From the Research
Alopecia in lupus is primarily caused by inflammation attacking hair follicles, and the most effective treatment involves controlling the underlying lupus with antimalarials like hydroxychloroquine, as evidenced by a recent study in 2021 1. In lupus, the immune system mistakenly targets the body's own tissues, including the skin and hair follicles, leading to hair loss. This can occur in two main forms: scarring alopecia (discoid lupus erythematosus), where permanent hair loss results from destruction of follicles, and non-scarring alopecia, which is often temporary and associated with systemic lupus flares. Some key points to consider in the management of alopecia in lupus include:
- The importance of early intervention to prevent scarring and permanent hair loss, as highlighted in a study from 2024 2
- The use of topical treatments such as corticosteroid lotions or injections to help with localized scalp lesions, as discussed in a study from 2021 1
- The potential for hair regrowth with non-scarring alopecia once the lupus is controlled, as noted in a study from 2018 3
- The variable efficacy of hydroxychloroquine in treating hair disorders, including lichen planopilaris, frontal fibrosing alopecia, and alopecia areata, as summarized in a study from 2023 4 The most recent and highest quality study, from 2021 1, provides the strongest evidence for the management of lupus alopecia, and its findings should be prioritized in clinical decision-making.