Hair loss: Expert addresses common concerns

There are several types of hair loss in lupus. One type can cause reddish scales on the scalp, and hair loss in those areas. Another type causes lesions shaped like discs, or circles; this type is quite inflammatory and can cause scarring. The level of inflammation, and whether or not the hair follicle is scarred, will determine what the outcome is.

Re-growth of hair on the scalp depends on whether there is scarring and the extent of that scarring. When the hair loss is widespread, but non-scarring, the hair often will grow back. If there is too much damage to the skin, though, the hair cannot re-grow. In all cases, the main thing is to control the disease activity.

There is not any organized evidence that suggests that altering diet can improve lupus, whether it involves only the skin or other parts of the body. A balanced diet is important.

The main things to avoid are immunostimulatory herbal treatments, including green algae, spirulina, and echinacea. You don’t want to be stimulating your immune system when it’s already overactive. Studies have showed increased levels of inflammation in the blood when these herbs are added. You should talk to your doctor before you start taking any herbs or supplements, as some can interact with medications, as well.

For more extensive skin disease activity that’s not responding to just hydroxychloroquine (the antimalarial drug Plaquenil®), other possible therapies include combinations of antimalarials, immunosuppressives, and other immunomodulatory medications. Each person needs to evaluated by a doctor experienced with lupus to determine the best approach.