Alopecia of all types is a daily occurrence at the CENTRACA clinic and in the wake of Chris Rock’s bad taste joke about Jada Pinkett Smith, we offer you this article for a better understanding of this much hated and poorly tolerated condition. We propose to talk about some of the most common forms of alopecia and about the hard fight that people who suffer from it have to face. First of all, let’s say that behind all the charm and elegance that this precious ornament on women’s heads provides, hair is a dead cell. Because of its location, it is extremely important not only for its aesthetic aspect but also for its function of protecting the scalp from the sun’s ultraviolet B rays. The love of hair makes alopecia one aesthetic abuse too many and fuels the hatred of hair lovers. Before going any further, let’s say that the integumentary system represented by the skin, nails, glands and hair is a mirror that allows us to see if everything is going well inside our body.
Throughout the ages, baldness has had divided opinions, both favorable and unfavorable. While some associate it with virility and think that bald men are more charming, others think that those who suffer from it look older than they are. In any case, alopecia in general and andro-genetic alopecia in particular is responsible for lowered self-esteem, lack of self-confidence, suicidal ideation and even attempted suicide (Study Franzoi S & al. and Cash T. for.the Journal American Academy of Dermatology).
Alopecia refers to the seasonal loss of hair in foxes, and its most simplistic definition is a loss of hair that can be reversible (curable) or irreversible (incurable). The causes of alopecia are multiple and the treatments are legion. The will to treat it and the great financial means are not enough to stop it because some alopecias are irreversible or incurable. In addition, the treatment of the underlying cause is the highlight because it could be psychological distress, internal diseases or scalp diseases not or badly treated in childhood. In addition, some modern treatments are expensive and have limited effectiveness or are dependent on other conditions.
The addiction to false hair in some women. As a palliative, it is not always an easy and desired choice but results from the fact that the treatment of certain types of alopecia is long and costly. Fake hair is a quick fix and offers better styling options than short, straight, diseased hair. Therefore, if you need to fantasize about it, if you need to get rid of your stress, it is better not to do it on a bald person, because behind the alopecia there are hidden moral sufferings, bad illnesses, clandestine medication, painful separations, unacknowledged sexual abuses, bitter and recurrent failures, a precarious economic situation and so on.
Alopecia of the psychodermatosis group, such as alopecia areata, trichotillomania and lichen planus pilaris, are associated with depressive syndromes and chronic states of stress that the psyche cannot overcome. Associated with this phobia of psychiatrists and psychologists at the risk of being taken for madmen, and in the absence of psychological and psychological care, these alopecias become chronic and are hidden under mats instead of being treated. At the CENTRACA clinic, we have cases of minors who have been sexually abused by close relatives and who suffer from these types of alopecia.
Autoimmune alopecia universalis is due to the fact that the body recognizes the hair as a foreign body and expels it from the body with the help of autoantibodies. The treatment can be long and disappointing and the person who suffers from it, if he cannot afford the most advanced and effective treatments, will hide his illness under synthetic hair, under penalty of suffering the most derogatory comments.
Alopecia of women with micropolycystic ovaries with all its unsightly side effects (male hyperpilosity) is only the tip of the iceberg because it often hides another, much sadder reality. The alopecia of ringworms that occurred during childhood is the result of the parents’ financial incapacity to provide antifungal treatment.
Other less serious alopecias, therefore curable, but with the same socio-psychological consequences, deserve to be elucidated even though they are reversible. This is the case of genetic andro alopecia or baldness which, in addition to being genetically transmitted, is partly linked to the transformation of testosterone into dihydro-testosterone. Telogen effluvium, which is a diffuse hair loss that can go unnoticed, hides health problems that are often serious, such as iron deficiency anemia, hyperthyroidism, untreated or abused diabetes. Chemotherapy-induced alopecia, which is an anagenic effluvium, also deserves to be highlighted, as it is a heavy burden for the victims.
Traction alopecia, although it is a provoked alopecia, which CENTRACA denounces most often as a crime done to girls on the basis of protocol hairstyles for schools, most often congregational. It is due to the fact that a prolonged traction made on the hair extracts it from its follicle causing wounds, and the scarring that follows can lead to the irreversibility of the alopecia. Other causes of alopecia such as infectious folliculitis, Quinquaud’s folliculitis, mucinous alopecia and follicular degeneration syndrome are all causes of irreversible alopecia and we must resolve to live with them because the treatments are rather palliative.
These alopecias are caused by unwanted situations that are socially disturbing. Besides the alopecia itself, one of the limiting factors justifying the persistence of the alopecia is the cause which, if it persists, constitutes the failure of the treatment itself. The other limiting factor is the delay between the beginning of the alopecia and the beginning of the treatment, because some alopecias that are normally curable, with time, become incurable or difficult to cure.
For all these reasons and to avoid explaining themselves, some women wear false hair to hide their misfortune, their disease, their shame, their struggle, their daily life, their weakness. Let’s stop fantasizing, because behind what is visible are hidden painful disillusions, horrible stories, silence would do more good than hurtful, humiliating and derogatory remarks. A woman who walks around with a shaved head is full of courage and has a strong self-esteem. Again, we must remember that the father of medicine, Elisha the prophet, the father of philosophy and King Louis XIV suffered from alopecia.
Roldan CELESTIN, Dermatologist, Professor of Dermatology and Venereal Diseases, Deputy CEO of CENTRACA
Léonie DESROSES, Nurse, Trichologist, Cosmetician, CEO of CENTRACA