Hair and Skin Problems in Lupus

posted in Hair, Nails on January 16, 2024 by

Gavin Abson

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Lupus, a chronic autoimmune disease, affects multiple organs, including the skin. This article explores the nuanced relationship between lupus and hair and skin problems, shedding light on people’s challenges with this complex condition.

This blog on “Hair and Skin Problems in Lupus” was edited and contributed to by Donald Thomas, MD; author of “The Lupus Encyclopedia.” Parts of this blog post come from “The Lupus Encyclopedia: A Comprehensive Guide for Patients and Health Care Providers, edition 2“

The Impact on Skin: A Multifaceted Challenge

Lupus often presents many skin-related issues, ranging from rashes to lesions. Cutaneous lupus erythematosus (CLE) refers to when lupus affects the skin. Discoid lupus, characterized by red, scaly lesions, is a common form of cutaneous lupus. Someone can have cutaneous lupus alone or as a part of systemic lupus erythematosus (SLE). For example, someone can have discoid lupus by itself. Over time, around 20% of people with discoid lupus will have other organs affected. The person at this point is considered to have SLE. The cutaneous lupus (discoid lupus, in this case) is one of the complications of the person’s SLE, and the discoid lupus was the initial manifestation of SLE. Most people with SLE also have cutaneous lupus as part of their disease.

There are many other examples of cutaneous lupus. Some occur only in lupus patients (like discoid lupus, tumid lupus, the butterfly rash, lupus profundus, and subacute cutaneous lupus).

However, many other forms of skin involvement with lupus also occur that are not specific to lupus and can be seen in other disorders. Examples of the latter include things such as livedo reticularis, vasculitis, telangiectasia, and erythema nodosum, to name a few. Chapter 8 of “The Lupus Encyclopedia” discusses the wide variety of cutaneous lupus lesions.

Hair Loss and Skin Problems: Unraveling the Connection

Hair loss, or alopecia, is a distressing symptom for many with lupus. The mechanisms behind lupus-related hair loss are intricate, involving inflammation of the hair follicles. Reversible alopecia means the hair grows back when doctors successfully treat lupus, reversing this inflammation around the follicles. However, if the inflammation permanently destroys the hair follicles, scarring alopecia occurs. Scarring alopecia means the hair loss is irreversible and does not grow back. This primarily occurs when the hair loss is due to discoid lupus affecting the scalp. Understanding the emotional toll of hair loss is crucial, as it often intertwines with the complex psychological aspects of living with a chronic illness.

Managing Challenges: A Holistic Approach

Addressing hair and skin problems in lupus necessitates a holistic strategy. Dermatological interventions, such as topical corticosteroids for skin issues or minoxidil for hair loss, may be employed. Equally important is the broader management of lupus through medications that suppress the overactive immune response.

Much of the time, hair loss in lupus patients is due to causes other than their lupus. It is important to figure out the cause of the hair loss to figure out the correct treatment. If you have hair loss and lupus, make sure to watch my 2 part video series from The Lupus Foundation of America (called Lupus Locks), where I talk about the causes of hair loss in lupus and give lots of practical advice on what you can do to help yourself and find answers.

Sun Protection as a Shield

Photosensitivity, an increased skin sensitivity to ultraviolet light (especially sunlight), is another common concern for lupus patients. Ultraviolet (UV) light exposure can worsen skin involvement and trigger lupus flares. Given the photosensitivity associated with lupus, robust sun protection becomes paramount. Patients should use broad-spectrum sunscreen, wear protective clothing, and avoid peak sunlight hours. Avoiding other UV light sources, such as using LED bulbs in the home, is also essential. Unlike fluorescent and incandescent bulbs, LED bulbs do not emit UV light. Therefore, it is important to learn how to avoid UV light as part of its treatment. Click the UV light protection icon at the bottom of the “Lupus Secrets” page to learn more about good UV light protection habits.

Navigating Hair and Skin Problems in Lupus

In the realm of lupus, the connection between the immune system and the skin and hair follicles creates challenges. Acknowledging and addressing these issues, both physically and emotionally, is pivotal. By creating a comprehensive understanding of lupus-related hair and skin problems, individuals and healthcare providers can work together to navigate this difficult terrain with empathy and practical solutions.

For more in-depth information on hair and skin problems in lupus:

Lupus can affect the skin and hair in numerous ways. Read chapter 8 of The Lupus Encyclopedia, edition 2

Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia

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