Anemia, stress, and side effects of lupus medications may cause brittle hair for people with lupus.

Dry, brittle hair is not a natural hair type — it is a treatable condition that occurs when strands of hair are stripped of their natural oil. The causes can be diverse including the weather (particularly the summer season), hormone changes, or even using the wrong shampoo. But, for #LupusWarriors, co-morbid conditions may be linked to brittle hair.

A new study published in 2017 claimed that low red blood cell counts and low lymphocytes are the two most common blood disorders associated with lupus. Additionally, people with lupus are at a higher risk of developing hemolytic anemia. Both iron and vitamin deficiency anemias cause a decreased amount of red blood cells which is linked to brittle hair.

Iron Deficiency Anemia

Iron deficiency anemia is the most common type of anemia worldwide. This condition occurs when there is not enough iron in the body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can’t produce enough hemoglobin for red blood cells to perform their function of carrying oxygen throughout the body.

What Iron Deficiency Anemia Does the Body

When an individual becomes iron deficient, the body can go into survival mode. Hair follicles are unnecessary when it comes to the overall health of the body. At first hair strands will seem to become thinner. If the condition is not treated, hair will start to fall out in a non-patterned way. This type of hair loss is known as telogen effluvium.

Anemia and Medications

Some lupus medications also inhibit the production of bone marrow. Drugs such as azathioprine or cyclophosphamide can drastically lower the levels of bone marrow produced. The result on hair, unfortunately, is the same.

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Stress, Shock, and Telogen Effluvium

Stress can be a major part of a #LupusWarrior’s journey. Unfortunately, stress can have tremendous impacts on our physiology—not just our emotions. Stress is the generic term for when cortisol – the stress hormone – is released within the body.

When a stressful situation occurs, cortisol is supposed to tap into our blood glucose reserves to give the energy for flight or fight. When bodies don’t complete this process, the system thinks it is in shock. Nervous shock can cause telogen effluvium (TE) or temporary hair loss in a non-patterned way.

Typically, hair grows in three stages:

1. Anagen
   • Hair growth stage where individual strands may grow roughly half an inch per month
2. Catagen
   • Following the anagen phase, the catagen is the end of hair growth and lasts about 10 days
3. Telogen
   • This is a resting phase where the hair is released and falls out. After falling out, the hair follicle remains inactive for 3 months and then the process will repeat.

The problem is when too many hair follicles go into the telogen phase especially at the same time and for an extended period of time.

More needs to be understood about how stress can impact skin. However, a great number of anecdotes can confirm stress can wreak havoc on the skin. The scalp is skin, and one of the most sensitive parts of the whole organ.

Scalp Care and Treatment

Microcirculation

Scalp care is essential for people experiencing hair loss or brittle hair. There’s a delicate balance between pulling on the hair and stimulating the hair follicles. Cosmeceutical and haircare experts claim that stimulating hair follicles brings blood to the follicles—which is a good thing.

A couple of ways to stimulate hair follicles is to get a brush with wide or thick bristles. Bristles that are wider reduce the risk of pulling out hair. The wide bristles gently massage the scalp, increase circulation, and gently exfoliate dead skin or build-up from hair products away to let new strands grow.

Light Therapy

Light therapy is an up and coming treatment for hair loss. The best type of phototherapy is low-level light therapy (LLLT). Studies have shown that LLLT stimulates hair follicles and shifts them from the telogen phase (dormant) into anagen phase (active growth.)

Supplements

Some nutraceuticals claim to target common causes of hair loss (oxidative stress and free radical damage) with plant-powered ingredients. If a #LupusWarrior has true iron/vitamin deficiency anemia, looking into supplements like this might be worth the effor—but this needs to be combined with a vitamin- and mineral-rich diet.

As always, talk to you lupus treatment team to help decide what options are best suited for you.

The Good News

The good news is many #LupusWarriors experience telogen effluvium due to stress, low-iron levels, and medication side-effects. Telogen effluvium is 100% reversible. If in this stage, try to diminish stress, talk to a doctor about supplements, and take care of the scalp. Brittle hair and thinning hair can grow back.