Ayanna Pressley Opens Up About Living With Alopecia and Hair Loss

Representative Ayanna Pressley, Democrat of Massachusetts, revealed in a video released on Thursday that she has a condition called alopecia and is now bald.

“This is about acceptance,” Ms. Pressley said of her decision to publicly discuss her baldness. “I hope this starts a conversation about the personal struggles we navigate, and I hope that it creates awareness about how many people are impacted by alopecia.”

Alopecia — a medical term for baldness — is an autoimmune disease that causes hair to fall out from the scalp, face and other parts of the body.

Scientists are not sure what causes the immune system to attack healthy hair follicles. Most people with alopecia are otherwise healthy, but the hair loss may occur very rapidly and may cause severe emotional distress.

Ms. Pressley said that she began to wake up to “sinkfuls of hair,” and that she tried wrapping her hair and wearing a bonnet, measures some black women take to protect their hair while asleep. But the efforts failed.

Though alopecia occurs at all ages, it is often first diagnosed during childhood or adolescence. About half of children and teenagers with alopecia will see their hair regrow within a year, even without treatment.

But it is a lifelong condition, said Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic: “Once you have it, you have it.”

“It can go into remission, so people may have patches once and never again,” she added. “But it’s an autoimmune disorder. It’s not like an infection that is treated and goes away, and you never have it again.”

The first sign usually is a small bald patch on the scalp. After that, hair loss may occur very abruptly over the course of several weeks, or may progress more gradually, over several years.

The course is extremely unpredictable: Hair may grow back only to fall out again.

Though people who have alopecia are generally healthy, the loss of hair may lead to anxiety, depression and reduced self-esteem. Youngsters with alopecia often experience bullying and ostracism in school. Many people first suspect that people with alopecia have cancer.

“There are studies about how much this impacts quality of life, not just for the patients but for their family members,” Dr. Piliang said. “There are health problems you can have that no one really knows about it, but this is very visible. People are curious and ask questions, and you have to do a lot of explaining.”

“People spend a lot of time trying to cover it up, and that adds to feelings of shame, even though it’s not their fault,” she said. “The congresswoman was quite open about her feelings. I applaud her.”

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