Table of ContentsView AllTable of ContentsWhat Is Alopecia?SymptomsTreatment and ManagementWhen to See a Healthcare ProviderFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is Alopecia?
Symptoms
Treatment and Management
When to See a Healthcare Provider
Frequently Asked Questions
Hair loss is common in people living withlupus. 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.
Maciej Toporowicz / Getty Images
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.
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:
Hair Loss (Alopecia)
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. Insystemic lupus erythematosus(SLE), the most common form of lupus, hair loss can occur all over the scalp (diffuse) or only in certain spots (localized).
Hair loss typically coincides with lupus flare-ups and resolves when the disease is under control.
Early Signs of Lupus in Females
Non-Scarring Alopecia
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 chroniccutaneousordiscoid lupus erythematosusand subacute cutaneous lupus.
Microneedling for Hair Loss: At-Home vs. Professional Results
Lupus Medications
Medications used totreat lupus, such as prednisone and other immunosuppressives, can lead to hair loss.
Azathioprine(Imuran, Azasan) is a drug often used to treat lupus, as ismethotrexate(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:
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 LossPeople 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.
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.See Photo
This photo contains content that some people may find graphic or disturbing.
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:
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:
Skin lesions can cause scarring and significant damage to hair follicles. Treating scalp plaques promptly may prevent bald spots.
Stay Out of The SunLupus 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.
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:
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 WarningsDietary supplements may interfere with some medications. It is important to talk to your rheumatologist or pharmacist before taking any supplements.
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.
Which Vitamin Deficiency Causes Hair Loss?
Can Hair Transplants Treat Lupus Hair Loss?
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.See PhotoDiscoid lesions on scalp.DermNet /CC BY-NC-ND
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.
Summary
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.
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.
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.
The term “lupus hair” refers to broken hairs and hair regrowth of shorter hairs along the hairline.
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.
Autoimmune conditions that can cause hair loss include:Alopecia areataAlopecia universalisCrohn’s diseaseGraves’ diseaseHashimoto’s diseaseLupusPsoriasisRheumatoid arthritis
Autoimmune conditions that can cause hair loss include:
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alessandrini A, Starace M, Bruni F et al.Alopecia areata incognita and diffuse alopecia areata: clinical, trichoscopic, histopathological, and therapeutic features of a 5-year study.Dermatol Pract Concept. 2019:272-277. doi:10.5826/dpc.0904a05Desai K, Miteva M.Recent Insight on the Management of Lupus Erythematosus Alopecia.Clin Cosmet Investig Dermatol. 2021 Mar 30;14:333-347. doi:10.2147/CCID.S269288.American Academy of Dermatology.Do you have hair loss or hair shedding?Concha JSS, Werth VP.Alopecias in lupus erythematosus.Lupus Science & Medicine.2018;5:e000291. doi:10.1136/lupus-2018-000291Udompanich S, Chanprapaph K, Suchonwanit P.Hair and scalp changes in cutaneous and systemic lupus erythematosus.Am J Clin Dermatol. 2018;19(5):679-694. doi:10.1007/s40257-018-0363-8Lupus Foundation of America.Medications used to treat lupus.Saleh D, Cook C.Anagen effluvium. In: StatPearls.Gong Y, Ye Y, Zhao Y, et al.Severe diffuse non-scarring hair loss in systemic lupus erythematosus - clinical and histopathological analysis of four cases.J Eur Acad Dermatol Venereol. 2013;27(5):651-4. doi:10.1111/j.1468-3083.2011.04388.xCenters for Disease Control and Prevention.Diagnosing and treating lupus.Milam EC, Ramachandran S, Franks AG.Treatment of scarring alopecia in discoid variant of chronic cutaneous lupus erythematosus with tacrolimus lotion, 0.3.JAMA Dermatol. 2015;151(10):1113-6. doi:10.1001/jamadermatol.2015.1349Hosking AM, Juhasz M, Atanaskova Mesinkovska N.Complementary and alternative treatments for alopecia: A comprehensive review.Skin Appendage Disord. 2019;5(2):72–89. doi:10.1159/000492035American Society of Plastic Surgeons.Hair transplantation and restoration: What hair transplant procedures are recommended for women?Ekelem C, Pham C, Atanaskova Mesinkovska N.A systematic review of the outcome of hair transplantation in primary scarring alopecia.Skin Appendage Disord. 2019;5(2):65–71. doi:10.1159/000492539Lupus Foundation of America.Hair loss and lupus.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alessandrini A, Starace M, Bruni F et al.Alopecia areata incognita and diffuse alopecia areata: clinical, trichoscopic, histopathological, and therapeutic features of a 5-year study.Dermatol Pract Concept. 2019:272-277. doi:10.5826/dpc.0904a05Desai K, Miteva M.Recent Insight on the Management of Lupus Erythematosus Alopecia.Clin Cosmet Investig Dermatol. 2021 Mar 30;14:333-347. doi:10.2147/CCID.S269288.American Academy of Dermatology.Do you have hair loss or hair shedding?Concha JSS, Werth VP.Alopecias in lupus erythematosus.Lupus Science & Medicine.2018;5:e000291. doi:10.1136/lupus-2018-000291Udompanich S, Chanprapaph K, Suchonwanit P.Hair and scalp changes in cutaneous and systemic lupus erythematosus.Am J Clin Dermatol. 2018;19(5):679-694. doi:10.1007/s40257-018-0363-8Lupus Foundation of America.Medications used to treat lupus.Saleh D, Cook C.Anagen effluvium. In: StatPearls.Gong Y, Ye Y, Zhao Y, et al.Severe diffuse non-scarring hair loss in systemic lupus erythematosus - clinical and histopathological analysis of four cases.J Eur Acad Dermatol Venereol. 2013;27(5):651-4. doi:10.1111/j.1468-3083.2011.04388.xCenters for Disease Control and Prevention.Diagnosing and treating lupus.Milam EC, Ramachandran S, Franks AG.Treatment of scarring alopecia in discoid variant of chronic cutaneous lupus erythematosus with tacrolimus lotion, 0.3.JAMA Dermatol. 2015;151(10):1113-6. doi:10.1001/jamadermatol.2015.1349Hosking AM, Juhasz M, Atanaskova Mesinkovska N.Complementary and alternative treatments for alopecia: A comprehensive review.Skin Appendage Disord. 2019;5(2):72–89. doi:10.1159/000492035American Society of Plastic Surgeons.Hair transplantation and restoration: What hair transplant procedures are recommended for women?Ekelem C, Pham C, Atanaskova Mesinkovska N.A systematic review of the outcome of hair transplantation in primary scarring alopecia.Skin Appendage Disord. 2019;5(2):65–71. doi:10.1159/000492539Lupus Foundation of America.Hair loss and lupus.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Alessandrini A, Starace M, Bruni F et al.Alopecia areata incognita and diffuse alopecia areata: clinical, trichoscopic, histopathological, and therapeutic features of a 5-year study.Dermatol Pract Concept. 2019:272-277. doi:10.5826/dpc.0904a05Desai K, Miteva M.Recent Insight on the Management of Lupus Erythematosus Alopecia.Clin Cosmet Investig Dermatol. 2021 Mar 30;14:333-347. doi:10.2147/CCID.S269288.American Academy of Dermatology.Do you have hair loss or hair shedding?Concha JSS, Werth VP.Alopecias in lupus erythematosus.Lupus Science & Medicine.2018;5:e000291. doi:10.1136/lupus-2018-000291Udompanich S, Chanprapaph K, Suchonwanit P.Hair and scalp changes in cutaneous and systemic lupus erythematosus.Am J Clin Dermatol. 2018;19(5):679-694. doi:10.1007/s40257-018-0363-8Lupus Foundation of America.Medications used to treat lupus.Saleh D, Cook C.Anagen effluvium. In: StatPearls.Gong Y, Ye Y, Zhao Y, et al.Severe diffuse non-scarring hair loss in systemic lupus erythematosus - clinical and histopathological analysis of four cases.J Eur Acad Dermatol Venereol. 2013;27(5):651-4. doi:10.1111/j.1468-3083.2011.04388.xCenters for Disease Control and Prevention.Diagnosing and treating lupus.Milam EC, Ramachandran S, Franks AG.Treatment of scarring alopecia in discoid variant of chronic cutaneous lupus erythematosus with tacrolimus lotion, 0.3.JAMA Dermatol. 2015;151(10):1113-6. doi:10.1001/jamadermatol.2015.1349Hosking AM, Juhasz M, Atanaskova Mesinkovska N.Complementary and alternative treatments for alopecia: A comprehensive review.Skin Appendage Disord. 2019;5(2):72–89. doi:10.1159/000492035American Society of Plastic Surgeons.Hair transplantation and restoration: What hair transplant procedures are recommended for women?Ekelem C, Pham C, Atanaskova Mesinkovska N.A systematic review of the outcome of hair transplantation in primary scarring alopecia.Skin Appendage Disord. 2019;5(2):65–71. doi:10.1159/000492539Lupus Foundation of America.Hair loss and lupus.
Alessandrini A, Starace M, Bruni F et al.Alopecia areata incognita and diffuse alopecia areata: clinical, trichoscopic, histopathological, and therapeutic features of a 5-year study.Dermatol Pract Concept. 2019:272-277. doi:10.5826/dpc.0904a05
Desai K, Miteva M.Recent Insight on the Management of Lupus Erythematosus Alopecia.Clin Cosmet Investig Dermatol. 2021 Mar 30;14:333-347. doi:10.2147/CCID.S269288.
American Academy of Dermatology.Do you have hair loss or hair shedding?
Concha JSS, Werth VP.Alopecias in lupus erythematosus.Lupus Science & Medicine.2018;5:e000291. doi:10.1136/lupus-2018-000291
Udompanich S, Chanprapaph K, Suchonwanit P.Hair and scalp changes in cutaneous and systemic lupus erythematosus.Am J Clin Dermatol. 2018;19(5):679-694. doi:10.1007/s40257-018-0363-8
Lupus Foundation of America.Medications used to treat lupus.
Saleh D, Cook C.Anagen effluvium. In: StatPearls.
Gong Y, Ye Y, Zhao Y, et al.Severe diffuse non-scarring hair loss in systemic lupus erythematosus - clinical and histopathological analysis of four cases.J Eur Acad Dermatol Venereol. 2013;27(5):651-4. doi:10.1111/j.1468-3083.2011.04388.x
Centers for Disease Control and Prevention.Diagnosing and treating lupus.
Milam EC, Ramachandran S, Franks AG.Treatment of scarring alopecia in discoid variant of chronic cutaneous lupus erythematosus with tacrolimus lotion, 0.3.JAMA Dermatol. 2015;151(10):1113-6. doi:10.1001/jamadermatol.2015.1349
Hosking AM, Juhasz M, Atanaskova Mesinkovska N.Complementary and alternative treatments for alopecia: A comprehensive review.Skin Appendage Disord. 2019;5(2):72–89. doi:10.1159/000492035
American Society of Plastic Surgeons.Hair transplantation and restoration: What hair transplant procedures are recommended for women?
Ekelem C, Pham C, Atanaskova Mesinkovska N.A systematic review of the outcome of hair transplantation in primary scarring alopecia.Skin Appendage Disord. 2019;5(2):65–71. doi:10.1159/000492539
Lupus Foundation of America.Hair loss and lupus.
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