Hair loss is a common problem seen in the dermatologist office. In many cases, hair loss is the result of hormonal changes that occur as you age. Less commonly, hair loss is the result of an underlying autoimmune disease, which may require treatment from various specialists to improve.
If you already know you have an autoimmune disease, it is easy to infer the onset of hair loss might be related to the disease. For some people, hair loss might be the first symptom they experience, which can make finding a diagnosis more challenging. Sometimes the hair loss is more obviously the result of an autoimmune process. For example, alopecia areata is a type of autoimmune hair loss and it typically shows up as small, round areas of hair loss. Your dermatologist may do a scalp biopsy to make a definitive diagnosis. People with lupus-related hair loss may have distinct areas of hair loss and scarring, even before they are diagnosed with the disease.
For hair loss related to a specific disease process, medications can be helpful. If the autoimmune disease causes systemic symptoms, you will need to work with a rheumatologist for treatment. Some autoimmune diseases that only affect the skin, like psoriasis, may be managed by a dermatologist. Biologics are often prescribed for moderate to severe rheumatoid arthritis or psoriasis/psoriatic arthritis. Disease-modifying anti-rheumatics, specifically hydroxychloroquine, may be used in the treatment of lupus. Sometimes your dermatologist may spot-treat areas with steroid injections. Treatment with steroids can be used to reduce inflammation and potentially prevent the area from scarring in lupus.
If the underlying disease process is sufficiently controlled, the hair may grow back, or there may be spontaneous recovery, such as in the case of alopecia areata. People who experience scarring may find the hair never returns, which may be common in lupus. Other treatments, such as the use of monoxide or cold laser treatments can be recommended in some instances of autoimmune hair loss, but the results are less predictable. These treatments may help regrow hair, but there is always the risk the immune system will begin to attack the hair follicles again. The best approach will be to tackle future episodes promptly to minimize long-term damage to any hair follicles.
Autoimmune hair loss is a challenging type of hair loss since the immune system can be unpredictable. Finding a diagnosis quickly will give you the best chance at controlling any underlying systemic processes and preventing permanent hair loss.