Alopecia: The condition at centre of Oscars’ slap

“I was in the shower one day and had just handfuls of hair in my hands and I was just like, ‘Oh, my God, am I going bald?’” American actress Jada Pinkett Smith said during an intense Red Table Talk broadcast in 2018.

It was the first time she had publicly addressed her hair loss, recounting the emotional roller coaster that had been losing her once long, curly black hair, embracing the big changes and learning to accept herself through it all.

The actress said she suffers from the autoimmune disorder alopecia, which causes hair to come out dramatically in patches, an imaginably stressful experience for the afflicted.

The actress has been the centre of controversy after her husband, actor Will Smith slapped the comedian Chris Rock for making a joke about her bald head at the 94th Academy Awards.

Here is what we know about the condition:

The American Academy of Dermatology Association (AAD) lists the ailment as alopecia areata, describing it as a disease that develops when the body attacks its own hair follicles (where hair grows from).

“Many people who develop alopecia areata are otherwise healthy. They have hair loss and sometimes nail changes, but they remain in good health. Hair loss tends to be unpredictable. Hair may regrow without treatment. This happens more often when someone has a few bald patches. When the hair regrows, it may fall out again — or it may not,” AAD reports.

The onset of this disease can be at any age, whether young or old. It does not discriminate in terms of gender, race or ethnicity.

“Researchers do not fully understand what leads to the immune system mistakenly attacking hair follicles. Genetics may play a role in one’s risk factor of developing alopecia. It is also possible emotional stress or illness can bring on alopecia in people who are at risk,” the Wall Street Journal reports.

“It was one of those times in my life where I was literally shaking with fear. That is why I cut my hair — and why I continue to cut it. And my hair has been a big part of me. Taking care of my hair has been a beautiful ritual, you know? And having the choice to have hair or not, and then one day to be like, ‘Oh, my God, I might not have the choice,’” Pinkett said as she revealed her experience.

Dr Brett King of the Yale School of Medicine told CNN people with alopecia areata often have a genetic predisposition to manifesting hair loss.

“But as with all diseases with a genetic predisposition, the factors that make the disease turn on or off are unclear. If you take identical twins who have the same genes, and one of them has alopecia areata, there is only about a 50 per cent chance that the other one develops it. So again, there are other factors that we do not understand that make the disease turn on and off.”

The US National Centre for Biotechnology Information (NCBI) places the lifetime incidence of the disease at two per cent worldwide. In its report, Epidemiology and burden of alopecia areata: a systematic review, NCBI notes that “both formal population studies found no sex predominance.

The first onset is most common in the third and fourth decades of life but may occur at any age. An earlier age of the first onset corresponds with an increased lifetime risk of extensive disease.”

The study explains that treatment options for the disease have had limited success and no cure has been found.