What should I do if lupus causes hair loss?

Written by Zhang Lin
Rheumatology and Immunology Nephrology
Updated on September 18, 2024
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What should be done when a lupus patient experiences hair loss? Patients with lupus should keep their hair clean in daily life, not use too much shampoo when washing their hair, avoid dyeing or perming their hair, and reduce the damage to hair from chemical products. This prevents rashes or worsening rashes caused by allergies to hair dyes and damage to hair quality from perming. If hair loss occurs due to the effect of medications, patients can choose to wear a wig during treatment. After chemotherapy ends, new hair will grow, so patients need not worry excessively. Maintaining a pleasant mood is also quite important for recovery from the disease. The basic pathological change in lupus patients is vasculitis. When the small blood vessels in the skin become inflamed, the nutrient supply to the hair follicles is disrupted, which can easily lead to hair loss and affect hair growth. Generally, hair can regrow after the disease is controlled. If hair loss occurs again, it could be a symptom of a disease relapse.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Will the rash of lupus fade away?

Patients with lupus often experience recurrent, stubborn skin lesions on their hands or face, and some may even develop ulceration, atrophy, or scarring on top of the existing erythema. Most lupus patients exhibit erythema, centered around the bridge of the nose and appearing on the cheeks. The lesions are disc-like on both sides with generally clear boundaries, either flat or slightly raised, and are categorized as exudative inflammation. Depending on the severity of the inflammation, the erythema can range from light red, bright red to purple-red. In severe cases, localized edema resembling erysipelas may occur, and scaling and hyperpigmentation may appear as the inflammation subsides. Facial rashes generally resolve, and most rashes do not leave marks after resolution. If hyperpigmentation remains after the erythema has resolved, it suggests a good prognosis. However, erythema in other areas, such as acral erythema and reticular cyanosis, may last for varying durations depending on the patient's individual condition.

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Written by Zhang Lin
Rheumatology and Immunology Nephrology
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Can lupus be treated without steroids?

Hormones are currently the first choice of drugs for treating lupus erythematosus, and there are no other drugs that can replace them temporarily, so we still recommend using hormones for treatment. Hormones can quickly and effectively suppress the immune response, reducing the damage to the patient's body from the inflammatory substances released during the immune response. This kind of immune-suppressive and anti-inflammatory action is a protective therapeutic effect on the body. Although long-term use of large doses of hormones has certain side effects, it can quickly block the development of the disease and alleviate the condition. The function of hormones cannot be replaced by any other drug at present, so, no matter what stage the lupus erythematosus patients are in and regardless of the type of damage, hormones are the first choice of drugs. Hormones have many side effects, therefore, we need to use hormone drugs for treatment rationally and standardized under the guidance of a doctor, and should not take them arbitrarily to avoid serious consequences.

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Written by Liu Li Ning
Rheumatology
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Do the rashes caused by lupus itch?

The erythema triggered by lupus erythematosus may or may not be itchy, varying from person to person, with each individual's condition not being entirely the same. The erythema caused by systemic lupus erythematosus also presents very differently clinically, with the typical manifestation being a butterfly-shaped erythema on the face. Other common forms include discoid erythema, reticular purpura, polymorphic rash, periungual erythema, and more. The specific pathogenic mechanism is currently unclear, and in some patients, the condition is caused by photosensitivity. After treatment, the erythema cannot completely disappear in a significant number of patients, leaving some pigment deposition. If only the skin is affected, treatment can involve the topical use of tacrolimus ointment or the oral intake of immunomodulators like hydroxychloroquine, and if necessary, oral corticosteroids may be administered.

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Written by Liu Li Ning
Rheumatology
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Where does lupus erythematosus generally appear?

Lupus erythematosus can appear on various parts of the body. The most typical rash is the butterfly rash on the face, but it can also appear on other parts, such as discoid lupus, annular erythema, periungual erythema, and livedo reticularis. Additionally, systemic lupus erythematosus affects not only the skin and mucosa but can also involve the lungs, kidneys, heart, central nervous system, and other systems. Common manifestations include lupus nephritis and lupus pneumonia. The precise pathogenesis of systemic lupus erythematosus is still unclear. If the damage is confined to the skin and mucosa, immunomodulators such as hydroxychloroquine can be used for treatment. If important organs are involved, it generally requires long-term maintenance treatment with corticosteroids combined with immunosuppressants to control the progression of the disease.

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Written by Liu Li Ning
Rheumatology
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What does the early rash of lupus look like?

The early characteristic rash of lupus erythematosus is typically a butterfly-shaped rash on the face. Other common presentations include palm and periungual erythema, discoid rash, nodular erythema, and livedo reticularis. If the rash is not notably itchy, it generally indicates lupus erythematosus. If there is significant itching, it may suggest the possibility of an allergic factor active in the disease. After immunosuppression, itchy rashes should be monitored for possible fungal infections. The specific pathogenesis of systemic lupus erythematosus is still unclear. If a patient exhibits the typical butterfly-shaped rash on the face, systemic lupus erythematosus should be highly suspected. Testing for antinuclear antibodies, and specifically for anti-Sm and double-stranded DNA antibodies, which represent a variety of autoantibodies, can diagnose systemic lupus erythematosus.