Four years ago, during one of my regular coloring sessions, my longtime stylist gently pointed out that I had a nickel-sized bald spot — otherwise known as a stress patch — on the crown of my head, right above where my center part and bangs meet.
I was stressed. My mom was undergoing breast cancer treatment, my best friend/roommate and I had a falling out but were still living together, and I was at a dead end in my writing career. My brain was constantly throwing out worries about death, loss, and hopelessness — you know, all the greatest hits.
The idea that stress was physically manifesting itself in the form of a bald patch wasn’t completely shocking, but I still needed to figure out what was really going on with my hair. When I got back to my apartment after the salon, I googled “hair loss patches” all afternoon, in true hypochondriac fashion.
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Eventually, I came across alopecia areata, an incurable autoimmune disease that affects an estimated 4.6 million people in the U.S. It attacks the hair follicles so that hair falls out in concentrated spots or patches, just like the one my stylist found. The hair loss isn’t restricted to your scalp. Some people lose all of their body hair, while others develop multiple patches on their head.
The hair loss is caused by an inflammatory immune system response where cells attack the hair follicles while they’re in the growth stage. Exactly why the hair loss happens remains unclear, but Dr. Francesca Fusco, a dermatologist at Wexler Dermatology in New York City, explains it like this: Your immune system is like a tree, and for some reason, for some individuals, this one branch goes haywire. “We don’t know why, but sometimes a branch of the immune system goes into hyper alert.”
The more I read about the condition, the more convinced I was that I had it. I canceled my plans that night so I could stay home and cry. I also called my dermatologist.
Suddenly, stressing out over whether or not I was going to lose all of my hair jumped to the top of my list of worries. My hair had always been the same: dark brown and long, with bangs. It served as a source of confidence throughout a lifetime of insecurities about my body. From the cruel nicknames my classmates gave me because I gained a lot of weight during puberty, or my family members teasing me about my large feet, my hair felt like something I could control by making it look exactly the way I wanted it to with the right products and tools.
And, if my hair was tied so closely to my identity, who would I be if it was all gone?
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My worries didn’t disappear when I saw my dermatologist, who confirmed my self-diagnosis and went through my treatment options. Cortisone injections are the most common form of treatment for alopecia areata because they’re cheap and generally effective. The injections work by reducing the inflammation around the affected hair follicles so that they have optimal conditions for regrowth. Unfortunately, I had just moved to New York and didn’t have health insurance. Affording injections was out of the question. For anyone willing to pay out of pocket, there are other options, like topical creams and immunotherapy, both of which can be expensive — and not guaranteed to work.
Instead, I spent hours looking up cheap solutions for hair loss, I tried a number of at-home remedies, including rubbing raw grated ginger and castor oil on the spot where my hair was gone. The mess was worth it because some of my hair did grow back — results I recently talked to a dermatologist about.
“There’s studies that herbs, specifically rosemary and peppermint oils, can improve circulation which can result in hair growth,” says Dr. Francesca Fusco, a dermatologist at Wexler Dermatology in New York City. Seeing results from these home remedies is possible, but Dr. Fusco says that it could be the herbs improving the circulation in the scalp and not really changing the immune system.
Without in-office treatment or injections, though, my hair has never completely grown back, but luckily, the condition hasn’t progressed beyond the initial patch my stylist found — though I’m told that the condition could worsen at any time, a fact that leaves me with anxiety. The bald patch I have now is also a preoccupation. Although I’ve changed how I part my hair so that you can’t see the spot, I rarely wear it up. On windy days, I’m constantly patting the area to make sure my hair hasn’t blown a certain way to make the spot invisible, and at one point, I avoided dating because of it.
Between the time of my diagnosis and now, I became a beauty editor. Hair is literally a part of my job. I love writing about it, but it hasn’t exactly helped me get over the fixation I have with my own hair. All day, I look at photos of styles I’ll never try because you’d be able to see my hair loss. I also visit a number of different salons, an experience that fills me with anxiety. I feel like I owe stylists an explanation as to why there’s a chunk missing from my otherwise thick hair. If I don’t say anything, I’m thinking about whether or not they’re judging me the whole time I’m sitting in their chair.
Why do I care so much about my hair when losing it doesn’t affect my overall health? I’ve been asking myself this question since that first afternoon Google session I had four years ago.With time, I’ve started to accept that my hair, among other things, isn’t something I can have complete control over anymore. I’ve also looked to other ways to help me calm down when I’m stressed out. Pilates, for me, has worked wonders.
You can’t tell that I have a spot, in fact most people I have told said they would have never been able to tell I had hair loss. But I do. Even though there are fine baby hairs sprouting from it, and even if I finally tried treating it with injections, my spot may never completely go away. It could be a permanent part of me, like the beauty mark on my right cheek or the scar on my right thumb.
And finally, I’m ok with that.
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