By Emily Wojcik
A lupus diagnosis often brings many physical changes-from skin rashes to weight gain. And often, the most upsetting of these changes can be losing your hair.
"For so many people, it is a major quality-of-life issue," says Victoria Werth, M.D., a professor of dermatology and medicine at the University of Pennsylvania School of Medicine in Philadelphia.
Although hair loss can be overwhelming, it needn't be totally devastating. These days it's easier than ever to face the problem head-on.
Hair loss is a common side effect of both lupus and the medications used for treatment, so work with your doctor to discover the cause. "There are many reasons for hair loss," says Werth. "Some is caused by scarring associated with discoid scalp lesions, and some is diffusive and does not result from scarring, as with systemic lupus."
If hair loss is caused by medication, you may have to wait until your lupus is under control. Luckily, says Werth, this type is "mostly reversible." Hair loss associated with discoid lesions and scarring is generally permanent, so early treatment is key.
But don't experiment with over-the-counter medications, like Rogaine, without your doctor's approval. "Rogaine is for treating male- and female-pattern alopecia, which is a completely different type of hair loss than we usually see in lupus," says Werth.
Brittle hair also is common, and many treatments-including steroids and immunosuppressives-cause hair to thin.Once your diagnosis is clear, maximize your assets. If your hair loss is mild, try a new haircut. Long hair is weaker than short, so consider a shorter 'do' with layers to hide thinning or bald patches. Wash fragile hair with baby shampoo, and use a leave-in conditioner with sun block. Avoid adding more stress to your hair from using curlers and alcohol-based styling products, which can irritate sensitive skin.
Finally, don't shy away from wearing a hairpiece, hair extensions, or a wig. Hairpieces and extensions can be added into thin areas to create a fuller look. Just make sure that these aren't too tight, because tension on weakened hair also can lead to hair loss. Wigs come in a wide range of styles, colors, and lengths. And don't forget your scalp! Keep it dry to prevent chafing, and remove the wig occasionally to allow your skin to breathe.
Whether you decide to go with a wig or a new hairstyle, remember that there's no wrong way to deal with hair loss. "Everyone has a different comfort level," says Werth. "It should be an individual decision."
For general information about hair loss and treatments, click on these websites:
• American Academy of Dermatology – www.aad.org
• Peggy Knight Solutions – www.peggyknight.com (also features a line of vacuum and net-based wigs)
• American Hair Loss Council – www.ahlc.org