Information and Solutions for Men and Women

Hair Loss Caused by Discoid Lupus Erythematosus

Discoid lupus erythematosus is a chronic form of cutaneous lupus that can cause permanent hair loss.

A type of chronic cutaneous lupus erythematosus (CCLE), discoid lupus erythematosus (DLE) can cause cicatricial alopecia is a common cause of permanent hair loss. It is more prevalent in women, particularly African American women, and typically develops at age 20-40. Although most people who have CCLE/DLE only have lupus in the skin, it’s important to be tested for systemic lupus since this may require special treatment. 24, 185

Symptoms include: 24

  • Itchiness
  • Keratin plugs in hair follicles that pull up with scale as it is removed
  • Reddened, inflamed skin
  • Pigmentation changes
  • Round (discoid) shaped lesions with inflammation in center (can appear on body too)
  • Scaling
  • Scalp pain and tenderness

CCLE/DLE is much less serious than systemic lupus (which can cause telogen effluvium that is temporary if lupus is treated). If lesions in the cutaneous form of lupus are treated early, hair loss can be prevented. 2

Treatment Options for Chronic Cutaneous (Discoid) Lupus Erythematosus

Medications for skin lesions include:

  • Antibiotics (low dosage; anti-inflammatory effects) 24
  • Antimalarial drugs (believed to help by inhibiting the immune response and inflammation) 193
  • Immunomodulating drugs (e.g., mycophenolate mofetil and cyclosporine) 24
  • Nonsteroidal creams and ointments (e.g., pimecrolimus and tacrolimus)  24
  • Retinoic acid (Retin-A) 194
  • Steroid injections into active inflammatory lesions (e.g., triamcinolone acetonide 10 mg/cc) 24
  • Systemic drugs such as Dapsone or corticosteroids (e.g., prednisone)  24, 194
  • Vitamin A derivatives (oral) 193
  • Topical steroids (high dose) 24

CCCE/DLE is a photosensitive disease, and sun protection is important to avoid flare-ups or making the condition worse. Also, people with this condition should be careful not to use topical tea tree oil on the scalp because it is a potent photosensitizer. 37, 59, 135, 193

The disease is reversible and hair regrowth can be expected if treated early and aggressively. One successful approach demonstrated to regrow 80% of hair within four months in all lesions used multiple treatments at the same time: 195

  • Oral prednisone, 40 mg/day; eight weeks of treatment with 5 mg less each week
  • Hydroxychloroquine, 200 mg two times a day
  • Intralesional injections of triamcinolone (10 mg/cc) every four weeks

Quick Tips to Help Treat Chronic Cutaneous (Discoid) Lupus Erythematosus

Table 38: Diet, Lifestyle, and Nutrient Tips for CCLE (DLE)

DIET, LIFESTYLE AND NUTRIENT TIPS FOR CCLE (DLE)

DO
AVOID
Eat lots of fresh pineapple — it contains the enzyme bromelain, known to reduce inflammation (available in supplements too). 37 Foods that contain solanine (such as eggplants, peppers, white potatoes, and unripe tomatoes) since it can cause inflammation. 37
Load up on eggs, garlic, and onions — all of these foods contain sulfur, an essential nutrient for hair and skin. 37 Milk or dairy products, red meat, and sugar or sugar-containing food products may contribute to inflammation. 37

Take antioxidant vitamin A (25,000 IU daily or 10,000 if pregnant) and vitamin E (200 IU/day) — both of which promote healing of lesions. Lots of vitamin C helps too — as an antioxidant and for immune system support (take 3,000-8,000 mg/day). 37

All these vitamins are good for hair health as well. 32

Large crowds — exposure to lots of people without knowing their health status can increase vulnerability to infection.37
Use hypoallergenic cosmetic, skin, and hair care products to avoid aggravating or triggering lesions. 37 Fluorescent lighting and excessive unprotected exposure to UV radiation from sunlight may exacerbate or trigger a cutaneous flare-up.37
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Such as doxycycline or minocycline, 50--100 mg/day for 6-12 months.
Such as chloroquine, hydroxychloroquine, and quinacrine.
Plaquenil®, an anti-malarial drug.