This year’s Oscars may go down in history as one of the wildest in the academy’s 93-year history. The award show made headlines when actor Will Smith struck comedian Chris Rock on stage after he made a joke about his wife’s, Jada Pinkett Smith, appearance. Since 2001, the actress has kept a shaved head due to her alopecia, a condition that, until recently, many people may not have been aware of. While the altercation between Smith and Rock continues to dominate social media, many people are also asking, “what is alopecia?” To help answer that question, we’re bringing you everything you need to know about alopecia.
What Is Alopecia?
Alopecia, also known as alopecia areata, is a common autoimmune disorder that typically results in the unpredictable loss of hair. The condition affects roughly 6.8 million people in the United States and has a global prevalence of about 2% (156 million). In the majority of cases, alopecia causes the hair to fall out gradually in small patches around the size of a quarter. For most, this hair loss is typically contained to a few small patches, although it can become more widespread.
There are a few different types of alopecia, each with its causes and symptoms. Alopecia areata is the most common, but other types include:
- Alopecia areata totalis: This type of alopecia refers to a total loss of hair on your head. It is an advanced form of alopecia areata and affects a small number of people with alopecia areata.
- Alopecia areata universalis: As the name suggests, this type of alopecia refers to a complete loss of hair, both on your body and your scalp. It is the most severe form of alopecia areata.
- Diffuse alopecia areata: Diffuse alopecia areata is the sudden thinning of your hair, rather than lost patches. It is a rare form of alopecia, typically observed in young women.
- Ophiasis alopecia areata: This type of alopecia causes hair loss in a band shape around the sides and back of your head. Ophiasis alopecia areata can be more difficult to treat because it does not respond as quickly to medication.
Hair loss can be a difficult condition not only to treat but to live with as well. Some people prefer to let their hair loss run its course untreated and unhidden. Others may cover it up with hairstyles, makeup, hats, or scarves. Further still, others may choose to combat alopecia with one of the many types of treatment methods available. Before pursuing hair loss treatment, talk with your doctor about the cause of your hair loss and treatment options.
Symptoms of Alopecia
The most prominent, and oftentimes the only, symptom of alopecia is patchy hair loss. For most people, small, quarter-sized patches of hair begin to fall out, mainly from the scalp. Alopecia can affect any part of your body that has hair, including the face, arms, and legs.
This hair loss can be sudden, occurring in just a few days or over a period of weeks. Some people may experience an itching or burning sensation at the site of hair loss. Since the hair follicles are not destroyed, hair can grow back once the inflammation of the follicles subsides. People who experience alopecia that results in patches of hair loss may experience repeated growth and loss of hair.
It’s estimated that around 30 percent of people with alopecia experience a worsening of their condition over time. It’s also estimated that around 10 percent of people with alopecia will develop alopecia areata totalis or the complete loss of hair.
Other symptoms that may occur alongside hair loss include:
- Gradual thinning of the hair on top of the head
- Circular or patchy bald spots
- Sudden loosening of hair
- Hair that continually grows back in one spot and falls out
- Brittle, red, or pitted fingernails and toenails
Along with understanding the symptoms of alopecia, it’s also important to understand your risk of developing the condition.
Causes and Risk Factors for Alopecia
Alopecia is the result of white blood cells, part of your body’s immune system, attacking the cells in hair follicles, causing them to shrink and dramatically slow down hair production. This faulty immune response is what classifies alopecia as an autoimmune disorder. It’s still unclear why some people’s immune systems target hair follicles in this way.
While scientists remain unsure as to why these changes occur, it’s widely believed that genetics and family history play a role in your likelihood of developing alopecia. Studies have found that one in five people with alopecia areata also has a family member who has experienced the condition. Other studies have found that people with a family history of alopecia are more likely to have a family history of other autoimmune disorders such as atopy, thyroiditis, and vitiligo.
Other risk factors scientists believe contribute to alopecia include:
- Asthma
- Down syndrome
- Pernicious anemia
- Seasonal allergies
- Thyroid disease
- Vitiligo
If you believe that you may be at risk for alopecia, or if you have a family history of the condition, it may be time to talk with your doctor about what your next steps should be.
Getting an Alopecia Diagnosis
If you believe that you have a type of alopecia, you may want to talk with your doctor. They may recommend seeing a skin specialist, also known as a dermatologist, to help you determine what the cause of your hair loss is. Your dermatologist will:
- Ask you about your symptoms
- Examine the parts of your body where you have hair loss
- Check individual hair follicles to see if they are abnormally shaped
- Examine your nails and nail beds
- Pull gently on the hairs at the edges of your bald spots to see if they come out easily
In very rare cases, your dermatologist may recommend a biopsy, which involves taking a small piece of skin from your scalp to be looked at under a microscope.
Many conditions can cause hair loss, which means your doctor may test your skin for things like a fungal infection, or order blood tests to rule out thyroid, hormone, or immune system issues.
Alopecia Treatment Options
Unfortunately, there’s no cure for alopecia. However, it can still be treated, and in some cases, your hair may even grow back.
- Corticosteroids: By far the most common treatment for alopecia are corticosteroids. These drugs are powerful anti-inflammatory drugs that can suppress the immune system. These are most commonly administered through local injections, topical ointment application, or orally.
- Topical immunotherapy: This treatment is often used when there’s a lot of hair loss, or if hair loss happens more than once with other treatments. Chemicals are applied to the scalp to produce an allergic reaction. If it works, the reaction causes the follicles to grow back hair. It can also cause an itchy rash, and usually needs to be applied several times to keep hair growing.
- Other medications: Other medications that can be prescribed that either promote hair growth or affect the immune system include Minoxidil, Anthralin, SADBE, and DPCP. Although some of these may help with the re-growth of hair, they cannot prevent the formation of new bald patches.
- At-home remedies: If medications aren’t right for you, or if you choose to abstain from them, there are a few home remedies that you can try to help with hair loss. Some people recommend rubbing things like green tea, almond oil, or coconut milk on the scalp. While none of these are known to cause harm, they are also not scientifically proven to help. Other people turn to things like acupuncture or aromatherapy, although these are similarly not research-backed.
If you’re experiencing sudden, patchy hair loss, or if you’re still wondering, “what is alopecia?” or “am I at risk?” it may be a good idea to schedule an appointment with your doctor. They can help you assess your risk, examine your symptoms, and guide you toward the best treatment for you.
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