How to Prevent Hair Loss from Lupus

Lupus is an autoimmune disease where the body attacks itself. About half of all patients diagnosed with lupus experience hair loss. There are two types of hair loss associated with lupus. One is caused by the disease, and the other is caused by medication. Though some hair loss is unavoidable, there are some steps you can take to largely prevent it.^{[1]XExpert SourceCourtney Foster
Certified Hair Loss PractitionerExpert Interview. 9 December 2019.}

Part 1

Part 1 of 3:

Preventing Alopecia Related to Your Disease

Cutaneous lupus (lupus of the skin) can cause your hair to fall out. Alternatively, your hair loss may be a result of your medication, particularly if you are on a corticosteroid (like prednisone).^{[2]XExpert SourceCourtney Foster
Certified Hair Loss PractitionerExpert Interview. 9 December 2019.} Talk to your doctor to figure out which of these two reasons you’re experiencing hair loss (also known as alopecia).^{[3]XResearch source} Hair loss from lupus medications like corticosteroids is mostly reversible, but hair loss from scarring and discoid lesions is generally permanent.^{[4]XResearch source}
2
Begin your lupus treatment immediately. If you have been diagnosed with cutaneous lupus (lupus of the skin), you may quickly begin losing hair because the damage that lupus does to your skin can change the normal function of your hair follicles. The sooner you begin your treatment, the sooner you can reverse hair loss.
- If you haven’t been diagnosed with lupus, but you have been losing hair, talk to your doctor about the possibility that you have lupus. There are lots of other reasons you could be losing hair (heredity, chemical hair treatments, thyroid issues, nutritional deficiencies, etc.), but if you’re concerned, see a doctor.^{[5]XExpert SourceCourtney Foster
  Certified Hair Loss PractitionerExpert Interview. 9 December 2019.} Particularly if you’re also experiencing unexplained fevers, rashes, fingers and toes that turn blue in the cold, fatigue, and joint or muscle pain, there’s a decent chance that you have lupus. The key to stopping hair loss from lupus is early treatment. In most cases, the best way to control hair loss is to control the disease.
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There are such a wide variety of lupus medications that the directions vary greatly. It’s likely that you will need to take some at night, and some in the morning, some with food, and some without. Talk to your doctor or pharmacist about what to do if you miss a dose, because that will also depend on the kind of medicine you’re taking.^{[6]XResearch source}
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Part 2

Part 2 of 3:

Preventing Hair Loss from Lupus Medications

The most common is a corticosteroid, which will help regulate your blood pressure, help your immune system, and decrease inflammation. Your doctor will probably prescribe prednisone, prednisolone, or methylprednisolone. Corticosteroids frequently cause hair loss.^{[7]XResearch source} If your hair loss is from your medication, you may have to wait until your lupus is under control in order to address hair loss.
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Talk to your doctor about changing your medication. If medication is what’s causing your hair loss, your doctor may be able to change your dose or put you on a different kind of medicine.^{[8]XExpert SourceCourtney Foster
Certified Hair Loss PractitionerExpert Interview. 9 December 2019.} Keep in mind that you might have to wait a little while to switch medications, though. Even though hair loss can be really unpleasant, it’s important to manage your disease.^{[9]XResearch source}
- Depending on the severity of your lupus, your doctor may not be able to take you off the medications that are causing hair loss. However, they may be able to lower your dosage of some medicines while simultaneously increasing your dosage of others. (For example, they may lower your corticosteroid dose and add in an antimalarial, which will help regulate your symptoms without adding many new side effects.) Immunosuppressants and NSAIDS can also be used to treat lupus. Examples of immunosuppressants are azathioprine, mycophenolate, and methotrexate.^{[10]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
Check your face and scalp in particular. If there is anything round and scaly or anything that looks like a rash, you are at risk of permanent hair loss because of scarring. Your doctor may be able to prescribe medication or change your current medication to prevent this.
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Part 3

Part 3 of 3:

Avoiding Your Lupus Triggers

1
Manage stress. Lupus tends to flare up when you are stressed, and flare-ups can cause your hair to fall out. The best way to manage your stress level is to keep your list of obligations to a minimum and exercise often.
- You can also try relaxation techniques like meditation or yoga.
- If you are a religious person, prayer may lower your stress level.
- Make time for hobbies and other activities that relax you.
- Don’t use drugs, alcohol, or caffeine to reduce your stress. They may seem to help in the short term, but will only make it worse in the long term.
- If you’re having a lot of trouble managing stress, talk to a counselor or your lupus doctor. They may be able to help you cope.
2
Get plenty of rest. Remember that some people with lupus need up to 12 hours of sleep a night in order to manage their stress levels. Lupus attacks your immune system, so you’ll require much more sleep to build it back up than the average person does. Getting enough sleep will help you manage many of your symptoms, including hair loss.
- If you’re finding that it’s hard to get out of bed in the morning or that you wake up not feeling refreshed, you may not be getting enough sleep. Talk to your doctor about how much sleep you need, and ask them if a mild sleep aid might help.
3
Stay out of the sun. About half of lupus patients get flare-ups as a result of photosensitivity. If you have to be in the sun, wear lots of sunscreen, a hat that protects your face and neck, and long sleeves and pants. Even if it’s cloudy out, when you have to be outside for extended periods, protect your skin. About 70% of ultraviolet rays can still sneak through cloud cover.
- The sun is especially potent between 10am and 4pm. Try to stay indoors during these hours if you can.
- If you’re going to be out for more than a few minutes, put sunscreen on the parts of your body that are covered by clothing too. Most clothing only protects the skin up to SPF 5.
- Reapply often (about every 2 hours), especially if you sweat.
- Don’t forget that UV rays can go through car windows as well. You may want to purchase window shades or protective films.^{[11]XResearch source}
- Every day, you should use sunscreen that has broad spectrum coverage against UBA and UVB sunlight, has an SPF of 30 or greater, and is water resistant.^{[12]XTrustworthy SourceAmerican Academy of DermatologyProfessional organization made of over 20,000 certified dermatologistsGo to source}
4
Protect yourself from halogen or fluorescent lights. UV rays also come from indoor lighting, and they can cause lupus flare ups as well. Particularly if you work in an office that uses these kinds of lighting, you can protect yourself with shades, shields, filters, and tube covers. ^{[13]XResearch source}
- Don’t forget that many photocopy machines also emit UV rays. Close the cover when you’re using the copier to protect yourself from these rays.
5
Talk to your boss about accommodations. Depending on the severity of your disease, the Americans with Disabilities Act may cover some of the things you need to work comfortably. Typically, you will be covered under the ADA if one or more manifestations of your disease qualifies as a “disability.”
- The ADA defines a disability as an “impairment that substantially limits one or more major life activities.”
- Talk with a Job Accommodation specialist if you aren’t sure what your rights are or how to ask your boss for them. The U.S. Department of Labor offers a free service called the Job Accommodation Network (JAN), whose consultants will talk with you about accommodations.^{[14]XResearch source}
- For example, if you have high photosensitivity, the ADA might require that your company provide broad spectrum lights.
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Warnings

Never alter your medication without your doctor's approval.
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Consult your doctor before using over-the-counter hair loss products. Many of these products are only for genetic hair loss.
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