Being bald is not always a choice: Carol Ndida Alopecia areata victim

Before being diagnosed with alopecia areata, Carol Makandi Nkinda, a 44-year-old mother of two says she had never heard of alopecia or met anyone with the condition. “Nobody in my family has ever had hair loss issues, so I was as surprised as everyone else in my family when the disease struck,” she says. 

Alopecia areata is an autoimmune skin disease in which hair is lost from some or all areas of the body. Autoimmune disease develops when your immune system, which defends your body against disease, decides your healthy cells are foreign and gets rid of them. This leads to extreme hair loss or patches of hair loss especially on the head.

However, the cause of alopecia areata is not known, according to the USA National Institute of Arthritis and Musculoskeletal and Skin Diseases.

“Alopecia areata is a health condition that needs medical care, that’s all we know,” says Carol who has lived with the condition for over two years.

However, scientific researchers believe alopecia areata has a genetic background such that if the disease affected a relative in the past, there are high chances that an individual may inherit it. Researchers also suggest that for people whose genes put them at risk, some type of trigger starts the attack on the hair follicles.

The triggers may be a virus or something in the person’s environment. In his blog, Dr Jeffrey Epstein, a US-based surgeon and Founder of the Foundation for Hair Restoration and Plastic Surgery in Miami and New York, notes that there are different types of alopecia (general hair loss) and not all hair loss can be classified as alopecia areata. The expert says androgenetic alopecia, or female or male pattern baldness is the most common type.

In this type, the doctor explains that a patient experiencing androgenetic alopecia will lose hair in a very distinct pattern. The pattern may differ in male and female with the male’s hair receding from the hairline and can also begin to thin at the crown. If this condition is not medically addressed, eventually the entire top of the head may become bald. In women, the pattern is different as most women commonly experience a diffuse thinning all over the head, although different patterns can occur.

Dr Epstein notes that alopecia areata, which is more rare, affects 2 out 100 people. People who have this kind of alopecia might have small bald spots on their heads alongside hairless patches on the heads. He notes that there are some patients with this type of alopecia who may experience complete loss of all hair, all over the body.

Carol says that she hadn’t noticed a patch at the back of her head until her sister saw it. That patch, Carol narrates, was the genesis of her journeys to and from different dermatologists and admissions in hospitals. Carol, who was then in dreadlocks, watched sadly as her hair fell off and though she was in denial for a while, she took advantage of the situation and researched a lot on alopecia so that she could educate people on the symptoms.

“At first I would get shy and feel stigmatised if anyone commented on my bald head,” she says and adds that these days, she takes time to educate people that not all bald-headed people chose to be that way. Carol is a blogger and has formed a support group which currently has over 1000 local and international members. Carol, who now writes a blog to educate people on alopecia, advises women not to be remorseful or blame hair chemicals, treatment or even dreadlocks because they have nothing to do with alopecia.

Researchers and specialists say that although Alopecia can be treated, there is no guarantee that the hair may regrow. Dr Jeffrey Epstein however says that if the cause of the hair loss is as a result of taking some medication, the situation can be reversed upon terminating the use of the medication.

He further advises that permanent types of alopecia, such as scarring alopecia and male pattern baldness, are often best treated with a hair transplant. Carol encourages people with alopecia to embrace baldness and make the best out of it. “Standing on my platform now, if the hair regrows, fair enough, if it doesn’t, I am confident that I am still very beautiful and comfortable without it,” she says.