Lifestyle Changes To Support Hair Regrowth
The best way to encourage healthy hair growth is through a holistic approach to your general health, and there are some especially important tips for managing alopecia and general health for lupus patients.
Avoid Sun Exposure
People with lupus need to be especially careful about sun exposure since this can trigger or worsen symptoms. Protect your skin and head when outdoors by always wearing a hat and applying sunscreen.
Eat a Healthy Diet
A diet rich in a variety of fruits and vegetables, whole grains and moderate amounts of animal protein is the best way to get the vitamins and minerals your body needs to support hair growth. Vitamins for hair growth include biotin, vitamin C, vitamin D, and zinc — all of which you can get by popping a daily dose of GRO Biotin Gummies. However, some supplements might interfere with medications used to treat lupus, so be sure to talk to your doctor before adding new supplements to your routine.
Stress is a known lupus trigger, so it's vital to actively and proactively manage stress. Stress also plays a role in hair loss and regrowth. Add exercise, meditation and other things to support relaxation to your routine.
Get Plenty of Rest
Sleep at least eight hours a night to give your body the downtime it needs to heal. Sleep is essential for myriad reasons, and research has shown that timing, length and quality of sleep can impact levels of cortisol in your body, otherwise known as "the stress hormone."
Sleep On An Extra-Soft Pillowcase
To protect new hair and sensitive follicles from friction, consider a pillowcase designed to protect your hair. Not only is reduced friction ideal for stressed out hair follicles, but it's good for your skin, too.
Treat Your Hair With TLC
Avoid hair care treatments that stress your hair or your scalp, like coloring and blowouts. Also avoid frequent brushing, tight rollers or up do’s until your lupus is being managed and your hair growth is back to normal.
Keep Your Hair Moisturized
Dry strands break more easily, so keep your locks luscious with a good conditioner after shampooing. Speaking of shampoo: skip shampoos that might strip hair of natural moisture by avoiding ingredients like sulfates, and opt instead for shampoos that have been developed to nourish both your scalp and strands.
VEGAMOUR's GRO Revitalizing Shampoo contains a revolutionary (and proprietary) chemical-free vegan keratin, Karmatin™, a microencapsulated vegan b-silk™ protein that's designed to help soothe damaged follicles while making strands soft and shiny.
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