It hit the hair loss headlines this week when a boy in Philadelphia with alopecia areata got sent home from school for having hair that violated the school's short hair policy. The incident illustrates the woeful lack of awareness concerning the disease, which is thought to affect around 2% of the population.
When eight year old Zion Williams began receiving treatment (which included painful injections) for his alopecia areata hair loss, the doctor had warned his mother that he must allow his hair to grow for at least ten weeks without cutting it. However, despite submitting a doctor's note to the school to warn them that her son would be attending with slightly lengthened hair, Zion's mother was shocked when the boy was turned away from the school for violating their hair policy.
Speaking to Fox29 Philadelphia, Zion's mother commented: "I think it's heartless...It's heartless that he would actually take him out of school because of something so simple as a haircut." Whilst Zion is apparently being allowed to return to the school, his family unsurprisingly see his future there as uncertain after the incident.
Alopecia areata is categorised as an auto immune disease, and occurs when the body mistakenly treats hair follicles as foreign bodies and tries to destroy them. It appears as areas of patchy loss on the scalp, but can spread to the entire scalp (alopecia totalis) or even the entire body (alopecia universalis).
Patchy loss due to alopecia areata can often be treated, via steroid injections or a high strength minoxidil cream + azelaic acid, but when the hair loss becomes more extensive treatment is less likely to be effective. The extent of alopecia areata can wax and wane, and spontaneous remission can also occur. Because of the different extents to which alopecia areata can cause hair loss, people often wrongly assume that hair loss is due to other factors, but patchy loss all over the scalp is almost always due to this type of alopecia.
Whilst alopecia areata is caused by an auto-immune function in the body, it also seems that it can be triggered by various environmental factors. Whilst research into this is still ongoing, it would appear that everything from stress and shock to allergies, pregnancy and illness can trigger the condition.
Some people also wrongly believe that it needs to be an ongoing trigger to maintain the condition, or that alopecia areata will cease to be a problem when the likely trigger has been identified and stopped. Sadly this is not the case, as once an autoimmune disease is initiated it can be self-perpetuating. Tissue destroyed in the early stages of the disease can be broken down and the antigens presented to immune system cells in the lymph nodes. This recruits more self- reactive cells, which destroy more tissue producing more antigens, and so the cycle continues.
It's important that we spread information about alopecia, in order to prevent similar cases of unsympathetic schools and other problems that stand in the way of those with the disease and those who can help. There has also been a higher incidence of alopecia areata in those who have a relative with the condition, so raised awareness is important in educating those with an increased risk.
It's crucial that more research is done to work towards a better understanding of alopecia areata, and hopefully further scope for treatment of what at times can be an incurable condition. Until then, let's hope that school teachers and other authority figures learn to be a little more sympathetic towards those trying to tackle the disease!