JAKARTA - On Oscar night, Will Smith slapped Chris Rock after the comedian made a joke about Smith's wife, Jada Pinkett Smith, who was experiencing hair loss.
"Jada, I love you. 'GI Jane 2,' can't wait to see it," said Rock, referring to the 1997 film "GI Jane," which featured Demi Moore with her head shaved.
Pinkett Smith recently shaved his head because, as he explained in an Instagram video in December, he was "struggling with alopecia."
What is alopecia?
Alopecia is a broad term that refers to any form of hair loss, says Dr. Angela Lamb, a board-certified dermatologist at Mount Sinai in New York City, was quoted by The New York Times on Tuesday.
The causes can be many. Some people — especially men — lose scalp hair as they age due to changes in hormones known as androgens, he says, and it's considered a form of alopecia. A common type of hair loss in the black community is traction alopecia, which occurs when hair is pulled too long.
Quoted from ANTARA, alopecia can also be caused by their immune system starting to attack their hair follicles in what is known as autoimmune alopecia.
The autoimmune form of alopecia can be caused by discoid lupus erythematosus, which can cause sores and scarring on the face and scalp. Central centrifugal cicatricial alopecia is another immune-related condition that causes scarring of the scalp and permanent hair loss. CCCA occurs almost exclusively among black women between the ages of 30 and 55, and research suggests it may afflict as many as 15 percent of those women.
Another common form of autoimmune alopecia is alopecia areata. When people talk about alopecia, they are often referring to this type, which affects one in every 500 to 1,000 people in the United States. It's not clear what type of alopecia Pinkett Smith had, but her appearance suggests it is alopecia areata, Dr. Smith said. George Cotsarelis, a dermatologist at the Perelman School of Medicine at the University of Pennsylvania.
When, why and how does alopecia areata occur?
Alopecia areata can appear in childhood, adolescence or adulthood, says Dr. Lamb.
People who have the condition tend to lose hair in clumps, he says, causing round bald spots. (The word "areata" refers to the uneven nature of hair loss; when a person loses all the hair on their scalp, it's called alopecia totalis, and when they lose all the hair on their body, it's called alopecia universalis.)
Some people with alopecia areata lose some hair only on their scalp, while others lose it elsewhere on their body as well, she says.
More than half the time, the hair that fell out will grow back within a year, says Dr. Cotsarelis. But often, months or years later, people also experience other types of baldness.
It's not clear what causes alopecia areata, but Dr. Lamb notes that it can have a genetic component. If a parent has alopecia areata, for example, their child has a one to 10 percent chance of developing it as well, she says. Alopecia areata can also be triggered by stressful events and nutritional deficiencies, such as iron deficiency, says Dr. Cotsarelis.
Doctors diagnose alopecia areata by taking a scalp biopsy and then sending it to a pathologist who studies skin cells under a microscope to determine what might be causing the hair loss.
People with alopecia areata are more likely than those without the condition to develop related conditions as well, such as thyroid disease, diabetes, allergies and asthma, says Dr. Cotsarelis.
How is alopecia areata treated?
Some medications can treat alopecia areata, but some treatments aren't effective for some people, says Dr. Lamb, so patients may need to try several approaches before deciding on something that works.
The good news is that with alopecia areata, "your hair always has the ability to grow back if you remove the inflammation," says Dr. Cotsarelis.
One common treatment is injecting anti-inflammatory drugs such as steroids directly into the affected area of the scalp to stop the body from attacking the hair follicles, says Dr. Lamb. These injections can be given monthly and may cause side effects such as skin discoloration or small dimples. Some people also use topical corticosteroid treatments, such as betamethasone valerate.
Another drug that doctors have recently started using is a monoclonal antibody called dupilumab, a drug that has long been used to treat asthma and eczema, said Dr. Lamb. Dupilumab can be injected into the thigh or arm once every two weeks and rarely causes serious side effects, he says.
Some doctors have started treating the condition with oral medications such as tofacitinib and baricitinib, which are approved by the Food and Drug Administration to treat rheumatoid arthritis, but have also been shown to help with hair loss, says Dr. Cotsarelis.
But these oral medications can have serious side effects, he says, increasing the risk of blood clots and lymphoma, and more research is needed on their long-term effects.
Sometimes, alopecia areata goes away on its own, but generally, there's no cure, says Dr. Lamb. Partly because of that, diagnosis of alopecia can be troublesome, she says — but with the right treatment, many people see improvement.
Often, "we can take you to a place where you don't even notice the condition anymore," he says.
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