What is alopecia areata, the medical condition behind Jada Pinkett Smith's hair loss?
Here's a look at an autoimmune disease that has caused the actress-host to develop patches of baldness. Who's prone to it? What are the treatments?
If you caught the recent footage of Will Smith storming the stage during the Oscars to slap host Chris Rock after he made a joke about wife Jada Pinkett Smith’s bald head (who hasn't?), you might just have a question or two.
One: Was the slap scripted? (No, it wasn’t). Two: Why was Pinkett Smith’s head shaven in the first place, which was what brought on the comedian’s unfortunate quip: “Jada, can’t wait for GI Jane 2”.
The latter, as we all know by now, is caused by alopecia areata, an autoimmune disease where the body attacks its own hair follicles, leading to hair loss anywhere on the body, according to the American Academy of Dermatology (AAD).
WHAT IS ALOPECIA AREATA?
The hair loss experienced in alopecia areata tends to be patchy and unpredictable, noted the AAD website. “When the hair regrows, it may fall out again – or it may not.” This erratic hair loss and regrowth often occur on the scalp. Patients may also lose part or all of their eyelashes, brows, beard, or hair in the armpits, nostrils or ears.
There are a few main types of alopecia areata such as alopecia totalis (all hair on the scalp is shed) and alopecia universalis (a rare condition where only body hair is completely lost), according to the AAD.
Alopecia areata is unlike male and female pattern hair loss. Male pattern hair loss is characterised by a receding hairline and hair loss on the top of the head; in women, hair tends to thin at the top, starting with the widening of the hair’s parting. Male and female pattern hair loss are caused by a combination of hormones and genetic disposition.
WHO IS PRONE TO DEVELOPING IT?
Alopecia areata can begin at any age, noted the AAD website. “However, most people develop it during childhood or their teenage years.”
Women are more likely to develop the disease and among them, black women have a “greater lifetime incidence of (alopecia areata)” than white women, according to a 2018 study.
In another study based on the US population, it found that Asians have an even lower odds than Caucasians at developing the autoimmune disease.
It would appear that genetics are involved, according to Medical News Today. One in five people with the disease has a family member who has developed alopecia areata.
“Other research has found that many people with a family history of alopecia areata also have a personal or family history of other autoimmune disorders such as atopy, a disorder characterised by a tendency to be hyperallergic (and develop) thyroiditis and vitiligo,” noted the same website.
Despite what many people think, there is very little scientific evidence to support the view that alopecia areata is caused by stress. Extreme cases of stress could potentially trigger the condition, but most recent research points toward a genetic cause.
WHAT IS ALOPECIA AREATA’S IMPACT?
The condition has few physically harmful effects (it can also cause nail changes such as roughness, pitting and splitting) and doesn't cause pain. But it can create anxiety and depression in patients – more so in women. “Hair loss in women often has a greater impact than hair loss does on men, because it's less socially acceptable for them”, noted an article on Harvard Medical School’s website. “Alopecia can severely affect a woman's emotional well-being and quality of life.”
That was the situation for Pinkett Smith. In a 2018 episode of Red Table Talk (see video above), a web show she co-hosts on Facebook, the 50-year-old revealed for the first time why she’d kept her hair short. “I’ve been getting a lot of questions about why I’ve been wearing this turban. Well, I’ve been having issues with hair loss.”
The Matrix actress recalled the "terrifying" moment when she first noticed she was losing "handfuls of hair" in the shower. "It was one of those times in my life where I was literally shaking with fear," she said. "That's why I cut my hair and continued to cut it."
In 2021, she documented her decision to shave her head on Instagram. “Now at this point, I can only laugh,” she said in her video. “Y’all know I’ve been struggling with alopecia and just all of a sudden one day, look at this line right here.”
In the caption of her video post, she wrote: “Mama’s gonna have to take it down to the scalp so nobody thinks she got brain surgery or something. Me and this alopecia are going to be friends… period!”
WHAT TREATMENTS ARE AVAILABLE?
There is no cure for alopecia areata. But because it is an autoimmune disease, some of the treatments available, such as corticosteroids, involve suppressing the immune system to stop the body from attacking the hair follicles. These may be administered through injections, topically or orally.
Other forms of treatment involve stimulating hair growth, such as Minoxidil, which may work better for those with less severe hair loss, according to Healthline. However, the success rate differ from patient to patient and hair loss might recur.