Lupus Hair Loss: What is it?

Lupus is an autoimmune disease in which our immune system fights against healthy tissues because the immune system confuses our bodies with foreign objects.

There are three types of lupus:

  • cutaneous,
  • systemic and
  • drug-induced lupus.

Cutaneous lupus affects the skin. Patients with this disease may have symptoms like severe fatigue, joint pain, joint swelling, headaches, a rash on the cheeks and nose, hair loss, anemia, blood-clotting problems and so on. Individual hair or hair clumps may fall out, or sometimes it just thins out. Hair loss in chronic cutaneous lupus is known as “scarring alopecia.”

Treatment for lupus hair loss patients involves suppressing the immune system, and alleviating the symptoms namely joint pain, headaches, with corticosteroids such as prednisone. In an 865-participant study by Lamore and colleagues, participants who received belimumab, a monoclonal antibody, had more improvements on lupus hair loss compared to the control group (1).

Why does lupus cause hair loss?

Lupus hair loss can be caused by the disease itself, especially the type of lupus called “chronic cutaneous lupus erythematosus.” This is the most common type of lupus. It may affect a patient’s scalp, leading to alopecia. In this sense, the patient’s immune system destroys hair follicles. In a study by Chung and colleagues, they found that from the biopsy specimens of 33 patients, participants’ scalps had a shortage of hair follicles at deep levels. Also, the size of hair follicles was smaller, and most of them were at the stages of catagen or telogen in which the hairs just last for a few days (2).

Since lupus patients usually take medications like corticosteroids and immunosuppressive drugs for controlling their condition, these medications can also cause a lot of side effects. One of them is hair loss (3).

What should you do?

Don’t wait to get treatment for your lupus condition. The sooner you are treated for lupus, the less hair loss you may suffer from. Go to see a dermatologist if you are aware of lupus hair loss.

Let your doctor know that you have hair loss while receiving lupus treatment, notably while taking corticosteroids or immunosuppressive medications. Your doctor can help adjust the dose of these meds and ensure that you get the best dose for both controlling the disease and reducing the side effects of the medications(4).

Avoid lupus flare-up as much as possible by managing your stress level, staying away from getting exposed to the sun which may be a trigger for the lupus flare-up, maintaining your healthy lifestyle and adhering to the treatment.

Some other things you can do to control your hair loss are:

References

  1. Lamore R, 3rd, Parmar S, Patel K, Hilas O. Belimumab (benlysta): a breakthrough therapy for systemic lupus erythematosus. P & T : a peer-reviewed journal for formulary management. 2012;37(4):212-26.
  2. Chung HJ, Goldberg LJ. Histologic features of chronic cutaneous lupus erythematosus of the scalp using horizontal sectioning: Emphasis on follicular findings. Journal of the American Academy of Dermatology. 2017;77(2):349-55.
  3. Qiao J, Sun Q, Jiang X, Fang H. Facial rash and alopecia in a patient with systemic lupus erythematosus. The Netherlands journal of medicine. 2017;75(3):125.
  4. Sinclair R. Diffuse hair loss. International journal of dermatology. 1999;38 Suppl 1:8-18.
  5. Herndon J. Systemic Lupus Erythematosus Healthline2016 [Available from: https://www.healthline.com/health/systemic-lupus-erythematosus#overview1.

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