Lupus Related Hair Loss

When opening a trichology clinic, we commit to helping the people who walk through our doors. Many of those guests will be battling autoimmune conditions that affect their hair—its growth, quality, and even how they feel about themselves. One such condition is lupus. Guests fighting lupus may arrive wearing wide-brimmed hats, long sleeves, and gloves to protect themselves from UV light. They may also wear wigs daily and represent a wide range of demographics—they could be African American, white, or even male.

Dr. Don Thomas, a rheumatologist associated with the Lupus Foundation of America, highlights that 60% of patients with lupus experience alopecia. Lupus is a chronic autoimmune disease where the immune system attacks healthy tissue. UV light is a common trigger, initiating flares that cause inflammation. Normally, our bodies repair UV-induced damage, but with lupus, the immune system reacts abnormally, causing further harm. This inflammation can occur locally or impact organs and joints. Discoid lupus affects 20% of people with systemic lupus and often causes skin rashes. This can cause lupus related hair loss. When this rash occurs on the scalp or face, it progresses outward with a round border, leaving scarring alopecia in its wake. Discoid lupus lesions can appear with scaling, hypo- or hyper-pigmentation, and raised edges. Unfortunately, once scarring has occurred, hair cannot regrow in the affected areas.

Treating discoid lupus flares quickly is crucial. Topical steroids prescribed by a dermatologist can help, as can intralesional steroid injections to calm the immune attack on the hair follicle. Sometimes, antimalarials like hydroxychloroquine—used for systemic lupus—can also help achieve remission. However, the worst thing someone can do during a flare is nothing, as delays in treatment increase the risk of permanent scarring.

Common medications for lupus include NSAIDs, immunosuppressives, steroids, antimalarials like hydroxychloroquine, and monoclonal antibodies. These treatments can cause hair loss as a side effect. Guests experiencing severe, chronic shedding are encouraged to discuss medication options with their doctors. However, caution is essential with supplements like biotin, which may interfere with lab results, a frequent need for lupus patients.

During scalp assessments, follicular plugging may be noticed, a hallmark sign of discoid lupus. Bullous lupus blisters, though rare, are unique to this condition. Fungal imbalances are also common when immunosuppressives are used, and ketoconazole shampoo can offer relief in these cases. For areas unaffected by flares, Minoxidil often works well to encourage regrowth. However, waiting until flares subside is critical, as cytokines present during active inflammation can worsen the condition. Pruritus affects 76.8% of lupus patients, with 40.5% reporting scalp itching. This “pure itch” can also feel like crawling, burning, or tingling sensations. Anti-inflammatory scalp care can help manage these symptoms.

Smoking significantly reduces the effectiveness of lupus treatments and worsens symptoms. Guests who smoke are encouraged to consider quitting, as it may improve their treatment outcomes. Making small, consistent changes to routines can also help guests manage their condition better. For instance, incorporating UV protection—such as wearing hats, long sleeves, and sunscreen—is an essential habit to build.

A compassionate, informed approach to managing lupus-related hair issues can make a significant difference. By staying educated on the latest developments and creating a supportive environment, Trichologists can help guests navigate their autoimmune hair loss. Understanding the challenges of lupus allows us to provide personalized advice, helping achieve the best possible outcomes for people's hair and scalp health.

Ready to take control of your hair health? Whether you're dealing with hair thinning, scalp concerns, or looking for advanced regrowth treatments, I’m here to help. As a trichologist in Pittsfield, MA, I offer personalized solutions tailored to your unique needs, including scalp care, laser therapy, and growth factor treatments. Book your consultation today and start your journey toward healthier, stronger hair. Let’s work together to create a plan that works for you.

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