Lupus hair loss: Treatment and prevention

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Treatment for lupus-related hair loss can vary depending on the cause. It may include:

Lupus management

A person could be experiencing hair loss if they are yet to seek treatment for lupus or their current treatments are not working.

Each type of lupus has different treatments. For discoid lupus, these include:

• protecting the scalp from the sun
• topical or oral corticosteroids
• topical calcineurin inhibitors, which are immunosuppressants

Alternative treatments a doctor may recommend for other types of lupus include antimalarial drugs and methotrexate. If these are ineffective, a doctor may prescribe cyclophosphamide, rituximab, and other medications depending on a person’s symptoms and treatment goals.

If a person is stable on treatment and then experiences a lupus flare, a doctor may prescribe temporary high dose corticosteroids to reduce inflammation.

Medication adjustments

Hair loss could also be a side effect of lupus medication. Some drugs for lupus can cause a type of hair loss known as telogen effluvium (TE). TE extends the shedding phase of hair growth, meaning hair falls out faster than it can grow back.

If medications could be the cause, a doctor may suggest changing a person’s dosage or trying an alternative medication. People should consult a health professional before changing any lupus treatment regimen.

Iron supplementation

Certain nutritional deficiencies, such as iron deficiency anemia, can cause hair loss for people with or without lupus.

However, iron deficiency anemia is especially common among people with active lupus for various reasons. If this is a potential explanation for hair loss, a doctor may test a person’s iron levels and recommend an iron supplement.

Hair loss medications

In some cases, hair loss medications may be appropriate for those with lupus. According to a 2022 paper, the hair loss drug minoxidil may help with both TE-related hair loss and hair loss due to lupus inflammation. A doctor may recommend this treatment alongside a person’s other medications.

In addition to medical treatments, there are ways people can adjust their hair care routine to reduce lupus-related hair loss. This may involve:

Avoiding sun exposure

Avoiding the sun can reduce the symptoms of lupus. It can also reduce lesions from forming on the scalp for people who have cutaneous lupus.

A person can protect the scalp from sunlight by:

• wearing a wide-brimmed hat when outside, ideally one with UV protection
• using sunscreen on the scalp when a hat is not suitable, such as a scalp spray
• reapplying sunscreen every 2 hours or after getting wet

It is also important to avoid using ingredients or products that can make the skin more sensitive to the sun.

Preventing breakage

Lupus can cause hair breakage in addition to shedding. This is known as anagen effluvium (AE). Taking extra care to protect the hair from damage may reduce the amount or speed of the breakage. For example, it may help for people to avoid:

• excessive or rough hair brushing
• heat styling tools
• bleach or dyes
• chemical treatments, such as perms

Instead, a person can care for their hair by:

• using a gentle shampoo to clean the hair, such as baby shampoo
• massaging the shampoo gently to create a lather rather than rubbing
• using a detangling product when brushing the hair after washing

Careful styling

People have different ways of styling their hair when they experience hair loss. Some may embrace the change, while others may prefer wearing scarves, wigs, or hair pieces.

There is no right or wrong approach, but it is worth noting that some styles may cause further breakage. The Lupus Foundation of America recommends avoiding:

• tight braids
• buns
• other styles that pull on the scalp

Hair stylists with experience helping those with hair loss may be able to recommend some options.

There is no recent research on whether specific hair products, such as shampoos or conditioners, help with lupus-related hair loss. However, there is some evidence that minoxidil may help. Topical minoxidil products are available over the counter (OTC).

The effectiveness of these products can vary, so it is important for people to discuss the benefits and potential risks with a dermatologist before trying them.

No recent studies identify any specific hair supplement to help people with lupus. This does not mean there are no effective supplements — only that science has not yet investigated the effects of OTC supplements.

Anecdotally, some people report improvements with biotin supplements. However, there is no evidence that taking biotin helps with hair health unless a person has a biotin deficiency, which is rare in the United States.

Additionally, some supplements may interfere with lupus medication, so it is important for people to discuss with a doctor before trying any new supplement.

In some cases, it may be possible to prevent lupus-related hair loss. If a person receives early treatment, their medications may slow the disease process and stop hair from falling out. In discoid lupus, early treatment may eliminate lesions entirely.

However, lupus itself does not always cause hair loss directly. A person’s medications may cause it as a side effect, or they could experience hair loss for other reasons, such as anemia. As a result, it may not always be possible to anticipate when hair loss will occur.

People can speak with their medical team to better understand the risk of hair loss and what may help prevent it.

Whether hair will regrow after lupus-related hair loss depends on if it is scarring or nonscarring.

For example, there is no permanent damage to the hair follicle when the cause is TE or AE. This means the hair can grow back. The hair may regrow on its own or after a doctor helps treat the underlying cause. The process often takes between 1–6 months.

However, when there is damage to the hair follicles, less hair may grow back. Discoid lupus can cause permanent scarring that damages or destroys the hair follicles. Scarring-related hair loss is permanent, but it is often possible to prevent additional scarring and hair loss.

Below are some commonly asked questions about lupus-related hair loss.

What does lupus do to a person’s hair?

Hair loss, thinning hair, and changes in hair texture can occur in people who have different types of lupus. Hair loss can extend to the scalp, legs, eyebrows, eyelashes, or elsewhere.

Can lupus change hair texture?

Yes, the most common type of lupus, systemic lupus erythematosus (SLE), can change hair texture. It can cause dry, coarse hair to develop along the hairline. These dry, coarse hairs break off easily, causing the sparse-looking hair known as lupus hair.

Why do people with lupus lose hair?

Lupus attacks healthy cells, including skin cells, and causes widespread inflammation. Therefore, the follicles in a person’s scalp can no longer hold or grow hair.

Hair loss and thinning hair can also be side effects of anemia, which is common in people with lupus, or due to certain medicines used to treat lupus, like steroids and immunosuppressives.

What type of lupus causes hair loss?

There are four types of lupus, all of which can cause hair loss:

• systemic lupus erythematosus (SLE),
• cutaneous lupus erythematosus (CLE)
• neonatal lupus
• drug-induced lupus

Lupus can cause hair loss in several ways. Some causes are scarring, which means they can directly damage hair follicles. Other types are nonscarring, which means they are reversible.

Lupus hair loss treatment will depend on the cause. For example, a doctor may suggest adjusting medications, trying an iron supplement, or hair loss treatments such as minoxidil.

No studies have investigated the effects of different hair care products for lupus-related hair loss, but preventing sun exposure and reducing breakage may help reduce this symptom.