A beauty queen with no hair … that turns expectations upside down.
At the 90th Miss America competition in Las Vegas last weekend, Miss Delaware, Kayla Martell, was that girl. Martell usually — but not always — competes for titles wearing a wig, but far from trying to hide her baldness, she uses her beauty queen status to raise awareness about alopecia areata, the autoimmune disease that caused her to lose her hair as a child.
FOR THE RECORD:
Women's hair loss: An article in the Image section elsewhere in this edition, about thinning hair in women, identified Dr. Monte O. Harris as being affiliated with Cultura cosmetic medical spa in Washington D.C. Harris is with the Center for Aesthetic Modernism in Chevy Chase, Md. The error was discovered after the section went to press. —
Martell was a fan favorite in the competition, and although she ended in the top 10 — losing the Miss America title to Miss Nebraska, Teresa Scanlan — she did make us think about hair and the particular problems hair loss causes for women. In a culture where many look to movie stars and fashion magazines for standards of beauty, the term "brave" is often applied to women who've suffered hair loss.
"Men can get away with thinning hair, balding or a receding hairline but there really isn't a socially acceptable way for women to do that from an aesthetic point of view," says Dr. Monte O. Harris, of The Center for Aesthetic Modernism in Chevy Chase, M.D., who specializes in hair loss and hair transplants.
Hair loss causes are many. Only an estimated 2% of the population has the not-entirely-understood alopecia areata, which can cause partial or total hair loss that comes and goes. But other hair loss can be caused by genetics, stress, hormonal issues ( childbirth, coming off birth control pills, thyroid disease or menopause), medical conditions such as lupus, dieting (even losing 10 to15 pounds in a month can cause excess hair loss), nutritional deficiencies such as a lack of iron, medications, hair-styling practices and traction alopecia (often caused by pulling hair into tight styles such as ponytails or braids).
There is also a condition called central centrifugal cicatricial alopecia that can cause inflammation, scaling and scar tissue that eventually destroys the hair follicle so that hair can no longer grow in the affected area.
"What's important is to figure out why your hair is falling out," says David Kingsley, a well-known trichologist — a specialist in hair and hair loss. Thinning hair can be stopped or even restored in some cases, depending on the cause. "It's really important that people realize that it's not hopeless," Kingsley says.
Harris says that with the exception of genetic hair loss (and some experts consider even this condition potentially reversible), most of the aforementioned hair loss causes have a component that is reversible. "Prompt diagnosis and early therapeutic intervention is key," he says.
For instance, if hair loss is caused by tightly pulled hairstyles, you can alter your grooming practices. Hormonal hair loss following childbirth corrects itself with the passage of time. Hair loss related to vitamin deficiencies, anemia and thyroid abnormalities can all be reversed "if the culprit is identified," Harris says. "That's why obtaining basic labs during the initial work up is important. The unfortunate thing is that the reversible forms of hair loss often progress to emotional and irreversible [physical] scarring because they are left untreated."
Experts say genetic female pattern baldness is usually denoted by hair loss at the top and crown of the scalp. Hair breakage is different from hair loss at the root and often shows up at the hairline-temple area. Breakage can usually be stopped with a little TLC.
See a doctor about thinning hair when you see less hair on your scalp, a wider part or more hair than usual in your brush or sink; when the hair loss starts to bother you cosmetically; or when there's inflammation, pimples, scaling "or increased shedding for more than two to four weeks," says Kingsley who works with dermatologists when treating patients. Conditions such as these tend to get worse over time, not better, he and other experts say.
Make sure you go to a dermatologist who specializes in hair loss. "Many dermatologists don't specialize in hair loss because it's a slow, stubborn problem and the patients tend to be emotional," says Dr. Maria Colavincenzo, an assistant professor of dermatology at Northwestern University's Feinberg School of Medicine in Chicago, who is on faculty at Northwestern's Hair Loss Disorders Clinic.