Rushali Chandel was four years old when her mother spotted small bald patches on her scalp. “I was too young at the time to realise anything or feel much. But people started seeing me differently,” recalled Rushali.
Alopecia is an auto-immune disorder. According to the American Academy of Dermatology, it is defined as a condition when the ‘immune system mistakes a part of your body as foreign and attacks.’ In specific cases of alopecia, the immune system attacks hair follicles, causing hair fall or bald patches. Sometimes it may also affect nails. It can be caused by a variety of factors, including genetics, hormonal changes, autoimmune disorders, and underlying medical conditions.
One may recall the infamous incident from the 94th Academy Awards, when actor Will Smith walked onto the stage and slapped comedian Chris Rock, in response to a joke the latter made about Smith’s wife, Jada Pinkett Smith’s shaved head. Jada, in 2018, on her talk show Red Table Talk, revealed experiencing hair loss, potentially because of stress. After she was diagnosed with alopecia areata in July 2021, she started completely shaving her head.
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Studies found that searches for alopecia on Google had surged by 600 per cent as individuals tried to understand the condition, while Twitter interactions soared too, by over five million percent. These surges pointed towards a significant increase in awareness and education about the condition, alopecia, which was prompted by the incident.
For a deeper understanding of what Rushali and many others living with alopecia deal with, OnlyMyHealth contacted Dr Deepak Jakhar, Consultant Dermatologist – Dermosphere Clinic, New Delhi and author of the book ‘Good Skin Bad Skin’. His insights are under the ‘doctor speaks’ section in relevant parts of this article.
Rushali, 29, suffers from alopecia universalis, which involves the loss of all body hair, including eyebrows, eyelashes, chest, and other body parts.
This feature is a part of our series ‘Survivor Stories’, featuring people who’ve combatted or are living with various diseases or ailments. We combine their personal experiences with inputs from experts and specialised doctors, ensuring that you get credible and authentic information.
Symptoms of Alopecia
Doctor Speaks:
The symptoms of alopecia can manifest in various ways depending on the type and severity of the condition. Most notably, individuals may experience hair loss, which can occur in patchy areas or lead to gradual thinning of hair across the scalp or body. In cases of alopecia areata, distinct round or oval patches of hair loss may develop, while androgenetic alopecia often presents as a gradual thinning of hair, particularly on the crown or temples. While scalp sensitivity and tenderness can occur, itching or soreness are not typical symptoms of alopecia itself but may be present due to scalp irritation or underlying skin conditions like tinea capitis.
Apart from hair loss, Rushali has suffered from broils on her scalp, when the skin was exposed to extreme temperatures.
Doctor Speaks:
Alopecia is relatively common, affecting millions of people worldwide. It can occur at any age and may vary in severity from mild thinning to complete hair loss. While the exact prevalence of alopecia varies depending on factors, such as age, gender, and geographic location, it is estimated that a significant portion of the population will experience some form of hair loss during their lifetime.
“Discrimination is Taught”
At a young age, Rushali’s friends didn’t discriminate against her. The taunts largely started with comments from relatives. “How will you get married? How will you ever find love?” were taunts that haunted her when she grew up.
Rushali said, “Nobody is born with discriminatory thoughts, but they’re taught to discriminate.”
In the early years, the discriminatory comments and jibes shook up her confidence. “I stopped going out, and even talking to my friends,” she said. For a while, she avoided even looking into the mirror. She suffered from acute insecurity issues, which resulted in mental health concerns like depression.
One incident she vividly remembers is from a time she was dancing in a baraat (wedding procession), when a woman commented “This ugly girl dancing in front of us is ruining all our photos and videos.” Rushali overheard and was left shattered.
It took her years to rebuild her confidence. She says while her friend circle is empathetic and kind, dating has been difficult.
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Treatment Options for Patients With Alopecia
Multiple doctor visits weren’t fruitful in permanently regrowing thick hair for her.
Other treatments she tried were PRP, as well as having injections getting applied directly to her scalp.
Doctor Speaks:
Treatment options for alopecia vary depending on the type and severity of the condition. Here are some common treatment options:
1. Topical Treatments: Minoxidil is a commonly used topical medication that is applied directly to the scalp to stimulate hair growth. It can be used for both male and female pattern baldness.
2. Oral Medications: Finasteride is an oral medication approved for treating male pattern baldness. It works by blocking the hormone Di-Hydro Testosterone (DHT), which is thought to be a major factor in hair loss.
3. Steroid Injections: In cases of alopecia areata, corticosteroid injections into the scalp can help reduce inflammation and stimulate hair regrowth.
4. Topical medications or Immunotherapy: This treatment involves applying a chemical irritant to the scalp to provoke an allergic reaction, which may stimulate hair regrowth in cases of severe alopecia areata.
5. Light Therapy: Low-Level Laser Therapy (LLLT) or phototherapy involves exposing the scalp to specific wavelengths of light to stimulate hair follicles and promote hair growth.
6. Hair Transplant Surgery: In cases of advanced hair loss, hair transplant surgery may be an option. This involves transplanting hair follicles from areas of the scalp with healthy hair growth to areas of thinning or baldness.
7. Scalp Micropigmentation: This non-invasive procedure involves tattooing the scalp with pigment to create the appearance of fuller hair, particularly in cases of extensive hair loss or scarring alopecia.
8. Diet and Lifestyle Changes: It's important to consult with a dermatologist to determine the most appropriate diet plans and lifestyle modifications for your hair loss issues.
Thankfully for Rushali, after years of nothing working, she’s witnessed one drug working for her, recently.
A common question many search for is “Is alopecia ever completely curable?”
Doctor Speaks:
The prognosis for alopecia varies depending on the type and individual factors. In some cases, alopecia may resolve on its own without treatment, particularly if it is a temporary condition like alopecia areata. However, for many individuals, alopecia may be a chronic or recurring condition that requires ongoing management to control symptoms and promote hair regrowth. While certain treatments, such as medications, topical therapies, and procedures like hair transplantation can help stimulate hair growth, they may not always result in full restoration of hair. Additionally, the effectiveness of treatment can vary from person to person, and some individuals may experience fluctuating periods of hair loss and regrowth throughout their lives.
Coming to Terms With Her Own Beauty
In a bid to deal with all the taunts, Rushali used to primarily dress as a ‘tomboy’ earlier in her life.
It took her years to come to terms with her condition, and now she doesn’t shy away from wearing whatever pleases her.
She says that in today’s capitalistic world, beauty is presented to us in such a way that all of us end up buying multiple products to fix our so-called imperfections. These portrayals of beauty do take a toll on patients living with alopecia.
Doctor Speak:
Mentally, alopecia can lead to low self-esteem, social anxiety, depression, and feelings of isolation. Managing these challenges requires a comprehensive approach that addresses both the physical symptoms and the emotional impact of hair loss. Seeking support from healthcare professionals, joining support groups, and practising self-care strategies are essential for coping with the emotional toll of alopecia and improving overall well-being.
Is Alopecia Genetic? Can it be Caused by Any Shock or Trauma?
These two were some of the most commonly searched queries on Google about alopecia, so we asked Dr Jakhar to weigh in.
Doctor Speaks:
Yes, alopecia can have genetic factors, particularly in cases of androgenic alopecia, where the condition tends to run in families. However, alopecia can also be triggered by factors, such as trauma or shock. Alopecia areata, for example, is believed to have an autoimmune component, where the immune system mistakenly attacks hair follicles. Trauma, stress, or significant life events can sometimes trigger or exacerbate this autoimmune response, leading to sudden hair loss. While genetic predisposition plays a role in some cases, environmental factors and individual susceptibility to stress or trauma can also influence the development of alopecia.
Speaking Up On Social Media
Now, in a bid to increase representation and own her identity, Rushali talks openly about her journey with alopecia on Instagram. She was very apprehensive about putting herself out there but now says that the love she has received online has been far more than any hate that came her way. Her IG handle is that.alopeciagirl. https://www.instagram.com/that.alopeciagirl/?hl=en.
Rushali added that while everyone suffers from hair fall, hair grows back for most. However, if someone is noticing routine excess hair fall and bald patches, they should consult a doctor immediately.
Doctor Speaks:
It's advisable to see a dermatologist when experiencing sudden or significant hair loss, whether in patches or as gradual thinning. Additionally, if hair loss is accompanied by symptoms, such as scalp irritation, redness, or systemic symptoms like fatigue, it's crucial to seek medical attention promptly. A dermatologist can accurately diagnose the cause of hair loss, provide appropriate treatment options, and offer support and guidance to address any emotional distress associated with hair loss. Seeking early intervention from a dermatologist can lead to better outcomes and help individuals regain confidence in their appearance and overall well-being.