Hair Loss When You Have Lupus

Causes, Treatment, and How to Cope

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If you've been losing your hair when you have lupus, you may be wondering if this is normal. Why would this disease lead to hair loss? And, is there anything you can do?

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

Symptoms of Hair Loss in Lupus

Lupus, systemic lupus erythematosus (SLE), is a condition marked by a wide range of symptoms. While not as serious as some of the other symptoms of lupus, hair loss can still be bothersome.

Alopecia—the medical term for hair loss—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 the first sign that alerts people to its presence.

With lupus, there are generally two forms of hair loss. One results in scarring and the other does not.

Scarring alopecia most commonly results from lupus associated with skin diseases alone such as discoid lupus erythematosus or subacute cutaneous lupus, rather than with systemic lupus. In these conditions, lupus interferes with the normal functioning of the hair follicle.

With systemic lupus, hair loss can be either diffuse (all over) or localized (only in certain spots). When it is localized, it occurs most commonly on the front part of the scalp. Many short hairs at the front of the scalp have been coined "lupus hairs."

Hair loss may occur only on the scalp or may involve other regions of the body such as eyebrows, eyelashes, and body hair. Some people notice their hair thinning, while others note that their hair falls out in clumps or patches.

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

Normal Growth vs. Hair Loss

It’s not unusual to wash your hair and find a number of stray hairs in the bathtub. Sometimes, it may even seem like more than normal. But losing 50 to 100 hairs a day is perfectly common.

Generally speaking, 90% of a person’s hair is growing at any given moment, with the remaining 10% in a “resting phase.” The growth phase (anagen phase) can last from two to six years, after which the hair follicle enters resting phase (telogen phase), which lasts about three months. After the resting phase, hair is shed. A new hair grows where the last one shed, and the cycle begins anew.

Causes

There are general reasons for hair loss, as well as reasons specific to lupus.

Reasons for Hair Loss in General

There are several reasons why a person might experience excessive hair loss in addition to those caused by lupus. Those reasons include:

  • Heredity/genetics: Known medically as androgenetic alopecia, hereditary hair loss and thinning is the most common cause of hair loss. Typically, women will experience thinning hair while men 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.
  • Alopecia areata: A bit of a mystery, alopecia areata is believed to be an autoimmune disease in which the body forms antibodies that attack its own hair. The disease causes hair loss marked by totally smooth, round patches about the size of a coin or larger. It may even result in complete loss of scalp and body hair, though this is rare.
  • Chemical treatments: Hair dyes, tints, bleaches, straighteners, and other hair products with chemicals can cause weakness of 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.
  • Telogen effluvium: Many people lose hair after a severe illness, with stress, as well as after pregnancy. (Learn more about telogen effluvium.)
  • Tinea: Fungal infections can lead to hair loss.
  • Traumatic alopecia: Continuously playing with hair can cause hair breakage.
  • Nutritional deficiencies: Deficiencies in protein, iron, biotin, zinc are all associated with hair loss.
  • Thyroid conditions: Both hypo and hyperthyroidism can lead to hair loss.

Reasons for Hair Loss With Lupus

With lupus, hair loss may be related to any of the causes of hair loss found in people without the disease, but can also be related to the disease itself or the treatments for the disease.

With systemic lupus, it's thought that hair loss is related to the autoimmune basis of the disease.

With discoid lupus, permanent damage to the hair follicle resulting from scarring leads to hair loss.

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

Diagnosis of Lupus-Associated Hair Loss

Making the correct diagnosis as to the causes of your hair loss is important. If your hair loss is related to a flare of your disease, it will regrow in time.

Non-lupus causes, ranging from fungal infections to thyroid disorders need to rule out, rather than simply assuming the hair loss is due to your lupus.

Your rheumatologist may recognize your symptoms and be able to diagnose you based on your history, physical exam, and laboratory tests alone.

Sometimes a biopsy (skin biopsy of the scalp) will be needed to determine the exact reasons.

Is Lupus Hair Permanent?

Many people worry that their hair loss with lupus will be permanent. Sometimes it can be.

Whether or not your hair will return depends on the cause of the loss.

That said, much of the hair loss with lupus is reversible once treatment begins, or in the case of drug-induced hair loss, when the offending drug is discontinued.

When hair loss occurs due to scarring involving the hair follicle (discoid lesions on the scalp), however, the loss may be permanent. Discoid lupus is a major cause of "scarring" alopecia.

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

Treatment

Getting good control of your lupus usually results in good control of your hair loss as well.

In addition, when your disease is controlled, some of the medications, for example, steroids, can be tapered or discontinued, resulting in an improvement in hair loss.

People have tried a number of nutritional supplements, such as biotin. But at this time, there is no strong evidence they work.

Since dietary supplements may interfere with some medications, it is important to talk to your rheumatologist before taking any supplements.

Coping

Coping with hair loss is frustrating. While many of the other symptoms of lupus are more concerning from a medical standpoint, hair loss is something that is seen each time you look in the mirror.

It's important to talk to your rheumatologist about your 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. Getting an accurate diagnosis is important.

With reversible hair loss, the goal will be doing whatever is needed to help you cope with your hair loss until it grows back. Sometimes a good stylist can find you a style which minimizes the appearance of your hair loss, either covering bald spots and choosing a cut which makes your hair appear thicker. Hair extensions may help as well.

With both temporary and permanent hair loss, options such as wigs, scarves, and hats can be helpful. There are many options available, some of which are very attractive.

People have wondered about the option of hair transplants. Unfortunately, the process that resulted in your hair loss in the first place may also reduce the chances for transplanted hair to become established, although sometimes it is successful. Talk to your dermatologist about the best options for you.

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10 Sources
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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