What is lupus hair?

What is lupus?

Lupus is an autoimmune disease where the immune system attacks healthy tissue in the body. There are several types of lupus, the most common being systemic lupus erythematosus (SLE). In SLE, nearly any part of the body can be affected including the skin, joints, kidneys, brain, heart, and lungs. It is a chronic condition with periods of illness (called flares) alternating with remission where symptoms improve. Lupus most often impacts women of childbearing age, though men and children can also develop the disease.

What causes lupus?

The exact cause of lupus is unknown. Researchers believe a combination of genetic, environmental, and hormonal factors contribute to the development of lupus. People with lupus often have abnormalities in their immune system cells, genetic mutations, and environmental exposures that interact to trigger the disease. Some theorized triggers include:

– Sunlight exposure
– Viral infections
– Hormones like estrogen
– Medications
– Chemical exposures
– Stress
– Family history of autoimmune disease

However, exposure to these factors does not necessarily mean someone will develop lupus. Those with lupus likely have a genetic predisposition to reacting abnormally to certain triggers. The immune system then begins making autoantibodies that target the body’s own healthy cells and tissues. This leads to widespread inflammation throughout the body.

What are common symptoms of lupus?

Symptoms of lupus vary significantly from person to person and depend on which parts of the body are impacted. Some common symptoms include:

– Fatigue
– Fever
– Joint pain or swelling
– Muscle aches
– Butterfly facial rash across the cheeks
– Photosensitivity to sunlight
– Chest pain with breathing
– Hair loss
– Mouth or nose sores
– Fingers turning white or blue in the cold (Raynaud’s)
– Vision problems or eye irritation
– Headaches, memory issues, mood changes

What is lupus hair loss?

Many people with lupus experience some degree of hair loss or thinning. This occurs because lupus can cause inflammation and damage to hair follicles. Hair loss associated with lupus is called “lupus hair” or “lupus alopecia.” It has some distinctive features:

– Increased shedding and thinning of the hair on the head or elsewhere on the body
– Hair loss at the frontal hairline, temples, and above the ears, leading to a ragged appearance
– Breakage of hairs as they grow longer, giving hair a brittle texture
– Sudden hair loss occurring during a flare, which may regrow in between flares
– Reduced hair volume, making hair limp or lifeless

Lupus hair loss is usually not total baldness, but can be moderate to severe in some cases. It tends to come and go. Many lupus patients lose large amounts of hair for months at a time, which then grows back in between flares. The fluctuating nature of lupus hair loss makes it particularly distressing.

What causes hair loss in lupus?

There are several ways lupus can trigger hair loss:

– Inflammation – Lupus causes generalized inflammation affecting hair follicles. The resulting damage interrupts the hair growth cycle leading to shedding, thinning, and impaired regrowth.

– Poor circulation – Lupus can cause blood vessels to constrict, reducing blood supply to the scalp and follicles. This impairs their function and health.

– Medications – Corticosteroids like prednisone used to treat lupus symptoms may contribute to hair loss as a side effect.

– Antibodies – Some people with lupus produce antibodies that specifically target and damage hair follicles.

– Stress – The stresses of having a chronic illness may exacerbate hair loss. Stress triggers immune reactions and alters hormone production.

– Nutrient deficiencies – The immune activity, inflammation, and medications used in lupus can lead to deficiencies in vitamins, minerals, and other nutrients needed for healthy hair.

What are the types of lupus hair loss?

There are a few specific patterns of hair loss that may occur with lupus:

– Diffuse thinning – Overall thinning of hair volume all over the scalp. This is the most common type.

– Frontal fibrosing alopecia – Hair thinning and recession at frontal hairline and temples.

– Alopecia areata – Patchy rounds of baldness that can occur anywhere on the body.

– Telogen effluvium – Increased shedding of hair in the telogen (resting) phase of growth. Usually follows a stressful event, fever, or medication change.

– Anagen effluvium – Decreased hair production in the anagen (growing) phase. This can follow severe metabolic stresses like chemotherapy.

– Scarring alopecias – Permanent hair loss due to damage to hair follicles. Seen in discoid lupus skin lesions.

How is lupus hair loss diagnosed?

A doctor will diagnose lupus alopecia based on a patient’s symptoms, medical history, and a physical exam of the hair and scalp. They will look for typical patterns of thinning associated with lupus.

Sometimes a scalp biopsy is done to confirm the diagnosis by looking at the hair follicles under a microscope. Blood tests may also be ordered to check for antinuclear antibodies common in lupus. The doctor will likely also assess for nutrient deficiencies with bloodwork.

It’s important to rule out other causes of hair loss like thyroid disorders, iron deficiency anemia, or skin conditions like ringworm. Medication side effects must also be considered. The timing of hair shedding in relation to lupus flares helps distinguish it as lupus-related.

How is lupus hair loss treated?

While lupus hair loss is currently not curable, the goal is to minimize shedding and improve regrowth. Typical treatments include:

– Corticosteroids – Oral or topical steroids help control scalp inflammation that damages follicles. Topical options include clobetasol, fluocinonide, or hydrocortisone creams.

– Antimalarials – Hydroxychloroquine and similar medications help stabilize lupus disease activity and may reduce hair shedding.

– Other immunosuppressants – Drugs like azathioprine, cyclosporine, or methotrexate dampen the immune system attacks on hair follicles.

– Biologics – Newer injectable biologics like belimumab offer targeted immune suppression.

– Antibiotics – Oral antibiotics treat secondary infections that can exacerbate lupus hair loss.

– Laser devices – Low-level laser light devices may help regrow hair by stimulating follicles.

– Supplements – Hair health supplements with biotin, vitamin D, iron, zinc, or antioxidants can help compensate for lupus-related deficiencies.

In milder cases, using volumizing shampoos or hair thickening sprays may provide adequate management. Wigs or hairpieces can also conceal thinning hair. It’s important to be gentle overall when washing, brushing, and styling hair vulnerable to lupus damage.

What is the prognosis for lupus hair loss?

The prognosis for lupus patients with alopecia varies. Mild hair thinning may be permanent, but more significant shedding often comes and goes. Hair loss related to a lupus flare or starting a new medication can resolve over months.

However, unpredictable cycles of hair loss and regrowth can be frustrating to deal with. Scarring alopecias cause permanent bald patches. With optimal treatment, many people see gradual improvement in their hair volume and quality over time. The key is controlling lupus disease activity and inflammation.

Table summarizing key points on lupus hair loss

Lupus Hair Loss Patterns	Potential Treatments	Tips for Hair Care
Increased shedding and thinning Receding frontal hairline Brittle, broken hairs Cycles of sudden hair loss and regrowth Reduced volume and limpness	Topical or oral steroids Antimalarials like hydroxychloroquine Immunosuppressants Biologic medications Laser devices Supplements with biotin, iron, zinc	Use gentle shampoos Avoid tight hairstyles Limit heat styling Comb hair gently Manage stress Eat a balanced diet

Conclusion

Lupus is an autoimmune disease that causes widespread inflammation throughout the body, including the skin and scalp. Many lupus patients experience hair loss or thinning hair as a symptom, known as lupus alopecia. It is typically due to inflammation damaging the hair follicles, causing fragile hairs prone to shedding and breakage.

Lupus hair loss may be diffuse thinning or patterned recession at the forehead and temples. Cycles of sudden hair shedding often follow lupus flares, with regrowth in between. While not curable, treatments aim to suppress immune attacks on hair follicles using medications like steroids, antimalarials, and immunosuppressants. Lupus hair loss can be distressing to deal with, but controlling lupus disease activity offers the best chance of stabilizing hair volume. With a multi-pronged approach, significant improvement is possible for many lupus alopecia patients.