Wolf Howling at the Moon

Lupus and Hair Loss

If you have lupus and hair loss at the same time, sooner or later you look in the mirror and wonder if they are related. Perhaps it is not you, but a relative or a friend who is wondering that.    

Well, Lupus does cause hair to fall out or even thinner in different areas of the head, although just a few lose large amounts of hair.

But, in the first place, where does the word Lupus come from? This word comes from the Latin Lupus, and means "wolf". It was given that name, because the rashes that occur resemble the bites of a wolf.

Hair loss, rashes, wolf bites... Hmm, it seems that the only positive thing about this disease is that it is not contagious. However, it can damage different organs of the body, due to widespread inflammation of these.  

In the United States alone, there are 1.5 million people with this condition, and about 16,000 new cases appear each year, mostly women between the ages of 15 and 44, according to the Lupus Foundation of America.

Among other things, lupus causes joint stiffness, pain, fatigue, a butterfly-shaped rash on the face and, because it affects the scalp, it is also clear that lupus and hair loss are related to each other.  

In some people, hair loss is permanent, if the necessary measures are not taken. Although in most cases, hair loss is temporary.

Some may lose large chunks of hair, or locks due to its severity, although most do not lose as much hair.

Types related to Lupus and Hair Loss

There are basically four types of conditions related to lupus and hair loss. In addition, there is infantile and neonatal lupus, but in reality it is the same systemic lupus erythematosus, only the first occurs in children two years and older, and the neonatal in newborns.

In neonatal Lupus, 1 out of 10,000 to 20,000 gets it, almost always the female. The mother passes antibodies to the baby through the placenta.

Now, what effect can hair loss have here? Because almost all babies come into the world without hair. Sure, there are always exceptions, but if they come with hair it is so fine, which is what is known as "baby hair".

So that is why, I will consider the four types of conditions related to lupus and hair loss.

Young Man with Systemic Lupus ErythematosusYoung Man with Systemic Lupus Erythematosus

1.  Systemic Lupus Erythematosus (SLE)- This is the most common Lupus. SLE affects several organs, including the joints, skin, kidneys, lungs, heart, blood vessels, and brain.

It affects organ tissue through widespread inflammation. Why does this happen? Although the cause of the condition is not really known, it is believed to be related to genes, the environment, and even hormonal factors.

It is recognized as an auto-immune disease. This means that the body ends up attacking itself. This is what sometimes happens when soldiers go to war. Some get caught in what is known as "friendly fire."

Soldiers on the same side shoot at those in front, unaware that they are shooting at their own comrades. I really don't know why they call it "friendly fire", because there is nothing friendly about it.

The SLE is like that. With this disease, the immune system cannot detect healthy tissue and attacks it. But the type of alopecia it causes is the one that does not produce scars, that is, it does not cause permanent hair loss, as long as the patient is given the correct treatment.

Lab tests and imaging can be done to find out if you have it, but it is still not as easy to detect. What are the symptoms?

• Fatigue

• Loss of appetite

• Chest pain

• Difficulty breathing

• Butterfly-shaped rash on the face

• Mouth ulcers

• Inflammation of the Pericardium

• Sensitivity to light

• Inflammation of the Pleura

• Fever

• Edema, or swelling caused by excess fluid in the legs, or around the eyes

• Swelling of the joints

• Muscular pain

• Raynaud's disease, or a numb or cold feeling in the fingers or toes

• Chorea, that is, a neurological disorder in which involuntary movements of the hips, shoulders, or face occur

• Non-scarring Alopecia, or without scars

As you can see, there are many symptoms and many complications that SLE causes. We already saw how much this type of lupus could affect.  

2.  Discoid Lupus Erythematosus (DLE)

This is really dangerous, because this type of Lupus causes chronic irritation in the form of discs, especially on the scalp. Hence its name Discoid Lupus. It causes a type of scarring alopecia, because in the disc that forms in the skin, after irritation, scars are formed, where the hair does not grow back once it is lost.

To see the relationship between this type of Lupus and hair loss, and how it looks like a cattle branding iron, read the article: Discoid Lupus and Hair Loss.  

 3.  Subacute Cutaneous Lupus Erythematosus (SCLE) Although it is not known exactly where it comes from, it is known that is related to SLE. The difference between one and the other is that with SCLE the condition is triggered, when the person is exposed to the sun, causing sores and inflammation in the skin.

 4.  Drug Induced Lupus Erythematosus (DIL)

This type of Lupus is induced or caused by medications or drugs. This syndrome is also related to SLE, but some of the symptoms are different, such as arthritis and myalgia, in which the pain affects the muscles that are under the control of the central nervous system.

Some medications, such as Prednisone and Methylprednisolone, cause hair loss. It is known in the case of the latter, that it affects women between the ages of 50 to 59 years. Coincidentally, women are the most affected by Lupus.

Since drug-induced Lupus does not form scars, hair can grow back. Many times it is just a matter of substituting certain medications, such as the ones I just mentioned, with others that do not cause hair loss.

Lupus Treatment

In recent years, much progress has been made in the treatment of Lupus, but with all that, there is still no cure. The remedies used to treat Lupus are palliative. This means that it does not treat the root of the problem, but only the symptoms.

These include non-steroidal anti-inflammatory drugs such as: 

·         naproxen sodium, such as Aleve

·         ibuprofen, such as Advil or Motrin 

·         diclofenac

Then, there are anti-malarial drugs, or those used to treat malaria, such as hydroxychloroquine. It became famous in the midst of the COVID-19 pandemic, because some mistakenly believed that it could fight the virus.

There are steroid creams to reduce breakouts. Among these steroids are Triamcinolone, and Fluocinolone.

Another alternative is cannabidiol. You only have to see the name to know that it is extracted from Cannabis, or the plant from which the marijuana comes. Cannabidiol helps reduce chronic pain and improves joint flexibility.

In summary, there are four basic types of conditions related to lupus and hair loss, although all can cause hair loss or thinning, only one can cause permanent hair loss; the Discoid Lupus, which leaves a scar on the skin, like the marks of some cattle branding iron.

If you want to know more about this condition go to Discoid Lupus and Hair Loss.