• Reshma Khan MD

Story of “Fa Mulan’

Updated: May 5, 2019



Last week I saw Disney’s ‘Mulan’ with my 8-year-old son for the first time. I was impressed with this Disney movie for so many reasons but I will admit the most important reason that I loved the movie was because the story was centered around a girl rather than countless stories about boys being heroes. In this movie Mulan disguises herself as a male soldier named “Ping” to bravely take her father’s place in the Imperial Army. She cuts her beautiful long hair to disguise herself. This made me think how hair is a symbol of femininity. This is not just because many of us believe that appearances are important, but also because our hair represents our personality, thoughts and beliefs. After watching this movie I kept thinking about my patients who have been upset in the past about their hair loss.




Being a woman physician, I am definitely more sympathetic towards my women patients when it comes to their hair. As a rheumatologist I come across patients suffering from hair loss either from autoimmune diseases or as a side effect from their arthritis medications. I remember the day when I saw a young woman in my office who was upset because she was experiencing hair loss from one of her arthritis medication. I clearly remember her telling me that,

“If I have to choose between my hair and my joints, I will choose my hair!”

I explained to her that I could understand her frustration and she did not have to make that choice.


Autoimmune diseases can cause hair loss in many patients. Some conditions like lupus can cause significant hair loss and it can be scarring. Sometimes medications to treat certain autoimmune conditions such as rheumatoid arthritis can also cause hair loss. Fortunately hair loss from medications is not very common and most of my patients do just fine. Most common medication used in rheumatoid arthritis that can cause hair loss is Methotrexate. It is a very effective medication to treat rheumatoid arthritis. I always prescribe daily folic acid which is a vitamin (B complex family) with methotrexate. Folic acid helps mitigate some of the side effects from methotrexate. I usually prescribe 1 mg Folic acid everyday however in some patients I prescribe higher doses to help with hair loss. Methotrexate is a very effective medication to treat rheumatoid arthritis and most of my patients do fine with methotrexate and daily folic acid. However if you are concerned with significant hair loss please talk to your rheumatologist to discuss other treatment options. Another medication called leflunamide may also cause hair loss like methotrexate.


In my lupus patients I also recommend avoid using hair chemicals or heating devices to reduce the damage to hair follicles.


Being an Indian, I am blessed with good genes for hair. In India, growing up my mother use to put coconut oil in my hair for healthy hair growth. I am often being asked if I have secret for having good hair. I am not sure if it is my good gene or all that hair oil massage. But I still sometimes do ‘warm oil’ treatment in my hair when I get time. In case if you are wondering the recipe….


I take coconut oil in a microwave safe bowl and warm it in a microwave for 30 seconds making sure it is not overheated. I apply oil with my fingertips all over my scalp and hair and then gently massage it. I then take a big towel soaked in warm water and squeeze all water out so towel has just moist heat. I wrap towel around my head covering all my hair. I keep it for 15 minutes and wash my hair 2-3 hours after this process with my regular shampoo and conditioner.


If you are suffering from significant unexplained hair loss, please talk to your doctor. You may need further evaluation as it may be due to underlying serious medical condition.

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