In the last few weeks, since the 94th Academy Awards ceremony and the controversy surrounding Will Smith‘s slap on Chris Rock, a lot has been said about the hair loss condition affecting Jada Pinkett Smith: Alopecia Areata. But do you know what exactly is the disease and what are its impacts on the daily lives of those affected?
Her Campus spoke with Dr Paula Sanchez, member of the Brazilian Society of Dermatology, about Alopecia and other information related to it. Get to know more about the condition:
What is Alopecia?
“Alopecia is a term that refers to any form of hair loss on some part of the body or scalp. There are different types of hair loss patterns and, therefore, different types of alopecia”, explains the dermatologist. However, the most common is the loss of hair in the scalp region, which is known as baldness, according to a research disclosed by Pfizer Laboratories Brazil.
What causes Alopecia?
There are many different forms of alopecia that can manifest in the body, therefore, there are several causes. Androgenetic Alopecia, for example, is genetic. “In the case of Androgenetic Alopecia, the hormone testosterone is converted into dihydrotestosterone, which acts on the hair follicle and causes its thinning. This can occur by a combination of environmental and genetic changes”, says Sanchez. It is the most common type and causes hair loss in the scalp. It can start to appear during the teenage years, but becomes more apparent when the person is 40 or 50.
But genes aren’t the only factor. Traction Alopecia can be caused by excessive tension when tying back your hair, braiding or doing other tight hairdos that damage the follicle and destroy the roots. “Abscedens and Decalvans Folliculitis occur due to a neutrophilic inflammation of the hair follicle, which results in hair loss and pus formation. Thereby, we can say that each alopecia has a type of cause that varies from nutritional to hormonal changes, so it is difficult to determine an exact one”, highlights the doctor.
Alopecia Areata, on the other hand, is considered an autoimmune disease, that is, when the immune system attacks its own body and stops it from producing new hair. It causes inflammation in the hair follicle bulb and can affect not only the scalp, but also eyebrows, beard and eyelashes. “It is not known for sure why this happens, but we do know that it is linked to genetics and stress”, points out Sanchez. This form of alopecia can also be related to other autoimmune diseases, such as vitiligo or lupus. Another type is Frontal Fibrosing Alopecia, which is very common to happen with women going through menopause.
“Alopecias can be non-scarring, such as Alopecia Areata and Androgenetic Alopecia, or scarring, like Frontal Fibrosing Alopecia, Lichen Planopilaris, Lupus Erythematosus, Folliculitis Decalvans and Abscedens”, adds Dr. Paula Sanchez.
How is the diagnosis made?
Hair loss can be noticed by anyone, but it is needed to get a professional evaluation to detect the condition and specify the type. “The diagnosis of alopecia is often only clinical and can be complemented by trichoscopy, a method of hair and scalp analysis. However, especially in cases of scarring alopecia, a scalp biopsy with anatomopathological examination may be necessary”, says the dermatologist.
Are any other body parts affected?
We usually think that alopecia affects only the scalp region. However, hair loss may occur at other points throughout the body. “Other parts of the body can be affected in some types of alopecia, such as areata and lichen planopilaris”, reveals the doctor. In the case of Alopecia Areata, as it compromises the structures in skin that form hair, hair loss can be noticed on the face as well, like eyebrows and beard. What many do not know is that this type of the disease has subtypes, and each of them has a different pattern of hair loss.
Patchy Alopecia Areata, the most common subtype, causes coin-shaped hair loss in one or more patches of the body. People with Alopecia Totalis are prone to losing all or almost all of their scalp hairs. Speaking of Alopecia Universalis, the rarest of them, patients can lose completely – or nearly – all the hair on their body.
Lichen Planopilaris, an inflammatory condition affecting the skin and mucous membranes, also affects the scalp and hair in general. The big difference is that, in this type, scaly skin and redness around the hair follicles, baldness and pain, burning or itching on the scalp are some of its characteristics, according to the Genetic and Rare Diseases Information Center (GARD).
Does it affect more women than men?
“It depends on the type of alopecia. For example, androgenetics affects men more and frontal fibrosing affects women more”, points out the dermatologist. The English word ‘androgenetic’ comes from English ‘genetic’ and English ‘andro’, which means male. That’s the reason why this name was given to the disease. In this instance, as we already mentioned, the hormone testosterone is converted into dihydrotestosterone, which acts on the hair follicle and causes its thinning – and that is why men are part of the group with the highest occurrence. Over time, the hair gets weaker and weaker until it disappears. Women also produce testosterone, but in a smaller amount, which makes them suffer less from this variant.
When we mention frontal fibrosing alopecia, we are talking about a health problem that is almost exclusive to adult women, usually post-menopausal, but that also affects the younger ones. As specified by the Brazilian Society of Dermatology, the cause is still unknown. What is known is that the organism, for some reason, begins to attack and inflame the hair follicle, destroying it. Although, scientists believe that frontal fibrosis may be related to genetic, hormonal, environmental and immunological factors as well.
Self-esteem and emotional: how do patients deal with it?
“Alopecia greatly affects the emotional state of those affected by the disease”, comments Sanchez. Based on a study by the International Society of Hair Restoration Surgery (ISHRS), hair, or lack thereof, is the physical attribute that most affects a person’s self-esteem. Besides, whoever thinks that men don’t care about their appearance is wrong: the research data showed that 75% of men who have hair loss feel less confident, even more so when it comes to romantic relationships.
For 85% of women, hair is a determining factor for feeling good about themselves, confirms a Head & Shoulders survey carried out with 1,300 women from all over Brazil. “That is why psychological counseling and support groups are important for the exchange of experiences between patients”, complements the specialist.
Is it treatable?
“All alopecias have some type of recommended treatment. However, not always the hair can be fully recovered. Alopecia Areata Universalis, for example, can be very difficult to treat and Scarring Alopecia leaves areas that once affected may not return to normal”, explains the doctor. Some treatments may include the use of specific antibiotics and other medications, such as topical ones. When the cause of alopecia is related to nutritional deficiencies, the intake of supplements may be indicated by a specialist.
Talking about aesthetic repairs that can improve patients’ self-esteem and quality of life, hair implants become an option for those with Androgenetic Alopecia. However, something that many do not know is that, even with the hair implant, the patient needs to continue with drug treatment to delay the progression of the disease.
Classifying the type of alopecia is essential for the treatment to be well targeted, and that’s why it’s extremely important to look for a dermatologist or trichologist when you notice a very sharp hair loss – more than 100 strands of hair a day.
Do you have any comfort words for people with alopecia?
“I would tell them to find a dermatologist who can take the time to answer their questions and help them. Furthermore, do not lose heart. In most cases we can improve and it is highly recommended to start treatment as soon as possible”, says Dr. Paula Sanchez. It is known how much a disease can hit the psychological aspect of those affected by it, even more when it directly impacts the appearance. Because of that, it is very important to seek medical help and also psychological support from specialists and, not least, from those we love. The most important thing is not to lose hope and never give up!
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The article above was edited by Amanda Moraes.
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