Across the world, hair can be a form of self-expression, pride, and cultural significance for people — women and men — across the globe. However, for some, hair consultations and conversations are not always about beauty, but health, such as the more than 6 million Americans across the U.S. who have alopecia areata, a disease causing the immune system to attack hair follicles, resulting in hair loss on the face, scalp, and other parts of the body.
During Alopecia Areata Awareness month – recognized every September – patients reveal the various types, symptoms, and social effects experienced when living with the autoimmune disease.
“Research suggests that women are more likely to develop alopecia areata than men and people of some races and ethnicities may have a higher chance of developing the disease. Several U.S.-based studies found the odds of developing alopecia areata were higher among Asian, Black, and Hispanic individuals than among whites,” the National Alopecia Areata Foundation (NAA) reports.
Although alopecia areata is a known autoimmune disease, scientists have yet to confirm why the immune system of people with the gene variation attacks the healthy hair follicles. Likewise, researchers are still working to examine exactly what triggers the disease beyond having a genetic predisposition or increased likelihood to the illness, whether from inside of the body (bacteria or virus), an environmental factor outside of the body, or a combination of both.
But what does appear consistent for those living with the condition, is the hair loss on either the body as a whole, or various parts, largely affecting the scalp and face.
Diagnosing Alopecia Areota
Local dermatologist and surgeon, Dr. Yolanda C. Holmes explained that in many instances, patients find themselves with little to no symptoms outside of the physical hair loss.
“Most times, patients have no symptoms at all, and a lot of times, folks will come to us and say, Oh, I didn’t even know I had this bald spot until my hair stylist or my family members told me I had it.’ So typically, even with the more severe forms, alopecia universalis or alopecia totalis, people have no symptoms at all,” Holmes tells the Informer.
The NAA details that more than 80% of patients show signs of the disease before age 40, and 40% experience symptoms by the age of 20. Currently, there is no found cure for alopecia areata, and while many will feel no symptoms other than the hair loss, others might experience irritation to the scalp due to the condition.
“Now, with some of the scarring alopecia, patients will have symptoms like itching, burning, or they also may have no symptoms at all. With telogen effluvium, they may not have any symptoms. So a lot of times, you may not have any symptoms at all,” Holmes said.
Waleola Oyegbola, 54, was in her early 30s when she started to experience shedding and dermatitis of the scalp while using popularly known hair products. After years of toiling with various products and hairstyles to remedy the issue, she shaved her head in hopes to repair her broken hair growth.
“What is interesting is after I chopped my hair and grew it back, I got locks. Locks were OK, but after a while I was seeing the locks get thinner and thinner. So finally, I cut it and I could see where it was very light on top and then fuller in the back. That’s when I went to the dermatologist to do a pull test.”
Oyegbola was diagnosed with androgenetic alopecia, a common form of hair loss in both men and women, due to an excessive response to androgens.
Battling food allergies amid her bout with alopecia, Oyegbola began making a connection between her dietary habits and its potential impact on her scalp health. In some instances, food allergies can indirectly impact hair health or cause an allergic reaction leading to a nutritional deficiency.
Dr. Holmes underscored the importance of a balanced diet and sufficient intake of vitamins to promote overall wellness.
“We have a lot of environmental [factors that affect] hair growth. The vitamins that are important for hair growth include Vitamin A, or B vitamins like B12 folate,” Holmes said. “A lot of patients are vitamin D deficient, and that definitely affects hair growth. If you are iron deficient, that can also [trigger] hair loss. If you know that you are not eating a well-balanced diet, fruits and vegetables are important, but supplements are also very helpful.”
Confronting Alopecia from an Early Age
Kalayna Walker, 20, was only 3 years old when she started losing patches of hair on her head. Terrified that she may have an undetected cancer, her parents took her to a doctor looking for answers. It was shortly after that her family learned that she had alopecia areata.
Since the condition was caught early into her shedding, prescribed creams and treatments helped recover her hair up until the age of 7, when she began to lose all of her hair in clumps.
“In 2011, I [went] completely bald. I was devastated, because there was nobody [around me] at that time [who also had this condition],” Walker said.
Initially, Walker experimented with various remedies including hair spray paint, and eventually an acid treatment to promote her hair growth, which she still recalls as a physically painful experience. To no avail, she proceeded through the most tender years of her adolescence learning how to cope with the disease.
Wigs became the common cover to shield her from the social discomfort of exposing her condition in front of her peers. Actively participating on her school dance team, her mother was instrumental in customizing wigs that allowed her to dance and blend in with her peers without any noticeable difference.
“My mom would make sure that I felt as normal as possible, because I was not ready to go to class with no hair. [Before] when I had hair, everybody would love my hair. Like, ‘oh my gosh, your afro!’ [But] then, my mom had to make a wig out of bundles with a wig cap to almost mirror the fact that I didn’t have hair.”
Removing the Wigs, Living the ‘Bald Truth’
Her journey with wigs became a learning process, learning to customize her wigs to prevent removal from sweat or dancing, as she never shared her condition with any of her peers. Even into her adulthood as a dancer for the NBA’s New Orleans Pelicans basketball team, hair was an idolized feature that weighed on her consciousness while performing.
The stress of worrying about wig choices or whether her hair would be stable enough during performances impeded her ability to strictly focus on dance.
After months of stress and inner turmoil, Walker felt a deep conviction to step out from behind the shadow of fear and share her truth with the world.
“It was very toxic for me, because while others were thinking about the routine, I’m thinking about, ‘is my hair gonna come off,’” said Walker. “God literally told me to tell my story and to write my own book, and that when I turned 20, on August 12, 2024, I would be free from all of this.”
‘Bald Truth,” Walker’s first book, details her journey from “self-doubt to self-acceptance,” as she fought through the majority of her life feeling shackled and ashamed of alopecia.
“From 7 years old, we kept it a secret until I was able to embrace it, which was 13 years later. I’ve been living in wigs, hiding because of fear and shame,” Walker said. “Alopecia is a different type of insecurity that not only hits the way you see yourself, but also, [makes you question] how do others see me? And that was a hard pill to swallow. I literally just despised the fact that I had alopecia.”
Now, Walker stands as a testament to the ability to embrace her identity and condition in front of the world when facing an illness that pushes against social constructs and expectations.
Oyegbola’s journey with alopecia led her to an alopecia awareness group, which has encouraged her to don her hairdo confidently, without the burden of internal stressors or societal standards.
“What was so empowering for me is joining [the] group and really accepting what I had. I would say [to myself], ‘OK, this is it. I can’t be ashamed,’” Oyegbola told The Informer. “When we tie ourselves to hair, [we can feel] so deficient. I kept on trying to grow it and do these styles, and it just wasn’t working for me. I had to realize, though, that’s just not for me. I had to be OK with me.”