Systemic Lupus Erythematosus (SLE or Lupus) is a serious autoimmune disorder that affects many parts of the body. About half of those with Lupus experience hair loss. Lupus affects about 1 in 2,000 people but it’s higher in non-white populations and affects women more than men by a ratio of about 9:1. Incidence increased sevenfold in the US between 1955 and 1974.
A drug-induced variety of SLE caused by any one of about 400 different medications but most commonly procainamide, hydralazine, quinidine, and phenytoin is reversible, but the more common autoimmune disorder has no cure although nowadays it’s also not life threatening. Treatment aims to minimise symptoms which can come and go unpredictably.
In general, autoimmune systems must be sensitive enough to recognise and deal with foreign material. However, in evolutionary terms, a population must have genetic diversity in order to withstand disease. Lupus may be more likely in someone with a particular set of genes where some part happens to be near the edge of what the human immune system has evolved to deal with. Add in an environmental factor such as stress, medications, hormones or infections, and the body’s immune system starts to create antibodies against itself which ultimately damage blood vessels in critical areas of the body.
Diagnosis is difficult because many symptoms such as fever, malaise, joint or muscle pain, fatigue, temporary loss of cognition and skin complaints may also have other causes so it’s often only when a full list of symptoms is considered that a diagnosis of Lupus can be achieved.
Michael Jackson is reported to have SLE, and Seal’s facial scars are reportedly due to a Lupus variant.
One classic Lupus symptom experienced by about 40% of those with Lupus is the ‘butterfly rash’, a photosensitive red skin rash across the bridge of the nose and over each cheek. Sunlight makes Lupus symptoms worse. This combination of avoidance of light with skin lesions is thought to have inspired vampire stories.
Skin rashes appear in the majority of patients with Lupus. Besides the butterfly rash, similar rashes, bruising, hives, blisters or ulcers may be present in other areas. Diffuse hair loss caused by Lupus can temporarily recover or it may come and go, however hair loss caused by Lupus is often permanent and the best treatment is often either hair transplants for small patches of scarring alopecia or hair replacement which will undetectably cover up the appearance of the hair loss.