Can Hair Loss Be a Symptom of Lupus?

Causes, Treatment, and How to Cope

Hair loss is common in people living with lupus. The autoimmune disease causes body-wide inflammation that attacks the joints and skin, including the scalp. This can result in hair loss (alopecia).

Lupus-related hair loss can occur slowly, causing hair to become noticeably thinner gradually. In addition, lupus can sometimes cause hair to fall out in clumps, leaving small, round bald patches behind. Medications used to treat lupus also are linked to hair loss.

This article takes an in-depth look at lupus and hair loss, including the causes, common medications that promote hair loss, and photos of lupus hair loss. It also discusses other possible causes of hair loss, treatment options, and the best ways to camouflage lupus hair.

Hairbrush with many strands of hair on white background
Maciej Toporowicz / Getty Images

What Is Alopecia?

Hair loss, formally known as alopecia, is common with certain conditions including autoimmune disorders like thyroid dysfunction or lupus. Patchy bald spots emerge quickly on the scalp, sometimes even within a few days.In some cases, the nails on your fingers and toes become brittle as well.

The hair loss is caused by the body's immune system, which misidentifies its own healthy hair follicles as a threat and begins to attack them.

There are many possible causes of hair loss, including the medications you take, your age, and physical or emotional stress. Sometimes, as is the case with lupus, an underlying condition leads to hair loss. Other possible causes include:

  • Heredity/genetics: Known medically as androgenetic alopecia, hereditary hair loss and thinning is the most common cause of hair loss. Typically, female hair thins while males will experience thinning hair, baldness, or both. There is no cure for this form of hair loss, but medical treatments may help stem the onset.
  • Chemical treatments: Hair dyes, tints, bleaches, straighteners, and other hair products with chemicals can cause weakness in the hair, making it brittle and causing it to break and fall out. If you encounter this form of alopecia, simply stop using chemical treatments until your hair has a chance to grow out.
  • Tinea: Fungal infections can lead to hair loss.
  • Nutritional deficiencies: Deficiencies in protein, iron, biotin, and zinc are all associated with hair loss.

Is Hair Loss a Symptom of Lupus?

Alopecia affects roughly 45% of people with lupus at some time and to some degree. It is common enough to have been coined "lupus hair." Hair loss most often occurs early on with the disease, and it can even be one of the first signs of the autoimmune disease.

Lupus-related hair loss can take different forms, depending on the type of lupus. In systemic lupus erythematosus (SLE), the most common form of lupus, hair loss can occur all over the scalp (diffuse) or only in certain spots (localized).

Localized alopecia in systemic lupus tends to occur on the front of the scalp and has a distinctive look. Sometimes referred to as lupus hairs, this type of hair loss results in lots of shorter or baby hairs framing the face and thinning patches along the hairline.

Hair loss typically coincides with lupus flare-ups and resolves when the disease is under control.

Non-Scarring Alopecia

Non-scarring alopecia associated with lupus is primarily caused by inflammation that attacks the scalp. This type of lupus-related hair loss often causes diffuse hair loss and not distinct bald patches.

Non-scarring hair loss in lupus is commonly mistaken for stress-related hair loss (telogen effluvium). Research, however, suggests that hair loss is related to the autoimmune basis of systemic lupus.

Scarring Alopecia

Scarring alopecia is the result of skin lesions on the scalp that damage hair follicles. Lesions (sores) can be red, thick, and scaly and typically do not itch or hurt. Inflammatory cells infiltrate the outer root sheath of hair follicles, causing fibrosis (thickening) of the follicular structure.

This results in scarring that causes permanent bald patches that are round or misshapen, and about the size of a coin. Discoloration of the skin is common. Scarring alopecia is not reversible. 

It occurs with specific types of lupus, including chronic cutaneous or discoid lupus erythematosus and subacute cutaneous lupus.

Lupus Medications

Medications used to treat lupus, such as prednisone and other immunosuppressives, can lead to hair loss.

Azathioprine (Imuran, Azasan) is a drug often used to treat lupus, as is methotrexate (Rheumatrex). Hair loss and other side effects like nausea or urinary problems are common with these drugs.

Other medications that can lead to hair loss include:

  • Cellcept (mycophenolate mofetil) 
  • Cytoxan (cyclophosphamide)
  • Lupkynis (voclosporin)
  • Plaquenil (hydroxychloroquine) 

Lupus can lead to hair loss in parts of the body other than the scalp, including eyebrows, eyelashes, beards, and body hair.

Normal Growth vs. Hair Loss

People typically shed between 50 to 100 hairs a day.In general, 90% of a person’s hair grows at any given moment (anagen phase) with the remaining 10% in a resting phase (telogen phase), which lasts about three months.Lupus-related hair loss may be gradual, but it comes on suddenly in some people whose hair strands come out in clumps.

This photo contains content that some people may find graphic or disturbing.

systemic lupus hair loss
Hair loss caused by systemic lupus.

DermNet / CC BY-NC-ND

Treatments and Management of Lupus-Related Hair Loss

Hair loss from lupus often stops once the autoimmune disease is treated and under control. Types of medications used to treat lupus and put the disease into remission include:

  • Antimalarial drugs such as Plaquenil and Aralen (chloroquine phosphate)
  • BlyS-specific inhibitors such as Benlysta (belimumab), newer biologic drugs delivered intravenously to inhibit B-lymphocyte stimulator (BLyS) protein
  • Immunosuppressants such as Imuran, Cellcept, and methotrexate

Plaques on the skin and scalp are treated with a combination of topical, oral, and injectable medications. In addition to those listed above, medications to treat skin lesions include:

  • Corticosteroids delivered topically, orally, or by injection directly into the plaques to relieve inflammation
  • Protopic (tacrolimus), a topical immunosuppressant ointment 

Skin lesions can cause scarring and significant damage to hair follicles. Treating scalp plaques promptly may prevent bald spots.

Stay Out of The Sun

Lupus can make your skin and scalp more sensitive to the sun. A mild sunburn on your scalp can trigger an outsized autoimmune response that causes skin lesions. These plaques can damage hair follicles and lead to bald patches.To prevent sunburn that leads to hair loss, keep your head covered when it is sunny outside.

Natural Remedies for Lupus Hair Loss

In addition to managing lupus flares, these other things can help with lupus hair loss:

  • Eat a balanced diet with ample protein, fats, and micronutrients.
  • Get regular exercise, which can help to keep stress in check.
  • Lower stress levels using stress-reduction techniques such as yoga, meditation, or breathing exercises.

Vitamins, minerals, and other supplements may help to keep hair healthy. Biotin, a B vitamin, is often recommended for hair health, however, there is limited research to prove its effectiveness.

Other nutrients that may promote healthy hair include healthy fats including omega-3 fatty acids, vitamins A, B, C, and D, and minerals including zinc, iron, copper, selenium, calcium, and magnesium.

Interaction Warnings

Dietary supplements may interfere with some medications. It is important to talk to your rheumatologist or pharmacist before taking any supplements.

Styling Lupus Hair

The right hairstyle can help camouflage thinning lupus hair. Changing your part, cutting it shorter, or adding layers will give the illusion of thicker and fuller hair while hiding bald spots. Hair extensions, wigs, scarves, and hats can also be used to hide bald spots and thinning.

To minimize hair breakage, be gentle with your hair. Avoid heated styling tools like hot curlers, curling irons, and flat irons or straighteners. Blow-dry hair on cool or low settings. You should also not tease hair or secure it too tightly with an elastic or barrette, and use caution when dying or bleaching hair.

Can Hair Transplants Treat Lupus Hair Loss?

Hair transplants may help people with lupus fill in bald patches caused by scarring alopecia as well as overall hair thinning. A hair transplant is a surgical procedure that moves hair from one part of your body and implants it into bald spots.

Hair grafting, the most common hair transplant procedure, removes small pieces of skin (a graft) with healthy hairs from the back of your head to transplant into bald or thinning areas. This is typically done by a dermatologist or plastic surgeon using a local anesthetic.

A hair transplant should only be considered if your lupus is well controlled. Otherwise, the underlying inflammation that contributed to hair loss in the first place makes it difficult for transplanted hair to become established.

This photo contains content that some people may find graphic or disturbing.

discoid lupus lesions on scalp
Discoid lesions on scalp.

DermNet / CC BY-NC-ND

When to See a Healthcare Provider

A health care professional should evaluate any type of excessive shedding or hair loss. Your hair loss may be caused by a condition other than your lupus, or you may have a combination of hair loss from lupus and something else.

People with lupus generally see their rheumatologist every three to four months. If you are experiencing mild hair loss, be sure to tell your healthcare provider at the next appointment.

Your rheumatologist may recognize your symptoms and be able to diagnose you based on your history, physical exam, and laboratory tests alone. In addition, non-lupus causes of hair loss, ranging from fungal infections to thyroid disorders should be ruled out, rather than simply assuming the hair loss is due to your lupus.

Skin lesions on the scalp should be treated promptly to prevent scarring and permanent bald spots. Call your rheumatologist immediately if you have a lesion or rash on your scalp. You should also call if you are losing clumps of hair or if the hair loss coincides with starting a new medication.

A biopsy of the scalp is sometimes needed to determine the exact reasons for hair loss. The procedure removes a small patch of skin that is examined under a microscope. Local anesthesia is typically used to numb the scalp before using a scalpel to take a skin sample.

While hair loss can be a side effect of certain medications, it is also associated with conditions unrelated to lupus, such as anemia and thyroid disease. Your provider may take blood work to rule out other potential causes of hair loss.


Hair loss associated with lupus is typically due to an autoimmune response that attacks the scalp. This inflammation can lead to excessive hair shedding that causes overall thinning. Medications used to treat lupus can cause hair loss as well.

Lupus subtypes that affect the skin can also cause scalp lesions and clumps of hair to fall out. If not promptly treated, these lesions can scar, leaving permanent bald spots. 

The primary treatment for lupus-related hair loss is managing the underlying autoimmune disease. Lupus-modifying medications include immunosuppressants, antimalarial drugs, and biologics.

Hair loss can also be caused by other underlying health conditions, including thyroid disease and anemia. Excessive hair shedding and hair loss should be evaluated by your healthcare provider.

A Word From Verywell

Hair loss is common in people with lupus. While other lupus symptoms are concerning from a medical standpoint, hair loss often takes a toll on your emotional health. In addition to treating the underlying causes of hair loss, a good hair stylist can help. The right hairstyle can minimize the appearance of your hair loss and help you feel more confident.

Frequently Asked Questions

  • Is hair loss from lupus reversible?

    It depends. Lupus-related hair loss is often reversible once treatment begins, or in the case of drug-induced hair loss, when the offending drug is discontinued.

    Hair loss caused by lesions on the scalp, on the other hand, may be permanent if scarring is involved. Scarring alopecia is common in types of lupus that affect the skin, including discoid lupus.

  • What does lupus hair look like?

    The term "lupus hair" refers to broken hairs and hair regrowth of shorter hairs along the hairline.

  • What does lupus on the scalp look like?

    Some types of lupus cause lesions on the scalp. These can be perfectly round or misshapen patches that are red and covered in crusty scales. Hair loss is common at the site of these lesions.

  • What autoimmune disease makes your hair fall out?

    Autoimmune conditions that can cause hair loss include: 

    • Alopecia areata
    • Alopecia universalis
    • Crohn’s disease
    • Graves’ disease
    • Hashimoto’s disease
    • Lupus
    • Psoriasis
    • Rheumatoid arthritis
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Jeri Jewett-Tennant, MPH
Jeri Jewett-Tennant, MPH, is a medical writer and program development manager at the Center for Reducing Health Disparities.