Losing hair can feel like losing your identity
Alopecia can have a big impact on the children and adults affected, but what causes it and will it grow back? LISA SALMON finds out more
HAIR loss isn’t just something that happens to older men – alopecia can affect anyone at any age. And while genetics play a part, there are lots of possible causes, including stress, underlying illnesses, pregnancy and menopause.
A number of celebrities have been affected too, including Little Mix’s Jesy Nelson, who’s talked about experiencing hair loss after being bullied at school; Matt Lucas, who lost his hair at age six, and Oscarnominated actress Viola Davis, who opened up about losing half her hair to stress-related alopecia aged 28.
Here, an alopecia specialist, and a functional health coach whose own son had alopecia, tell us more...
WHAT IS ALOPECIA?
THERE are many types of alopecia, the most common being the predominantly hereditary androgenetic alopecia, or ‘male or female pattern baldness’. Another common type is alopecia areata, which can causes patchy hair loss, with typically circular bald patches that range in size.
For some, total baldness can develop (alopecia totalis), or total loss of all body hair (alopecia universalis), although this is more rare. Consultant dermatologist Dr Sharon Wong, of the London Bridge Hospital (part of HCA UK) says alopecia areata is an autoimmune condition, in which the immune system attacks growing hair follicles.
“Alopecia is a term many are familiar with but is actually often misunderstood. The word alopecia simply means hair loss – nothing else,” says Dr Wong.
WHO IS MOST LIKELY TO GET ALOPECIA?
ALOPECIA areata can affect anyone, children and adults, says Dr Wong. However, she continues: “Genetic factors are important. In 20% of those affected, there’s a family history of alopecia areata. The risk of developing it may also be greater in those with a personal or family history of other autoimmune conditions. In some, stress can be a trigger, but in many people no specific trigger is identified.”
A ‘trigger’ simply means something that prompts the symptoms to start, in people who may already have been more predisposed to developing them.
Other triggers might include a viral infection or trauma.
WILL IT GROW BACK?
THERE’S no cure for alopecia areata, although some choose to try treatments. Many find it gets better on its own after a while, or patches come and go.
Dr Wong says up to 80% of adults with small patches of alopecia areata on the scalp will spontaneously regrow hair with no treatment, usually within a year. “But hair loss can sometimes get worse before it gets better,” she adds.
WHAT IMPACT CAN ALOPECIA HAVE?
HAIR loss can have a very big impact, particularly on things like self-confidence and mental wellbeing. “To lose hair, for many people, feels like they’ve been stripped of their identity. It is never ‘just hair’,” stresses Dr Wong, who says because alopecia areata can cause very sudden hair loss, those affected often don’t have much time to come to terms with it and have to quickly adapt to their new appearance.
They also don’t know whether their hair will ever regrow, which can be very distressing.
She adds: “Anxiety, depression, and social phobias are common consequences of hair loss, which are sadly too often overlooked and trivialised.”
WHAT TREATMENTS ARE THERE ?
THERE’S no rule that says you have to ‘treat’ alopecia, but for those who are interested, steroid scalp solutions, steroid injections into the hair loss area, or oral steroids are the most common treatments for alopecia areata.
“Steroid injections can be highly effective,” explains Dr Wong, “resulting in hair growth in around 60-80% of patients, particularly if treated early and in those with less extensive hair loss.”
Other treatments include topical immunotherapy, which deliberately creates irritation on the scalp surface to act as a decoy to distract the immune cells away from the hair follicle, and immune suppressant drugs, which dampen the effect of the immune system.
CAN OTHER FACTORS PLAY A ROLE?
THERE’S still a lot of mystery around alopecia areata and why it affects some people more than others, and it can be very unpredictable. That said, there are steps people can take to help make living with alopecia easier.
Laura Krippner, whose son, Harrison, was diagnosed with alopecia in 2016 when he was 11, believes lifestyle can play a role.
After seeing many doctors, Laura took Harrison to see a functional medicine doctor, who helped them with positive diet and lifestyle changes. Harrison’s hair did eventually regrow, and although there’s no concrete evidence around these things, Laura believes the lifestyle interventions were important – and has since trained to become a certified functional health coach herself (practicalhealthcoach.uk).
ONE FAMILY’S STORY
LAURA knew of a history of autoimmune disease in the family,
I want people to know they have options above and beyond the steroid lotions they will typically be offered in the dermatologist’s office... Functional health coach Laura Krippner
and Harrison first started to lose hair behind his ears in mid-2016, before badly breaking his leg later that year.
“This trauma, and the time spent recovering, was tough on him. The last straw was a course of antibiotics, which wiped out his gut bacteria and had his hair falling out in handfuls,” Laura says. She says Harrison was completely bald for two years, before regrowth started.
She believes there are close links between immune function and gut health, saying: “Eating a nutrient-dense, wholefood diet is a key element. Managing stress, getting enough sleep, your home environment and exercise also play a part. The approach is different for everyone.
“Making lifestyle changes can be difficult – I want people to know they have options above and beyond the steroid lotions they will typically be offered in the dermatologist’s office. That said, everyone’s root cause will be different.
“It takes time and persistence to sleuth it out and make the necessary changes.”