Autoimmune disorders often damage the body in invisible ways. On top of that, some affect how you look on the outside too: You might develop a rash, for instance, or bald spots on your scalp.
A mysterious and unwelcome change in your appearance might send you straight to the doctor to figure out what’s going on. Consider psoriatic arthritis, a disease that sometimes begins with dry, itchy, scaly patches of skin (plaque psoriasis) before progressing to joint pain. “We’ll usually see patients first, before a general practitioner,” says Soheil Simzar, MD, a dermatologist in Santa Clarita, California, and clinical instructor of dermatology at the David Geffen School of Medicine at UCLA in Los Angeles.
Getting the right medications and other treatments for the underlying disease can help relieve symptoms — both invisible and visible ones. With psoriatic arthritis, for instance, “Treating the root causes of the condition will help prevent the skin manifestation,” says Dr. Simzar.
Here are eight common autoimmune conditions that can impact your skin, hair, joints, and more — plus info about the best treatments.
Psoriasis Can Cause Scaly Patches of Skin
Plaque psoriasis, the most common form of psoriasis, results in the rapid overproduction of skin cells. Those cells pile up, causing plaques, most commonly on the knees, elbows, lower back, and scalp.
According to the American Academy of Dermatology, plaques on white skin are often red or pink with silvery-white scales; on darker skin, they often appear salmon-colored with silvery-white scales, or violet or dark brown with gray scales.
Psoriasis treatments include over-the-counter and prescription topicals (creams, lotions, foams, ointments, tars, shampoos, more); phototherapy (also known as light therapy); and systemic drugs (pills and injectable biologics).
“By addressing the inflammation associated with psoriasis, the right treatments may help relieve patients’ symptoms,” says J. Mark Jackson, MD, a physician at Forefront Dermatology and clinical professor of medicine at the University of Louisville in Kentucky.
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Alopecia Areata Can Cause Bald Spots
While it’s normal for some amount of hair to fall out with everyday washing and styling, hair loss that results in large bald spots may be due to alopecia areata, a condition in which the immune system attacks hair follicles.
The disease is marked by hair loss that occurs in round patches, but it can sometimes affect all the hair on the scalp or body, according to the National Alopecia Areata Foundation.
Treatments for alopecia areata include steroids in various forms (oral, topical, scalp injections) and minoxidil (Rogaine), an over-the-counter topical. The newest option is a highly effective drug for severe alopecia areata called baricitinib (Olumiant). It belongs to a class of medications called JAK inhibitors, which work by blocking certain enzymes in the body that cause inflammation. The U.S. Food and Drug Administration requires JAK inhibitors to carry warnings about potentially serious side effects.
Vitiligo Can Cause Light Patches of Skin
Vitiligo occurs when the immune system destroys melanocytes, the skin cells that make pigment, leaving behind white or light patches of skin. In some cases, a person’s skin may lose all its pigment and turn completely white, according to the Vitiligo Research Foundation. The condition can also affect hair, the inside of the mouth, and the eyes.
Certain methods can make vitiligo patches less obvious. These include using sunscreen regularly to minimize the contrast between affected and unaffected areas of skin and applying makeup or self-tanner on white spots.
There are also numerous treatments for vitiligo. Topical medications such as tacrolimus (Prograf) and light therapy may help. The latest treatment is the topical JAK inhibitor ruxolitinib (Opzelura), which is the first therapy that can restore pigment in people with the most common form of vitiligo.
Hypothyroidism Can Cause Dry Skin, Hair Loss, and Weight Gain
Hypothyroidism (also called underactive thyroid) occurs when the thyroid gland doesn’t produce sufficient hormones. Hypothyroidism is often a result of Hashimoto’s thyroiditis, a disorder in which the immune system attacks the thyroid.
Hypothyroidism causes a person’s metabolism to slow, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms tend to develop over time and may include fatigue and a sensation of always being cold, as well as visible signs such as dry skin, hair loss, and weight gain.
There is no cure for hypothyroidism, but doctors can treat it with a synthetic form of thyroid hormone (Synthroid) in a daily pill. Periodic blood tests can help your doctor make sure you are taking the right dose.
Rheumatoid Arthritis Can Cause Swollen Joints
With rheumatoid arthritis (RA), the immune system attacks the lining in the joints, leading to inflammation, pain, and swelling. If untreated, the disease can cause permanent damage to bones and cartilage in the joints.
Over-the-counter pain relievers like ibuprofen (Advil) and oral corticosteroids can help ease inflammation. Disease-modifying antirheumatic drugs like methotrexate are considered to be the gold standard of RA care. Injectable biologics and JAK inhibitors target the immune system to reduce inflammation.
Physical therapy, exercise, and stress-reducing activities like yoga and meditation can also improve joint and muscle strength as well as function.
Type 1 Diabetes Can Cause Itchy, Dry, Infection-Prone Skin
Type 1 diabetes occurs when the immune system attacks and destroys cells in the pancreas that produce insulin, a hormone that helps the body control glucose (blood sugar) levels. The resulting lack of insulin allows glucose to build up in the blood, making it difficult for the body to properly convert it into energy, according to the American Diabetes Foundation.
Because diabetes may impair blood flow, particularly to the feet, the skin can become itchy, dry, and prone to bacterial and fungal infections. People with type 1 diabetes are also more likely to have vitiligo.
Managing the condition with insulin therapy and good nutrition and lifestyle habits can improve symptoms, including skin issues.
Lupus Can Cause a Rash Across the Nose and Cheeks
A butterfly-shaped rash across the nose and cheeks is the hallmark of lupus, which develops when the immune system attacks organs and tissues throughout the body, leading to inflammation. A person with lupus may also experience skin lesions after sun exposure.
Lupus treatments include nonsteroidal anti-inflammatory drugs, immunosuppressants, corticosteroids, and antimalarial drugs, according to the Lupus Foundation of America. Work with your doctor to find a treatment plan that’s right for you.
Dermatomyositis Can Cause a Shoulder Rash
Dermatomyositis is a rare inflammatory disease that causes a rash on the shoulders, upper chest, back, and around the knuckles, as well as on the face and eyelids, according to The Myositis Association. Other symptoms include muscle weakness, shortness of breath, and trouble swallowing. It is most common in children between ages 5 and 15 and adults ages 40 to 60.
The most typical treatments for dermatomyositis are immunosuppressants and corticosteroids. In children, the symptoms often go away completely on their own. In adults, however, dermatomyositis may be a sign of another underlying disease. Since the condition can also develop into pneumonia or even cause lung failure, it’s important to see your doctor if you notice this type of rash.
Additional reporting by Beth W. Orenstein.
Alexa Meara, MD
Medical Reviewer
Alexa Meara, MD, is an assistant professor of immunology and rheumatology at The Ohio State University. She maintains a multidisciplinary vasculitis clinic and supervises a longitudinal registry of lupus nephritis and vasculitis patients. Her clinical research is in improving patient–physician communication. She is involved in the medical school and the Lead-Serve-Inspire (LSI) curriculum and serves on the medical school admissions committee; she also teaches multiple aspects of the Part One curriculum. Her interests in medical-education research include remediation and work with struggling learners.
Dr. Meara received her medical degree from Georgetown University School of Medicine in Washington, DC. She completed her internal medicine training at East Carolina University (ECU) at Vidant Medical Center in Greenville, North Carolina, then spent two more years at ECU, first as chief resident in internal medicine, then as the associate training program director for internal medicine. She pursued further training in rheumatology at The Ohio State University in Columbus, completing a four-year clinical and research fellowship there in 2015.
Anne L. Fritz
Author
Anne L. Fritz is a New York City-based freelancer with more than 15 years experience.
She enjoys covering a range of healthcare topics and has a particular interest in advances on the anti-aging front including lasers and cosmetic injectibles.
Prior to launching her freelance career, Anne was Style Director at Life & Style magazine and Fashion & Beauty Editor at Woman’s Day. She has also worked at InStyle.com, MarthaStewart.com and Working Mother magazine.
Anne is a graduate of Syracuse University and a Washington D.C. native.