Since the infamous Oscars slap by Will Smith at Chris Rock, Alopecia has become a hot topic. The spread of heightend awareness over this hair loss disease resulted from the joke Rock made about Jada Pinkett Smith’s bald head. She suffers from alopecia.

Talking with Dr. Evette Ramsay, a dermatologist at Kaiser Permanente Southern California, this reporter learned why there was such harsh backlash about the joke. 

Q: What is alopecia?

A: Alopecia is a medical term that means hair loss. There are many types of hair loss, and they are often divided into scarring types of hair loss, which are permanent, and non-scarring types of hair loss in which the hair can grow back. 

A common type of hair loss is androgenetic alopecia or male pattern alopecia. It’s estimated that about 50 percent of men will have androgenetic alopecia by age 50. Women may also get androgenetic alopecia. It is often less pronounced and starts later in age. 

Alopecia areata refers to an autoimmune induced type of alopecia. This alopecia attacks the hair follicles and causes a temporary loss of the hair in patches of varying sizes and locations. In mild cases of alopecia areata, one to a few patches of hair loss may occur, which may grow back spontaneously within months. 

In more severe cases, called alopecia totalis, complete baldness can occur. In the most severe cases, it is called Alopecia Universalis. All the hair on the scalp and body is lost. It’s estimated that there is a 2.1 percent chance of getting alopecia areata in one’s lifetime. 

Traction alopecia is a form of hair loss that results from chronic, prolonged, and repetitive tension on the scalp hair. Hairstyles like tight ponytails, buns, or braids can lead to damage and permanent loss of the hair follicles. 

Central centrifugal cicatricial alopecia is a form of scarring alopecia in the scalp, it is the most common cause of scarring hair loss in Black women. The multiple factors that can cause this include chemical processing, heat straightening, tight extensions, genetics, and infections.  

Telogen effluvium is a form of non-scarring temporary alopecia which occurs after severe stress such as major illness, significant weight loss, or childbirth. 

Q: What are the physical symptoms?

A: In androgenetic alopecia, there is a slow, gradual loss of hair from the temples and the crown of the scalp.

Alopecia areata usually starts as painless, non-itchy, round, or oval patches of hair loss of varying sizes with completely smooth patches of underlying skin.

Traction alopecia progresses slowly over time, with the hair loss occurring in the area of tension on the hair. This is usually the hairline. 

In central centrifugal cicatricial alopecia the hair loss usually starts at the crown of the scalp and spreads peripherally. 

Telogen effluvium usually presents with diffuse sudden onset hair shedding from the root of the hair with gentle hair pulling. 

Q: How does it affect people socially?

A: Throughout history, hair has played a significant role in our society. It is associated with youth and beauty in women and strength and masculinity in men. Alopecia can affect people socially and psychologically, it is associated with higher levels of anxiety and depression. People with alopecia also report poorer quality of life, lower body image, and lower self-esteem. This may lead to social anxiety and social withdrawal. 

Q: Why is it more common among African-Americans?

A: Traction alopecia and central centrifugal cicatricial alopecia are more common in African-Americans primarily because of hairstyling practices, such as tight braids, tight weaves, extensions, and straightening with heat. 

Alopecia areata is 1.7 to 2.7 times more likely in African-Americans when compared to Caucasians. The reason for this is poorly understood.  

Q: Is it harder for women who have the condition?

A: Hair loss, while hard on both sexes, is more distressing for women because it is generally more accepted and expected for men to lose their hair than women. The beauty industry has associated hair with an expression of wealth, power, attractiveness, and individuality. As a result, hair loss is associated with lower socioeconomic status and unattractiveness, this can be particularly psychologically challenging for women. 

Q: What are Positive Ways to Cope with Alopecia?

A: Join a support group. Being part of a community with the same condition is a great way to meet others with similar experiences who understand the challenges you are experiencing. 

Seek medical help. Some forms of alopecia including alopecia areata may respond to medical treatment with topical medications, oral medications, and injections. 

Consider wearing a hairpiece or wig. Wigs have improved and are lighter weight than in years past. Or, accept the hair loss and be bald and beautiful.

Q: Where can one seek help if they have this condition?

A: The American Academy of Dermatology, Aad.org, has resources including lists of doctors who treat alopecia. 

The National Alopecia Areata Foundation, Naaf.org, has resources on support groups, research, and community connections. X

Alopeciaworld.com is an online community support group with information and resources.

Kaiser Permanente offers valuable information about hair loss at https://tinyurl.com/3b8m7vww.

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