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“The running nose that you don't notice because there's no nose hair to tip you off... It's certainly been a nuisance for me, living in a cooler climate.”
“I haven't had a hair on my body (except for the ones I pay a fortune for!) in 4 years.....now I start getting some regrowth---guess where? In my NOSE!!! NOSE HAIRS, for cryinoutloud!! Where's the justice?”
Nose hairs offer some protection by clearing large particles from the air. Some pollen and dust particles are removed by this mechanism but only by passive impaction. The large majority of these particles, because of their small size, are cleared through other mechanisms. Theoretically the absence of nostril hairs may allow an excess of allergens to fall in contact with the mucosa, however, the body has multiple other defense mechanisms to take care of the burden. If your mucous glands are normal and there is an adequate production of secretions you should do OK despite the absence of nostril hairs. The only major observation I have drawn from some of my patients related to the absence of nose hairs is the development of a keen sense of smell. They can smell perfumes of ladies from far away. Some people tell me that they are so sensitive that most strong smells cause them to sneeze. That is the reason they can't wear any makeup.
Note: Cilia are appendages of cells that have a number of functions including clearing mucus and particles deposited within the respiratory tract. Their origin and structure are quite different from hair and are not affected in patients with alopecia areata.
“I believe that AA is auto-immune, and that auto-immunity grows and spreads, given enough time. Therefore, children (and even adults) contracting AA should be occasionally screened for the most common conditions associated with long-term AA. Few doctors know much about the co-incidency of these diseases, and earlier treatment can prevent later problems. For example, an experienced dermatologist suggested I be tested for thyroid problems. Ultimately I was found extremely low in T4 and 20 times normal in TSH and in desperate need of thyroid treatment. If undiscovered, I could have been seriously harmed.”
“The FAQs should mention these diseases. Thyroid problems are common, as are various hardy skin difficulties (psoriasis, dry skin, fungal infections, etc.). If you look at all atopic diseases, which are mentioned as correlated with AA and auto-immune diseases, there would be various allergies, asthma, lupus, and more serious conditions. My own auto-immune progress was AA to vitiligo, to thyroid disease, but the same dermatologist told me he's NEVER SEEN the condition progress to involve more than these. Still, I'm interested in what may happen to me... I've had plenty of experience with the ignorance of dermatologists so far!”
“Research indicates that some folks with AA/AU will get other autoimmune diseases. Statistics declare a higher than average co-incidence. In my case, follow the timeline: AU age 8; Vitiligo age 14; Allergies Age 20; Thyroid age 25.”
Autoimmune disorders occur when the immune system recognizes parts of our own body as foreign (a potential invader). Some of these conditions tend to be highly localized, affecting a specific organ (e.g. thyroid). In other instances, diseases like systemic lupus erythematosus cause reactivity against many tissues in the body. Organ-specific autoimmune conditions are usually directed against thyroid, adrenals, stomach and pancreas. Generalized disorders are seen in those cases where the primary target involves the skin, kidneys, joints and muscles. It is therefore not surprising that there is a concurrence of various autoimmune disorders in alopecia areata where the primary focus of reaction is the skin. Among the autoimmune disorders "associated" to alopecia areata are Hashimoto's thyroiditis, thymoma, hypogammaglobulinemia, autoimmune gastritis, pernicious anemia, Addison's disease, testicular atrophy, vitiligo, lupus erythematosus, rheumathoid arthritis, polymyalgia rheumatica, mysathenia gravis, ulcerative colitis, lichen planus, lichen sclerosus et atrophicus, lichen rubra, pemphigus foliaceous, and the candida-polyendocrinopathy syndrome.
Barbie is an abysmal role model for a young girl and some people don't allow them in the house. Taking a Barbie away from a child who has received the same as a gift may nevertheless result in a major league crying episode. A child may "love" Barbie because she's so beautiful. Her long blond hair must make her a wonderful person. The fact that a child's hair is dark and short (although quite lovely too) means that she isn't, and can never be, as wonderful a person as this plastic role model. Ouch! Here we have a [truly] lovely, intelligent, hard-working young girl who will always believe that she is somehow not as good as a plastic bimbo [sigh].
Everyone is familiar with the media/advertising focus on surface aesthetics, but what can we do to combat the lousy models that society appears to be foisting on our impressionable children? You can't escape the image anyway; check out Disney movies - Cinderella, Sleeping Beauty, etc. It is interesting how Disney jumped on the Barbie band wagon and has resorted to sexy, large breasted, small waisted, long haired females. Just look at the difference between Snow White (somewhat proportionately real) and, say, Esmarelda from the Hunchback movie or Jasmen from Aladin. If you look at these films it becomes REALLY clear that they were all so wonderful primarily because they were so terribly, terribly beautiful. Maybe the reason why there are so many eating disorders on college campuses has to do with the Barbie play.
Just think of all those magazines written at an 8th grade level. Ever wonder why? They appeal to the part of us that is vain. They offer us the fantasy of being something that we can never be. Most females would like to be 5'6", weigh 120 lbs and have perfect measurements (in this lifetime). But that is what magazines offer us, a dream. Those of us who work on mental health are aware of the damage these images cause. Television does not help either. It is an upwards battle for kids with this condition since society gives them images of perfection that no one can live up to.
My girls were Barbie fiends and collected all the rigamorole...houses, cars, clothes and accessories, not to mention the backpacks, lunchpails, t-shirts, nighties, running shoes, etc. About a year ago, Barbie suddenly became as unpopular as Barney the dinasour, which meant it was now cool for kids their age to go Barbie......uuuugh!! A few months ago we must have rounded up no less than forty naked Barbies, with enough doll clothing and footware to make Imelda Marcos and Princess Di jealous, and gave them all away. The dolls were all naked because my girls never could figure out how to get past undressing the damn things and I guess those mammoth mammaries made dressing the dolls too difficult. Maybe that's why Pamela Anderson is so often photographed nearly nude herself.
So why did we allow our daughters to get embroiled in such a materialistic, commercial pasttime?......for the same reason we actively celebrated Christmas and Santa Claus, it made our kids happy, so it makes us happy. You need to make a bad thing better. The trick, I feel, is to emphasize the positive aspects of the dolls. Talk about how unrealistic her figure is, and the fact that few people can have as fabulous a wardrobe as Barbie. We also read Barbie comics, which are pretty innocuous, but they do show Barbie doing much more than just being pretty. Sometimes she's a teacher, sometimes she's an anthropologist (for real!) other times, she's a photographer or even a pilot. The dolls feature her in many, many careers and although no one can have THAT many different careers, it does lead to discussions about what all girls CAN do. In the stories, the situations often deal with values and making decisions. They deal with honesty and integrity, with valuing other people's feelings and deciding what the right thing to do is. We read the comics together (they are out of print, now, unfortunately) and discuss the ideas behind the stories. She will act out stories with her dolls, but the "male" counterparts are used as little more than stand ins for her fantasies. Occasionally, she'll have a "wedding" with a dozen Barbies in wedding dresses and her one Ken and Aladdin there as grooms. The fun is in dressing them up and trading out their outfits. Occasionally, Ken has been known to wear a wedding dress. Didn't fit him well, though! :) Remember also that a girl/women's sense of self esteem and self is directly affected by her father and his opinion. Specially for fathers, spend quality time with your daughter. Have posters or conversations about famous women atheletes, artists, and the like, in order to provide a group of positive real role models for them to be familiar with... and I talk about it with them. I think it is completly understandable that kids that age would fall into the idealized barbie whopla, it's part of playing and pretending, imaginative fun. Just use it to your advantage.
Alopecia areata is associated with other disorders capable of changing the skin pigmentation. Among these disorders are included vitiligo (lack of pigmentation), Addison's disease (skin hyper pigmentation, although sometimes accompanied by patches of vitiligo) and Down's syndrome (almost similar to a black and blue mark). If therapy requires corticosteroid injections, their superfical deposition may cause skin depigmentation.
A bluish skin pigmentation in relation to those areas of hair loss may be due to a rare condition called "melanin incontinence." Occassionally, when under immunological attack, melanocytes do not shut down their production of pigment. Since there is no longer a hair fiber to incorporate the pigment, the pigment gets dumped at the base of the follicle. Melanin is difficult to break down or digest, so it builds up in large concentrations that give a bluish discoloration. Eventually the melanocytes do become inactive and the bluish spots disappear.
Patients using aromatherapy may take some preventive steps when using bergamot oil. This oil can can cause brown skin stains (berloque) when exposed to sunlight and is considered a prime photosensitizer (sensitivity to light). In addition, some perfumes may produce increased pigmentation (brown spots) in the area where the perfume has been applied, especially when it is immediately exposed to sunlight. There is no effective treatment, and the pigmentation generally persists for some time.
Don't assume that your ways of coping are shared by everyone around you. Consider who else needs information regarding you child's condition. It may be the teacher at school, the nurse or the bus driver. In some occassions it may be the child care personne at the child care center. One of our members was almost charged with neglect because she would not force their daughter to wear a wig. The mother really had to think hard about where they were coming from. The child care personnel felt that by not letting her child look like all other children, she was neglecting her needs. In their eyes it was most important to the child's development not to be different. Always educate from the beginning, meet with key personnel, and explain your decisions.
“Actually in a way, it seems to me that I may have been slightly depressed constantly ever since I first got the alopecia (12 years ago at the age of eleven).”
“… Any type of distress should not have to manifest clinically before we take it seriously....After all, I think it's the quality of life that we are concerned with, no?”
“ANY type of drastic change is bound to bring out certain emotions. I really belive that acknowledging those emotions, feelings, etc. is pretty darn healthy.”
“One therapist tried to help me by convincing me to be the best bald lady I could be, go bald, and not be ashamed. I could not do that.”
Some common links between depression and alopecia:
alopecia - "Oh, don't worry about it, many women lose their hair as they get older..."
depression - "Oh, it's probably just PMS..."
alopecia - "I don't know why you're so worried about it, it's just hair. Other people have real problems!"
depression - "Why are you feeling sorry for yourself, you have a nice home, some people have real reasons to be depressed..."
alopecia - "Maybe it will grow back..."
depression - "Oh, you'll feel better soon..."
alopecia - "Just wear a wig and no one will know..."
depression - "Just wear a big smile and no one will know... put on a happy face..."
alopecia - "If you hide it well enough everything will be OK..."
depression - "If you hide it well enough everything will be OK..."
alopecia - "Did you do something? Maybe it was caused by bleaching your hair..."
depression - "What did you do to bring this on yourself? Sometimes it's caused by guilt, you know..."
alopecia - "Oh, stop being so sensitive about it. Just cover it up and be done with it..."
depression - "Oh, stop being such a whiner. You could be happy if you wanted to..."
Is it normal to get depressed during the course of alopecia areata? Of course! Is your hair a part of you? Have you been losing it at an abnormal rate? Is your appearance different than it was? Are you trying hard to comb what's left so that others may not notice you're losing it? Are you wearing more hats to try to disguise it? Do you think that you are much more bothered by it than you should, and then feel even worse? If any of these has happened, then you have reasons to be depressed. Afterall, you have lost a part of your body. It would be abnormal if you were happy-go-lucky about losing your hair. Depression is normal with alopecia, especially in its begining. BUT, the important thing is that you can pull yourself out of it. Give yourslef an opportunity to grieve, to be sad, angry or upset.
One of the most important observations that I have noticed in depressed people is that they always live in the past. This stands in contrast to children, who generally enjoy life, live in the today and for the tomorrow. Learn to concentrate on the present. You have already learned many of life's lessons through the school of hard knocks. Now is time to apply whatever you have learned. Set goals, have something to look forward to. Write these on a piece of paper. Make your goals practical, things you can attain and are willing to work for. Visualize those goals. Have faith in the future.
Think of what is happening to you. Always consider all of the things you should be thankful for. Give God thanks for all of the difficulties you may encounter. It is not only of the good things that you should be grateful. Fortunately, I have noticed, that God will only provide for adversities to people that can overcome them. Take this as a challenge. As Nietzshe said, "What doesn't kill me makes me stronger."
I can attest that there is an important aspect of depression which makes it difficult to seek help for the same--- a sense of shame. When you are depressed, you often find yourself trying to hide it from others. Some people are particularly bright and engaging when they are drinking. They try very hard to speak without a slur and to hide the fact that they are slightly drunk. Because of hair loss, shame is already a feeling that many of us entertain. This feeling also adds to the depression. Funny thing, shame! Of course there is no reason why we should be ashamed of either our hair loss or depression, but the feeling lingers around, regardless.
One of our participants (within our list server) was tired of being stared at, feeling this way and not knowing if her condition would ever end. She probably felt like their nose fell off, that she was facially disfigured and had to wear a really good, natural-looking, expensive nose. In essence, she had valid doubts with answers that were not construed as uplifting. She failed to perceive that everything that happens to us, is for a reason. Life is school, and we need to learn the lesson, each person having a different lesson. Life will keep hitting us over the head until we recognize the lesson and learn it!! This is just what makes things work for many of us. The lessons that we learn from alopecia are actually pretty good. There are totally "perfect people" out there, that are perfectly miserable. Life is what we make it. If the staring is too much, is there something you can do to have it stopped or have their perception changed?? Either carry your head so proudly that others will look at you in awe??? Or to wear a look that blends in. You are who you are, no one can take that away, no other person can take that away.
Having alopecia is the single most difficult thing many people have had to come to terms with in their lives, and while they have come to accept this - they hate every minute of it. They hate having to worry about wearing a wig. They hate it when their head gets cold. They hate that whenever they are faced with a stress in their life - which is often - any hair that has started to regrow falls out. They hate this condition, it is not fair. You can read all of these paragraphs and agree to accept the condition and move on. There have been valuable lessons learned through having alopecia. Adversity is an excellent teacher for everybody. Everybody carries his/her own cross. Learn from the stories of others. Did you read about the person who ran the Boston marathon and arrived last, 4 days after he had begun (he had no legs and had to push himself with the pads of his hands). The man did not stop there, he set higher goals for himself. He went to run in another marathon (NY) and did better.
Please understand that when people say that they hate this condition, they are not saying that they hate themselves. In fact, they do not. It is just that when the truth is known and all the layers are peeled back, they resent that this has happened to them. Yet, through all the frustration, they have never felt, not even for a second, that they have had enough of it all. The very fact that they hate the alopecia means that they may get a kind of perverse pleasure from the idea or the hope that one day they might finally beat it. That one day they will look in the mirror and know for the first time know how it feels to have a full head of hair. I believe that no matter how bad things seem, you still have to believe that they can only get better.
What I am trying to say, is that it is all very well to say that there is no need to feel bad and frustrated and sorry for yourself - but sometimes you need to. Sometimes you need to vent just how awful this thing really is. In a way doing that keeps you grounded. It makes you appreciate everything else that is good in your life. Talk to yourself. Never let yourself down. Use a mirror if necessary. Aquire a postive outlook in life, and be convinced of it. If anybody asks you, "How are things going?" Answer, "Better than ever in my life!" Learn to be deliberate in a positive manner.
Exercise regularly. "Mens Sana in corpore sano". Exercise promotes mental toughness and at the same time is the Fountain of Youth.
“You build courage when courage seems to fail. You regain faith when there is little cause for faith, and create hope, when hope is lost. Learn to laugh, never forget to cry. Be serious, but don't take yourself too seriously.” —Gen. D. MacArthur
“I had a dream the other night that I grew some short black hair. A little *more than hopeful*, since my hair used to be gray. Ah well, still a Naked Noggin. ;-)”
“Interestingly....I had a dream the other night that I fell in love with an AT man. All I remember is the comfort of not having to explain everything......”
“Last night I had a terrible nightmare that I was being attacked by skinny, starving, angry mice. One of these mice was tangled in my hair and was biting and scratching to try and get away. In the dream, I was lying on the floor and my long brown hair was stretched out behind me, except for this big tangle where the scary, angry mouse was trapped. I kept screaming, "Where's Frances! Go get Frances!" (Frances is our cat) and "Get that thing out of my hair!" At last my son came to my bedroom and told me over and over, "There is nothing in your hair. Frances is by the window. There is nothing in your hair. You don't have hair. You have a hat on..."until I finally woke up enough to hear him and stop screaming. When I finally woke up, I was really, REALLY glad to be bald!!!”
Freud once argued that the "interpretation of dreams is the via regia to a knowledge of the unconscious". He proposed that dreams manifested an unconscious ideation or a need for fullfillment. Some of us have dreams of every type and nature, the I am thin dream, the I forgot my clothes, but always have on underware dreams, the I sex with people I know and have to see them at church dreams (and I don't even think they are attractive), the someone I love dies dreams, and the I cut someone up and got away with it dreams. However, for many, the worse ones are those that have to do with their hair.
Even though many of our participants have accepted their condition and recognize the fact that regaining their hair is improbable, the unconscious wish for hair may manifest itself in dreams. The desire may be expressed in symbolic fashion, displaced, have sexual conotations, be an expression of an anticipatory coping mechanism, or be quite concrete. For some, different senses may be affected. The end point is that having dreams about having, regaining, or loosing all of your remaining hair, is quite normal. In the beginning they may be I would have terrifying nightmares about losing the rest of it. After being bald for many years our dreams are usually about growing your hair back, that it is very short, or that you have long locks of hair (even if you never had them). Some examples are given from our archive of patient information:
Anticipation:
“When I had AA, on more than one occasion I had what I call my "Kojak" or "Yul Brenner" dream. That is, in my dream, I had no hair. These dreams seemed very real and I was always relieved when I woke up and found that I still had my hair.”
Different senses being involved:
“Since I have had AU, I have had dreams about my hair growing back. They seem to be more tactile than visual, i.e., I can feel some stubble and I am usually trying to get my wife to feel it, too. I don't think I ever get to the point in my dream where I can actually see the hair. (Although in general, I don't know what I look like in my dreams - the old me, the hairless me, or the be-wigged me.) I am always disappointed when I awaken to find out that I was only dreaming.”
What is really important for a person with AU for 21 years?
“I still have dreams related to Alopecia, never about getting my hair back, but always my eyelashes.”
Something tucked away that I don't allow to express during wake time or just wishful thinking?
“Several times throughout my life I've had very, very vivid dreams in which I had hair. It felt so realistic that I was almost surprised when I woke up to find that I had none. The weird thing is that I've never really had hair, so I wouldn't "know" what it felt like.
“On the same subject, over the years many people (teachers, friends, relatives) have confided in me that THEY have had dreams about me with hair, ranging from very short to very long, white to red to black. They always seem a bit embarrassed to tell me, but we usually end up having a good laugh about it.”
Some people find their dreams sexually exciting (no offense intended). For me, this suggests that our sexual and love relationships are closely linked to our hair. This may be a truth which helps us understand the devastaion of our hairloss.
It may be a shocker the first time you dream about losing hair. Some patients may be on denial until that dream. Then you realize that if it reaches your subconcious it is a part of your life whether you want to acknowledge it or not. There is no getting away from it, no chance of denial. It is with you and you have to learn to cope with it in reality. The whole idea of having to deal with it, even in your sleep, is stressful. You may feel better by telling your best friend about the dream(s). Verbal acknowledgement of fears helps a lot.
Disturbing dreams may be quite emotional. You can sob while holding in your hand a huge clump of hair when in reality this type of fall out has never happened. Maybe you are grieving subconsiously. In some patients nightmares are the result of restless sleep or difficulties falling asleep and depression. It may be a part of the fibromylagia syndrome (talked about in some detail in this section). Elavil (a tricyclic antidepressant) may be of use in some of these patients. Another useful and over the counter medication is melatonin. At night melatonin is produced to help regulate our sleep cycle. The amount of melatonin seems to decrease as we get older. This may offer an explanation as to why younger people have less trouble falling asleep than older people. There are vague warnings in the drug's information brochure that people with immune problems should not take this supplement.
Sometimes pangs of jealousy can be perceived from our "friends". These incidents may take you by surprise but occassionally they should be expected. One moment these individuals act as if they are there for you and the next moment they seem not to withstand you. Who is having a bad hair day anyway? These people may be jealous of the "perfect" way we look with our wigs. No greying of hair, excellent styling, etc. These people may need a dose of attitude adjustment called reality. It takes quite some time in the morning to apply the makeup just right and to comb the hair just the way you want it. On the other hand, they may be jealous of the way you may be facing your condition. Facing up to loosing all of your hair and remaining bouncy, confident and reassuring to others about your ordeal, etc. Maybe you are dealing with your alopecia much better than they are dealing with their personal problems. If your "friend" doesn't appreciate your healthy self-esteem then maybe he/she wasn't the friend you thought they were.
“I have noticed that since losing my eyelashes my eyes are irritated a lot more frequently and I am constantly using eye drops. As well my nose is constantly running, so everywhere I go I bring eye drops and tissue.”
“...Like you I have to keep eyedrops in the house because of irritation. I find artificial tears ideal. Have you tried hypo-allergenic make-up?”
“It's been quite a challenge to perfect my make-up. I am slowly learning the tricks... My biggest pet peeve is when I'm sitting at work and I have an itch on my face. The next thing you know I've scratched my eyebrow right off!”
“...I find that I sweat more NOW than I did BEFORE I developed AU. It's especially bad when I do aerobics or work out on our walk fit. That's when I miss my eyebrows!!! I have to keep a towel nearby! It's more on my head than anywhere else." To which another member answered, "You're right about the sweat running down your face when working out. I never thought about the NEED for eyelashes or eyebrows. When this first happened, I was washing my head---of course being use to using a lot of shampoo because I had such long thick hair. I was cleaning my head the shampoo came running down my face straight into my eyeball. That was PAIN! I don't have to buy as much shampoo anymore. I didn't realize how much I used.”
“Yes, I am AU, unfortunately. I used to say "at least my eyelashes are still here", and boy, wouldn't you know it, bam! I am now a firm believer in jinxing and I weigh everything before I say it.”
“Yes, I have learned not to scratch or rub my "eyebrows." Since I don't always draw them on if I'm just hanging around the house, I also have to stop and think a second as to whether I've got 'em on or not. I've asked my husband to give me a gentle nudge when we're out if I've inadvertently rubbed one off. I've always got that makeup pencil in my pocket. I've been out a couple of times without it, looked in the car mirror and thought, "Oh great, now what do I do? Get out the ballpoint pen? Dip my fingertip in the dirt and apply to my brow line?" Maybe I should have rubbed off half the other eyebrow, too, and let people think it's an avant-garde fashion look.”
“Forget about false eyelashes and me! I tried them for an experiment a few weeks ago, and it was a disaster. There were eyelashes and glue all over my face, and I looked like a creature from a Tammy Faye nightmare!”
If your eyebrows and eyelashes disappear, glare and dust may represent a problem. Some of our participants have found it useful to wear sunglasses, others wear bangs (or a fringe for our British audience) in their wigs. There is another reason to wear glasses with window-lenses (no correction). You may happen to look better in glasses and in addition they can seat high enough on the bridge of your nose so as to cover where the eyebrows used to be. If the attendant optometrist is ignorant but basically a good person, he may think you have cancer and give you a 25% discount on the lenses! Eyeglasses may also protect you against a possible corneal abrasion caused when a foreign body, not filtered by the eyelashes, lands in your eye.
Missing eyebrows can also be covered with false "bangs". The bangs may be attached to hats with velcro. The Tender Loving Care (TLC) catalogue of the American Cancer Society includes some synthetic versions. Their phone number is: 1-800-850-9445. Some people prefer hair compliments because they simply circle the head on a string, no fuss, no hassle.
Some people have found no success in using fake eyelashes when they have no eyelashes themselves to use as a guide. An alternative is to use an eyeliner pencil but it gets quite tricky, as normally you would use eyeliner just below the eyelashes. Without eyelashes you almost always end up by running the pencil on the inside. As such you can get chronic eye irritation. This appears to be especially true if you wear contact lenses.
If you are going to start using false eyelashes, remember to always carry a tube of eyelash glue in your handbag, you never know when the eyelash might start sliding off. There is nothing that can ruin a nice evening more than having to worry that your eyelash is going to fall off! Also, be careful when applying the glue or you may end up by giving yourself an inexpensive "eye lift". That is, when you open your eyes, the lid is glued open... almost like when the kids in the back of the bus used to turn their eyelids inside out! There are somethings that you can do that may help:
Note: You may find the addressess and telephone numbers of companies that sell alopecia-related accessories in section 5 under wigs. The eyelashes are pretty easy to get in drugstores, but the glue is meant to adhere to real lashes and doesn't work too well when the eye tears. If it's a cold day, your eyes will tear and very soon you will start feeling them coming off. Thank God for sunglasses to hide a multitude of sins!! Carry some replacements with you so that in case of an emergency you can whip out the ever present tube of eyelash glue and a pocket mirror, and stick the sucker back on.
Some tips for using false eyelashes (given by Ms. Peggy Knight a Medical Image Consultant and an AA patient herself):
“You can find inexpensive lashes at most drug stores. The most important thing is that you buy the thinnest and shortest lash available. An invisible band which has been individually tied will last longer.
“Do not wear the lash as it is out of the box. Using manicure scissors, cut the band to fit the eye, then cutting into the fiber take small snips giving the lash a shorter more irregular look." Remember that eyelashes can be trimmed as far as width and length to fit the eye and seem natural. Some people obtain good results wearing a pair of eyelashes simultaneously. The first one is cut fairly short and is used as a base, the second is trimmed to the length you desire. With two lines of lashes you may get a more realistic looking lash line.
“After you have mastered the glue application and it is set, go over the lash with a mascara brush. This gives you a very natural look.
“Allow an extra 15 minutes the first few weeks of lash application. Some patients have had more then their share of tears because of rushing. You will find that with practice it will take only a few extra minutes.
“A liquid eyeliner made by Lancome has given good results to a few patients. This product is made to be used over the eye area, but lasts much longer than brow pencils. Apply it similarly to brow pencils making sure to blot it first.”
And above all else; if you wear contact lenses NEVER put them in before you apply lashes. You may ruin several pairs of contacts thinking "Well, I'm just making a small repair....I'll just quickly fix this corner"......bad idea.
I don't know of a eyelash glue that is water-proof. I don't mean one that says it is water-proof, but one that actually is. Some of our members are tired of never being able to swim underwater and have fun in the water out of fear that something will happen to their false eyelashes.
It is important to make sure that the glue you are using is fresh. Once the tube has been opened bacteria has a chance to multiply. This may be the reason some people experience eye infections.
You should also make sure your mascara (if used) and eyebrow pencils are fresh. Mascara should be tossed after a few months and pencils should be sharpened before each use to discard the bacteria, which has formed on the tip.
Wearing false eyelashes is like anything else, it gets easier and easier with practice. At the end of this section you will find some helpful hints provided by Ms. Peggy Knight on wearing false-eyelashes. You can also look in Appendix C for other helpful hints under Other Problems (Eyebrows and Eyelashes). Also be aware that no matter how good you may be with fake eyelashes or drawing eyebrows, you can still defeat yourself by not paying attention to the eyelines. Here are some tips that may help you:
A make-up tip when drawing eyebrows is to sharpen the pencil and draw the hair from base to tip with a feathery effect rather than straight. Something to keep in mind is that natural hair is not all one color. So the next time you are using a brown pencil, mix some browns with the black lines (or whatever colors the brow hairs might be). Eyebrow pencils should be lighter or equal to your natural brow color and definitely in the right tone of color.
After using the brow pencil some patients blot their eyebrows with powder. The powder seems to tone down the starkness of the drawn eyebrows and seems to keep them a lot longer especially amid perspiration. Some people also add a dab of hairspray for the same reason. It also helps to set the color better. This technique is useful when covering a patch of hair loss. It is very difficult, however, to draw every single hair when all of the eyebrow is missing.
A company called Senna Cosmetics (1-800-537-3662) (in CA (310-274-1028)) offers stencils for drawing eyebrows. The product is called Form-A-Brow Kit, and it's $32.99 thru the catalog. The company is based in Valencia, Calinfornia. I think it would look good with partial brows, if you cover your whole brow for even color. It has 3 little plastic cards with cutouts of 3 different sized brows (normal, fine and full). It comes with 3 different brown-brown/black powders and 2 brushes. You put 3 dots on your brow (one where it would start just above and even with the inner corner of each eye, one at the top of the arc, and one at the end) so they will be relatively even (remember, no one's face is entirely symmetrical). Then you place the stencil cutout over the dots to line it up and fill it in with the powder on the brush. It is easier when a makeup artist shows you how to do it. It may take several tries if you are learning from the instructions. Senna does not have a website. The owner said if you call to order one, and mention the word "alopecia," they will give a 10% discount. If anyone wants to order 12 or more kits (setting up a wholesale account), they will discount 50%. The kit comes with instructions on how to apply them, but you can ask for a additional printouts, or a copy of their catalog that has instructions in it. Also, there is a website called eyebrowz that has brow stencils in the shapes of famous people's brows.
A product by English Ideas (800-547-5278) called Brow Last (also available in some stores) is a liquid that you brush over your stenciled on brows to seal them (keeps them from rubbing off). It's great. The whole things takes about as long as it takes to put in contacts or to put on mascara (remember that??!?). A cheaper alternative to the Brow Last which is $18.00/bottle is Liquid Bandade. Same size bottle for only $2.00 and no shipping charges. The only problem is its hard to get off, so use it when going to swim or going to sweat. The best way to take them off is to add more and wipe it away while wet. Also, you may try putting a little brown shadow on over them after it dries and it will take away some of the shininess. Another problem is that it is shiny and that there is a slight odor when you first put it on. Liquid Bandade is available at most drug stores.
An interesting alternative for those missing eyebrows is to have them tattooed. Dermatologists refer to the procedure as intradermal pigmentation. Can you imagine scratching your eyebrows and not having to worry about the make-up smearing or coming off? Or, having someone with glasses kiss you and not seeing your eyebrow walk off on his lens? For some reason tattooes are considered an option primarily by women. They don't generate a lot of enthusiasm in men. Some would say that they are getting used to the AU as time marches on, but I wonder about an image problem. Maybe it is something related to that old phrase, "Real men don't eat quiche, or, as the saying goes, "Vanity, the name is ME".
In some states you have to be 18 years of age or older to get tattooes or body piercing. If you decide on tattooes first consider the color. When old and gray, black eyebrows and eyeliners may look strange. I have also heard of a story where a woman tattooed her eyebrows. Then....her own hair grew back.....BUT NOT IN THE SAME PLACE AS THE TATTOOS (Ouch!!). She looked like a Picasso. Tattooes usually fade after 5 years or so, but they can be touched up. A negative aspect about tattooing is the possibility of developing an allergic reaction to the dye or an infection. Allergies are a trait of alopecia areata. Any attempt at tattooing should be preceded by testing for allergies (some do this behind the ear lobe). A woman who was allergic had weeping eyes all day long and nothing, not even laser surgery helped her. She looked HORRIBLE!
"Permanent" tattoo ink for earth tones contains iron oxide which consists of small particles of metal within the dyes. In the event you would ever need to have an MRI done of your brain, the magnetic fields may cause you to experience a heating or pulling sensation. Otherwise let the technician know so he/she can compensate the settings and get a clearer picture.
There are non-permanent but "natural" tattooing techniques using henna's, etc. The disadvantage is to repeating the time, discomfort and expense over time. The eyebrow tattooes themselves are not permanent. They will probably last for 4 or 5 years before fadding. If anything the faded guidelines are beneficial in drawing on the pencil ones. Some permanent make-up persons are adamant about ALWAYS using a sunblock over the brows to prevent fading. In this case the sunblock may run into your eyes which is very painful. Baby sunblock with 45% blocking is the least irritating.
I have not heard of a single case of HIV infection transmitted by tattooing techniques. Still, infections around the eye may be tricky and dangerous. There are case reports of reactivation of herpes simplex infections after tattooing and others that developed verrucae in the area of pigmentation.
If you decide in favor of the tattoes, remember that multiple sessions are going to be needed. You may need several consultations in which the individual tattooing the eyebrows will explore your feelings (expectations) and if assured will then proceed to draw various shapes in different colors until you are satisfied. The color will be selected according to your skin coloring and age. He/she will then photograph what you want and make notes as to the colors, shape, etc. When you go in for the actual tattoo, the eyebrows will be drawn again exactly as you wanted with the result serving as a template. You can hold a mirror and comment on every step of the way. Since some colors may look different depending on a person's complexion, the tattoing may take several appointments. The first appointment may start by introducing a subtle color and then waiting for two to three weeks to see how it reacts. Then appropriate colors are added to finalize the procedure. Gradually go darker because too dark eyebrows may be to obvious. The final visit is just for touch-ups.
The machine used is much more gentle than the one for used regular tattooing and topical salve is used to numb the area. A good professional will ask you if the tattooing is hurting and whether you need more aneshetic. If the artist is associated with a physician, the MD may prescribe a steroid to reduce the swelling. For the same reason you may also use ice packs.
The permanent eyeliner is more painful--brief, but painful. Because of the thinness of the skin, the make-up artist is unable to anesthetize without blocking the acceptance of the tatoo ink. The eyeliner may have to be gone over twice or three times.
It seems that some Japanese women have only half eyebrows, the inner-most half. This appearance is somewhat inconvinient in our culture. I know of one Japanese lady who is going to avail herself of a laser tatoo process that creates an eyebrow consisting of grey-tone dots instead of multiple lines. It sounds very interesting.
People performing this trade do not need a certification, so get good recommendations. The results are normally less than optimal as the tattooed skin itself has a shinny appearance uncharacteristic of hair. Tattooed eyeliner (above and below the eye) are usually done for $400. Eyebrow tattooes (done as sepaate hairs and using different shades) usually cost $500 to $600.
Some absolute medical reasons not to tattoo are (from LC Parish and GP Lask, Aesthetic Dermatology, McGraw-Hill, 1991):
You can obtain more information on permanent eyebrows on Tattoo Faces by Design 1-800-322-3741. Gena G. Harrison is a Board Certified Dermatologist who has performed over a thousand dermal pigmentation procedures since 1989. She has a pamphlet on intradermal cosmetics claiming that the pigment is removable. Her Toll Free number is 1-888-352-6799.
If you pursue the possibility of false eyelashes/eyebrows Ms. Holly Oyler has developed a product line specifically for people with alopecia areata. Ms. Oyler has had AA herself for over 30 years. Ask her about the lashes and pencils for brows. These products are usually made with higher melting point waxes to provide a firmer product. The inert pigments are also special because FDA prohibits the use of coal tar products in the region of the eye.
Holly Oyler Holly Cosmetics 4012 Dupont Cr, #108 Louisville, KY 40207 800 222-3964
Ms. Oyler also sells a product called brow stay. You apply it over your eyebrows and they are supposed to stay on all day.
Artifical eyebrows are now available that are made of synthetic or natural materials. The hair is usually knotted into a net and glued in place. Some actors use a special type of artifical eyebrow called crepe hair. This type of fake eyebrow is made from braided wool and comes in a variety of colors. As with other glued on prosthesis, a contact dermatitis may ensue as a reaction to the adhesive. Artificial eyebrows designed for the stage are not recommended for people with aloepcia. They are big, dramatic, and difficult to cut down to normal size.
Some comments by one of our members:
“I tried the synthetic brows from Beauty Trends, and my reaction to them is mixed. When I first put them on, I thought wow, this really looks like hair, much more authentic than drawn-on brows. But in the end, I don't use them anymore for the following reasons:
- They were hard to get off at night. The glue is very strong, and was pulling out the few real eyebrow hairs I have.
- They got kind of glommed up with glue, once when I made the mistake of putting the glue on the brow piece instead of on my skin. This made them stiff.
- They were just more bother than I thought they were worth, but keep in mind that I really like to keep things SIMPLE.”
Artificial brows have many uses:
The following story may be unrelated to autoimmune hair loss, however, some people believe it has helped to cure the drudgery out of painting eyebrows. It is an old Chinese folktale that can briefly be summarized as follows:
There was once a Chinese maiden who as a little girl was hit in the face by a rock as she played in the garden of her father's estate. When the wound healed it was discovered that her eyebrow was gone - the scar healed over quite well but the eyebrow never grew back. When she grew up, people said, "Oh, how sad! She is so beautiful except for that missing eyebrow!" Eventually the man to whom her family had betrothed her came to take her in marriage. When he saw that her eyebrow was missing, he reassured her that it would be no problem. "I am an artist and a calligrapher," he said. "I will paint for you each morning an eyebrow as slim and graceful as a willow leaf." One morning, he was painting on her eyebrow, and he asked her, "How did it happen that your eyebrow is missing?" She told him the story of being hit by a rock, and he asked her, "Was this the garden in which I first beheld you?" and she said yes. "OH!" he exclaimed. "When I was a child, I once threw a rock across that wall, and I heard a young girl cry out. I ran away to avoid being punished. It was I who took your eyebrow, and it is I who have given it back!!!"
I always liked that story for some reason. Anyway, painting your eyebrows everyday you can become a soothing art form.
“Sometimes the skin around my eyelids seems to get irritated and a bit itchy, causing my eyes to get weepy. This might last for several days at a time. It never happened before I lost my eyelashes, so I figured it's related to that. It's not that something is getting into my eyes, it just seems to be the edge of the eyelids that are affected. It hasn't been painful, just mildly annoying.”
“I miss wearing my eyelashes, but the glue got to where it swelled my eyes shut (a little worse than gluing them!.”
“I get that redness in my eyes, too. This happens especially when I wear my glasses. I thought it might be having my eye air trapped behind the lenses with the fumes from the sunblocker that I wear on my tatooed eyebrows.
“I believe that the lack of eyelashes causes more changes than a person might suppose. For example, I never wore sunglasses. I squinted my eyes to keep out the sun. Now, sans eyelashes, squinting does not work. My eyes are not able to screen out the brightness. I always wear sunglasses while driving, walking, etc. It was such a loss to keep losing sunglasses. Now, I need them so badly that I don't lose them anymore. Also, I believe that I am more sensitive to smoke and cleaning products. Again, I figured that the eyelashes are not there to do any screening. Blowing air is a problem, too. The eyes seem to be especially vulnerable.”
Since the eyelashes protect the eye by filtering foreign bodies, their absence may lead to chronic irritation of the eye. Patients with alopecia areata are also prone to allergic reactions and irritant eczema. If you and other members of your family suffer from dry skin or asthma this may be the diagnosis. Some recommendations for treatment include house dust mite avoidance (i.e., barrier material on mattresses and pillows, regular vacuuming of bedroom, the use of anti-mite sprays) and topical steroids.
Another complication that I have seen in patients is seborrheic blepharitis [blepharitis meaning inflammation of the eyelids and seborrheic means having to do with the sebaceous (sweat) glands in the skin]. Its manifestations include irritation (the feeling of a foreign body in the eye), burning, and itching of the lid margins. The eyes appear "red-rimmed". Quite often there are yellowish incrustations along the lid margin. The usual treatment is the daily loosening of the crusts with warm compresses followed by removing the scales with a damp cotton applicator (or face cloth) and baby shampoo. Those cases with a superimposed bacterial infection may need to be treated with an antibiotic ointment. Rarely, topical steroids are used when the inflammation persists despite treatment, but the routine use of steroids is discouraged. In any patient the long term use of these substances may lead to severe bacterial or fungal infections. Patch testing with irritants is not helpful and may be misleading.
If the eyelash glue promotes an allergic reaction you may try using Diamond brand hair-bond glue. It was not intended for use in this area, however, some people have found it very effective. It is hypo-allergenic, comes in a dark shade which acts as eyeliner, is easy to remove when you wish to remove the lashes, but will stay on for up to 2-3 weeks if you just want to keep them on. It is also very inexpensive (about $4.00 for a large bottle) and seems to be easier to work with than the adhesives intended for lashes (q.v.).
“I don't know if it's because I am AU, but I find women with shaved heads sexy. It probably has something to do with nakedness and exposed skin. I haven't been able to convince my wife to shave her head in solidarity with me. (Actually, I haven't even tried.) I am sure there a lot of other men who feel the same way, whether they are AU or not.”
“...My husband just said it isn't the bald head, it's the private parts. Any talk of a wome's private areas catches a man's attention- bald or not.”
The next potential problem appears to be most common for women with shaved heads. The weirdness comes in when people are attracted by (more like obsessed by) a feature regardless of whom it is on. If someone became enamored of you strictly because of your slick pate, and that person's only focus was on your scalp to the exclusion of the rest of your personality and talents, would you feel very special or flattered? This is a problem that women have dealt with for centuries. If she has an overly endowed chest, she may never be dealt with as a whole person. She is stereotyped from the start and has to work twice as hard to be perceived as intelligent and capable. That's just one hurdle. The next is the so-called admirers of her figure. While some are harmless whistlers and starers, others start fantasizing about a pair of boobs, without ever considering the person that owns them. That becomes scary. When people move from admiration to obsession it is not flattering. Attraction is one thing but fetishism or obsession is quite another. When you become attracted to a person because of a certain feature, you normally get to know them a bit better before declaring your undying love. That's a reasonable attraction. Obsession/Fetish comes in when they declare their love based on that one feature and don't know anything else about the person, or undertake to learn about the person. This is similar to the way a rock star groupie would act. It goes beyond normal and reasonable. A lot of the messages from the "bald women admirers" are things like "I want to shave a woman's head" and "I like pictures of girls getting their heads shaved better than the ones with alopecia," blah blah. Like it's a big control and humiliation thing. Another thing is how condescending they seem, like shame on you for wanting hair and not going out bald. There's just a difference between admiring a woman who has shaved her head and being strangely interested in women who have lost hair against their will. Check out the Hair Group Message Board and be prepared to be either amused or appalled.
“...my image was one of dobermans (dogs) gnawing on my joints. I'd be in tears at night from the pain. Iwould also wake up feeling myalgically sore - as if I'd been beaten up while sleeping.”
Fibromyalgia is a little publicized complication in some patients with alopecia areata. The condition is characterized by widespread and chronic pain of the muscles and joints, chronic fatigue and disordered sleep along with multiple other complaints (e.g., dizziness, clumsiness, irritable bowel syndrome). The onset and course of this illness is excerbated by physical and emotional stressors. Digital palpation should be performed with an approximate force of 4 kg. For a tender point to he considered "positive" the subject must state that the palpation was painful. "Tender" is not to be considered "painful." The presence of other medical disorders does not exclude the diagnosis of fibromyalgia. The typical patient is a middle age woman with symptoms of depressive anxiety. Diagnosis relies on clinical insight, there are no specific laboratory tests to confirm its presence. Even the diagnostic criteria given below provide an adequate diagnosis in only 88% of cases. The natural course of the condition somewhat resembles alopecia areata in the sense that it appears to have a mind of its own (unpredictable remissions and exacerbations). Treatment is basically with tricylcic antidepressants, nonimpact aerobics and patient education. Recent work has shown that patients with CFS have a reduction of hypothalamic-pituitary-adrenal(HPA) axis activity due, in part, to impaired central nervous system drive. These observations provide an important clue to the development of more effective treatment to this disabling condition (Ann N Y Acad Sci 1998 May 1;840:684-697).
The following is a definition from the American College of Rheumatology (1990 criteria). From Wolfe F et al: The American College of Rheumatology criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum 33:160 1990.
Definition. Pain is considered widespread when all of the following are present: pain in the left side of the body, pain in the right side of the hody, pain above the waist, and pain below the waist. In addition, axial skeletal pain (cervical spine or anterior chest or thoracic spine or low back) must be present. In this definition, shoulder and buttock pain is considered as pain for each involved side. "Low back" pain is considered lower segment pain.
Definition. Pain, on digital palpation, must be present in at least 11 of the following 18 tender point sites:
For those patients who suffer from fibromyalgia, it's important to have amino acid testing done (at a reputable lab that specializes in this). There are virtually always deficiencies in amino acids with this population of patients. Studies are being done in Australia (Newcastle Research Group) showing the benefits of amino acid supplementation. Also, those with chronic fibromyalgia show magnesium deficiencies and often deficiencies in intracellular K (potassium) so supplementation with Malic Acid (magnesium) and K is impt, usually relieving the aching associated with the condition. It's equally important not to take too much K as it can cause cardiac arrythmias.
As an aside, those with cfs/fms, gwc, mcs are testing positive for mycoplasma fermentans at an alarming rate. The treatment for this is long term antibiotic treatment (in 6 week cycles, often back to back). There are 5 types of mycoplasma to be tested for. My favorite lab for this is The Institute for Molecular Medicine in Southern California run by one of the top experts on mycoplasma, Professor Garth Nicholson.
“Heaven gives its glimpses only to those Not in a position to look to close.”—R. Frost
A five o'clock shadow is a common phenomenon for patients who shave their heads. There are some things that can be done to improve how it looks. First get some sun on it. When the scalp's skin tone matches the rest of your face the dark areas are much less noticible. Also, remember that just as it took time for your beard to be set up when you first started shaving, so too, must your scalp hair. In several weeks you should get a smoother and cleaner shave. When hair starts growing very fast and you are going on a date shave and reshave during the day. A positive aspect of the shadows is that it may inform you as to whether the hair is growing back. It is also worth noting that many people with alopecia areata suffer from a very sensitive skin. Chemicals that act as depilatories may cause severe irritation of the skin for these patients.
The following story provides a helpful beauty secret by one of our participants:
I was quietly munching my veggies the other day at my neighborhood Boston Market when this cool black dude named Damien, who is as bald and glistening as a cueball, strolled over and said, "Love your haircut, man."
"Thanks," I said. "I've got a condition where my hair doesn't grow right."
"Ohhhhh," he said surprised. "I thought you just shaved it to look cool."
"Yeah, last week when the wind chill factor got down to 10 below, it was cool all right."
He carefully inspected my pate, counting the number of knicks and scratches that I had inflicted on myself with my trusty Gillette.
"You know how the Boyz 'n the Hood keep their heads lookin' cool?" he said, sounding ike a dermatologist giving a second opinion.
"How?"
"With this!" He reached into his rear pocket and triumphantly whipped out something that looked for all the world like emory cloth: black, flexible sandpaper with very fine grit.
Whereupon he began industriously sanding his scalp!
"It makes you look great, it keeps your head shiny, it makes your skin tougher and smoother, and the women love it. I always keep one in my hip pocket to get rid of a six o'clock shadow. Up there. Women have been using these things for years to keep their legs smooth; now us guys use 'em."
Soooooooo, a few days later I got down to Revco drug store, made my way over to the women's depilatory section, and sheepishly purchased two paks of Hair Off Mittens, like a teen-ager shyly buying his first pack of prophylatics.
The kind I bought is called Hair Off Mittens, imported from Canada by CCA Industries of Rutherford, N.J., 07073, but I have to assume that this company has competitors. I paid $4.95 per pak of three mittens -- but I think you could save money by going to Home Depot and buying a year's supply of 600-grade emory cloth.
It worked: Now on my arm I've got a beautiful blond named Betty, who has long luxurious ringlets of cascading hair, who says she loves bald-headed men....
And, what's more, I've solved the eternal mystery of what basketball players talk about in the shower.
And even more importantly, I have finally figured out what women talk about when they leave at dinner in two's to go to the ladies' room. I think.
“I can't stand going to a salon and having my hair fooled with in front of everyone. It has been 2 years since I've gone. What you can do is find a hairdresser that works late, and see if you can get their last appointment. Explain that you have alopecia (most hairdressers know right away what that is. My old hairdresser is the one who diagnosed me 5 years ago) and that you're not comfortable having other people around while you're "exposed."”
One of the members of our list server is a hairdresser in a large, busy salon. She has seen all KINDS of people with all kinds of hair situations come in every day and 99% of them are self-concious about how they are looking to others, even if they don't have alopecia. What I'm trying to say is the other clients are not necessarily checking everyone else out, for fear someone might catch THEIR eye and see them with color on and every hair standing on end, or looking like something designed to pick up radio waves with foil all over the place. As has been said before, others pick up their attitudes from ours.
There is a strange item of jewelry that was used during Victorian times. It was quite the fashion then to memorialize the passing of a loved one by creating mourning jewelry. One such item is hair jewelry, where hair from the deceased is braided and inserted into a small gold and silver casing, to be worn by the mourner. This was also done with sentimental hair jewelry, of a living loved one. Now these examples are viewed as collectibles, but I think that in many ways we all mourn/grieve for our lost hair and how it used to be. It seems we look at hair in terms of grieving in many different ways....
The acute loss of hair in an adult often brings about a grieving process. Anger and social withdrawal prevail. Patients have difficulties accepting the condition and often obssesively ask themselves, "Why did this happen?" It is an emotionally trying experience, especially, for those loved ones interacting with the patient.
It is fine and healthy to mourn the loss of ones hair. In fact i feel it is necessary. But when we move on past that, we should feel no shame, and neither will our kids. The only shame my kids feel is when i dance in public!!!!!!! But that's their hard luck!!
Grieving should be looked upon as a normal process that lasts a number of months or even years. Several principles apply to the situation:
Besides styling some people become quite clever with the use of headbands and scarves to cover most of their patches. Some patients have used eyebrow pencil successfully. A water-proof pencil might solve the problem of it wearing off due to perspiration. With a pencil, you can color the smaller areas with light strokes (feathers) to make them look less obvious. Probably two pencils with some color variation would make them look even more natural, like a taupe and a light brown for someone with medium brown hair. I found that anything, including eyeshadow, that covered up the "shine" minimized the look of the bald patch. Even an off color showed less than the obvious pink of the scalp. If you have dark brown hair, buy Revlon's eyeshadow blackest brown (or is it darkest brown?). Dampen the spot with a little bit of water. Just get your finger wet and rub the spot a little, or put a little bit of moisturizer on it. Apply the eyeshadow while still damp and it will go on thick, dark and even. It only comes off if you rub it off or wash your hair, not while sweating. Other people have used wax crayons and vegetable dyes to diminish the contrast between the pale scalp and the hair. A friend of mine hides her boyfriend's spots by using brow powder a bit lighter than his natural color first, then going overtop of it lightly with a mascara wand in a color matching his hair - that really blends it well. A more professional appearance may be obtained with camouflage cosmetics. Sources of camouflage cosmetics (named in parenthesis) include the following:
Atelier Esthetique (Veil) Suite 209 386 Park Avenue South New York, NY 10016
Ben Nye Company, Inc. (Coverette) 5935 Bowcroft Street Los Angeles, CA 90016
Dermablend Corrective Cosmetics (Dermablend) P.O. Box 3008 Lakewood, NJ 08701
Fashion Fair Cosmetics (Cover Tone) 820 South michigan Avenue Chicago, Il 60605
Joe Blasco Cosmetics (Dermaceal) 1708 Hillhurst Avenue Hollywood, CA 90027
Kryolan Corporation (Dermacolor) 132 Ninth Street San Franciso, CA 94103
LS Cosmetics (Natural Cover) P.O. Box 32203 Baltimore, MD 21208
Lydia O'Leary (Covermark) 1Anderson Avenue Moonachie, NJ 07074
II-Makiage (Cream Makiage) P.O. Box 1064 Long Island City, NY 11101
Pattee Products (Corrective Concepts) European Crossroads 2829 West Northwest Highway Dallas, TX 75220
A product called Couvre (a colored cream) is specifically made to fill in bald spots on the scalp. It costs about $20/tube. It is an effective concealer that is waterproof. The 800 telephone number to order is 443-4521 or you can email them at couvre@couvre.com. One inconvinience is that when you apply it to a spot, it starts out nice and dark, but after trying to blend it, or smear it around, it just rubs off. Some people have tried using more, applying it with their finger instead of the sponge, on a damp scalp, and on a dry scalp - it still ends up rubbing off, looking lighter than it should and splotchy.
There is another product called “The Great Cover Up,” which is more pricey than Couvre and I can't for the life of me see how it can effect the transformation to one's head that its 'before/after' photos would have you believe it does. That said, it's not too bad for smaller spots - BUT the one thing that's not so great is that it has a very very fine powdery texture and you sprinkle it on your head like pepper (not that I often go around spinkling my head with condiments, but you know what I mean), and no matter how carefully I do it I always end up with sprinkles all over my face and all over the bathroom sink/floor/shelves - in fact, this stuff gets EVERYWHERE! Mind you, perhaps I'm just malcoordinated, who knows.
As stated previously some patients complain of itchiness (pruritus) in the scalp before or during the loss of hair. In this setting, the itchiness is probably due to the release of inflammatory chemicals acting on cutaneous nerve endings and signifying an active disease process. If itching is the result of an active inflammatory phase for the alopecia, the institution of topical or injected steroids may prove to be of benefit.
The psychological state of mind produced by the hair loss (e.g., anxiety or depression) may exacerbate the itchiness. Treatment for the anxiety and/or depression brought forth by alopecia areata may alleviate the itching.
An extreme, but not uncommon case, was provided by one of our participants:
“I have always had a very strange itchiness at times that seem almost deeper than the skin. I have taken antihistamines at night since I was 8 years old so that I can sleep. It always seems worse when I am extra tired or too warm. My skin just seems to prickle and I can't relax at all. It is very annoying at a restaurant or a movie, because I can't just sit still and enjoy it." It is not surprising that such a situation would add a lot of anxiety to an already fragile mood state.”
Similar expressions by other patients:
“It seems that as I itch one spot, another spot starts to itch. I noticed others here have mentioned this on occasion. What I have experienced as a prickling feeling is hard to describe, kind of like hundreds of little pin pricks moving about the upper part of my body including my arms and head, like my pores were erupting. It seemed that it would start when I was hot, even taking a shower. It happened mainly in the winter when the humidity is low and I didn't sweat. In the summer it didn't bother me too much, except taking a shower occasionally. This year I noticed it hasn't bothered me too much.”
“I had a similar problem, not with itching, but tingling... like a strange 'minty' sensation all over the area of my head that's experienced the hair loss. I didn't hurt, but was extremely annoying...and mainly served as a continuous reminder of my hair loss.”
Itchiness may be the result of a coexisting condition such as seborrheic dermatitis. The scalp of these patients is dry and scaly with similar changes manifested in their eyelids. In still other patients, itchiness is the expression of a contact dermatitis. Without the hair, the scalp is more thoroughly exposed to the active chemicals of shampoos and conditioners. The harsh chemicals result in inflammatory changes (redness and swelling) and even occasional vesicles with exudation. The increased sensitivity may make a ceiling fan an annoyance and wigs too hot to wear.
Remember that many patients with alopecia areata are predisposed to atopic conditions. Atopics have a lower threshold for itching and vigorous excoriation than non-atopics. Still another confounding factor related to the condition per se is itchiness due to therapy. In this regard psoralens with ultraviolet radiation (PUVA) has been reported to have itchines as a side effect.
If itchiness is the result of a dry skin adequate lubrication will produce a protective layer for the skin. Whenever this layer is absent (e.g., from overexposure to water, soaps, or your eczema/alopecia areata) microscopic fissures develop which result in small pockets of inflammation. The manifestation of this inflammation is itchiness. If this is the case with you I would suggest using a lubricant to cover the tiny fissures and hydrate the skin. Antihistamines are the classical prescribed medication, but at "anti-itch dosages" they produce sedation during the day. There are many lotions in the market containing menthol, camphor, etc. They produce a mild tingling of the skin, thus diverting your mind from the original itchiness. Cool compresses may also be of benefit. Agents like calamine lotion may act by initially cooling the skin (because they evaporate quickly), but then the resultant dryness may enlarge the fissures, the inflammation, and the need for more calamine lotion. Commercial preparations containing benzocaine (e.g., sunburn medications) should be avoided as they may induce an allergic contact sensitization. For similar reasons avoid buying creams and oils that have perfume, dyes, or lanolin.
In some patients, the itching is so widespread that they would literally have to bathe in a type of oinment or lotion in order to hydrate their skin. In this case try a bath oil. These compounds have special formulations of lanolin, mineral oil and other emulsifiers. The active compounds readily disperse in water and cover all of your body while bathing. Bath oils have anti-itch properties and help to hydrate the skin. Just be very careful because they make the bathtub or shower floor slippery. You can also try putting on baby oil while you are still standing in the tub, then towel dry. The result is hydrated, not oily skin.
Some of the available bath additives/shower gels include: Alpha keri, Balnetar, Domol, Lobana, Oilated Aveeno, and Robathol.
It is said that you should get in the tub and get thoroughly wet (5 to 10 minutes) and then add the bath oil. Otherwise, if you add the oil first, when you get into the tub, you get a layer of oil on your skin that prevents the water from getting in. Some of our participants have found that it does seem to help their skin to follow this procedure.
It is also noteworthy, and you already know this, that frequent contact with water tends to DEHYDRATE the skin. The hands can be washed some 5 times per day. Washing them 10 times causes a mild contact dermatitis to the soap. More than 10 exposures after a sustained period of time will produce severe inflammatory changes with cracking and fissuring of the skin.
Itchiness caused by the close apposition of the wig to the scalp can be avoided by using a stocking cap. This cap, usually sold at wig stores, is intended to keep all of your hair up and under the wig. For those of you without any hair, stocking caps are intended to keep the scalp from getting scratchy, acting as a cushion and feeling snug. Some people improvise a generic version of the stocking cap by cutting the leg of a pair of panty hose and use the body part as a cap. It is cheaper than the stocking cap and achieves the same thing.
“My fingernails are so brittle, they split going up my nail—very painful, so I keep them short.”
“The nails developed pits that looked as if a pin had made tiny dents in rows across the nail.”
“Don't panic about your nails. I have had AU for 10 years. It is not until about 3 years ago that I had my first problems with my nails. I never lost them completely, they just peeled, got very short and weak, then got back to normal slowly. I had no idea that it was related to AU until I got on the listserv. When I went to a dermatologist at that time he said he had no idea what the nail problem was, in fact it seemed symptomatic of being malnourished. I did not have another problem until maybe 1 year ago again which just happens to coincide with some major job changes for my husband and myself, some good some bad and very stressful. Once again the nails are very weak and peeling. I am taking vitamins and a special nail formula pill with magnesium and b vitamins besides and some are growing again. By the way.... I don't seem to have the problem with my toenails! They are ridged but very strong and they don't peel. Kind of interesting.....”
“A lot of manicurists think you have fungus, though, so you may have to explain your condition to them (for the umpteenth time!).”
For pitting, I use an old fashioned nail buffer --it looks like a small brick with a very fine "sandpaper"-like filing surface on all of its sides. Follow that up with a good cuticle cream a couple of times a week and see if that helps (it makes my nails shiny and smooth--reduces the pitting and lines).
The previous post about horse hoof cream reminded me of a cuticle cream I used to use (got too lazy to continue!) and that others I know have used with some success. It's called Healthy Hoof ( I don't know if it was from Straight Arrow) and while it is the same substance that's used on horses, it's sold in cosmetic stores (I bought it at The Cosmetic Center, a discount chain). It was only like $3 for a little cream colored jar with red writing. Maybe that would help Andrew. Also--if he'd go for this--it helps to use cotton gloves on his hands at night over whatever cuticle cream he uses. The warmth generated by the gloves helps to keep the cream on and to facilitate absorption. I also found that buffing my nails keeps them shiny and gets rid of the lines.
There are many shared anatomic characteristics between hair and nails that make them common targets of disease. According to Zaias (The Nail in Health and Disease, 1990), the "hardening" (keratinization) of the upper layers of skin and the formation of the nail are very similar. Zaias imagined a nail rolled up into a cylinder with the nail plate at the center of the tube as roughly equivalent to a hair follicle.
Nail changes have been reported in 5 to 66% of alopecia areata patients. The large variation in reported cases is likely related to how carefully the nails were examined. Changes may vary from subtle to prominent and from those involving a single nail to all of them. Some people believe that nail changes are proportional to the severity of hair loss, however, nail changes have been observed to precede, follow or occur concurrently with hair loss activity. Some of the observed abnormalities include fine pitting, longitudinal ridging, spooning, and the development of thick, opalescent nails. The nail pits are shallow and tend to have a geometric arrangement variously termed as "grid", "screen", so forth. These changes are not diagnostic for alopecia areata and are commonly seen in other conditions such as psoriasis and eczema. The pits can be camouflaged with several coats of base coat/nail enamel or the entire nail may be covered by a preformed (artificial) nail. Several patients have also found useful the use of nail conditioners. These commercial products contain a combination of proteins, lipids and water (an emulsion) which retard dehydration and fill in imperfections.
Sometimes the nail changes may be confused by the primary physician as being the result of a fungal infection. The few cases that I have seen receiving treatment for a fungal infection have made their nails worse or have developed other medical problems such as liver toxicity. If you have nail changes and prefer to obtain the diagnostic impression of a professional please consult your Dermatologist.
There are many theories that attempt to explain the formation of these structural abnormalities, but still we lack definite proof for any of them. Some people believe nail changes are due to a malfunction of the cell that produces the protein of the nail, others think that the nail bed is invaded by inflammatory cells, still others argue it may be a combination of multiple factors. The good news is that the nail changes are often temporary. A patient with alopecia universalis of 20 years duration may have nail changes that prove temporary.
I haven't read about a specific treatment for the nail changes of alopecia areata. However, a good diagnosis is the first step towards effective therapy. Nail changes may be symptomatic of a concomitant condition (e.g., lichen planus, psoriasis). In this case the nail disorder may need a different treatment to the scalp condition.
Some clinicians have attempted to treat the nail changes in similar fashion to the hair loss. Thus, intralesional monthly injections of steroids has been attempted but the therapy has proven quite painful and only temporarily effective. Possibly the best way to treat the nails is to avoid those environmental stimuli that may worsen brittle and split nails. Remember that flexibility of the nail is related to hydration. Dry nails become brittle and are more easily broken. The amount of nail hydration is directly related to environmental humidity. Therefore avoid exposure to irritants which dehydrate the nail. Avoid excessive hydration by using gloves when washing dishes. Keep your nails short (prevent trauma). Avoid the frequent application and removal of nail polish (not more than once per week). Nail polish may have a beneficial effect only by cementing together the fissures and lakes of dry brittle nails. Repeated applications of nail polish (and then remover) may be counterproductive and increase nail dryness. Nail harderners may contain formaldehyde (an agent often implicated in contact dermatitis). A lot of hand lotions contain alcohol which promote dryness. If nails are hard and brittle, apply lubricants to your finger tips (including nails). Calcium, gelatin, and vitamin A do no good to the nails. However, massaging the base of the nail with moisturizer daily may decrease ridges as they grow out. Some of our members have obtained good results by applying baby oil with a q-tip on their cuticles each night before bed. Other possibilities include Eucerin (at your pharmacy) or a product specifically for nails called Barielle (obtained at better department stores like Robinsons-May, Macy's, etc.). A three month supply of Barielle (very small jar) is about $15. It is pretty expensive but seems to work wonders for some people. Doing this while fresh out of the shower should help increase absorption. It takes 6 months for the nail to grow from the botom (cuticle area) to the top. So if you are trying a cure, be patient. (See also biotin.)
I once suggested that a possible cosmetic solution for severely malformed nails was the use of sculptured nails. I had seen cosmetically attractive results in a few patients where the acrylic nail was shaped over the natural nail. However, the experience of the group with this resource was negative.
“Whoever asked about acrylic nails, let me just say that when I did it years ago, the aftermath when I no longer wanted them was TERRIBLE! It took a long time to get what was left of my nails back to normal.”
“I agree, although I've never had the acrylic nails, even people without a nail problem seem to have very funky looking fingernails when they remove the cosmetic ones.”
There are case reports of permanent nail destruction after using acrylic nails. The damage is due primarily to allergies or secondary yeast infections.
“I think AU is making me even more paranoid. A friend invited me to a pool party. One part of me thinks, "neat." Another part of me says, "Yeah, she just wants to see my bald head." Bouncing in my head is alternating dialogue, "What about my bald head?" " I don't want to get sunburned." " I don't want to get laughs." "I am curious about the feel of the water on my bald head." "I won't go." My friend added that "she can't wait to see me." My paranoid AU says, "What is that supposed to mean?"”
“Since I lost my hair, though, I have had panic attacks and depression. Fortunately, I went for help and have been on Prozac for over a year. I finally got off the anti-anxiety medications and can even go into a crowded store or room without having to run out. There are days, though, when I have a hard time keeping it together. I can't share my "secret" beyond a few select family members and start to panic when I think someone is "staring" at my $2000 wig , wondering if it's a wig. If someone is looking at me too intently, I feel my stomach starting to knot. The other day, my brother introduced me to his friend. I was a basket case. I was convinced the guy was staring at me because my false eyelashes were drooping...or the wind had blown my "hair" back and he could see the edge of my wig...or he could see that my eyebrows were only makeup. Later that day, my brother called to tell me that his friend had told him that he "couldn't take his eyes off me because I was so beautiful." So, how come I don't feel beautiful anymore?”
See also Self Image.
Some people never getting used to the feeling of paranoia about how others are perceiving them, their cap, or whether they actually notice the lack of eyebrows and eyelashes. Sometimes they just want to scream "I'M FINE--I'M NOT SICK--DON'T LOOK AT ME THAT WAY!!"
People we see on the street have their own sets of problems. While they might take notice of us and maybe even comment to those with them, they soon go back to their own thoughts and problems. True, there are some little people out there, but they will find someone to "use", no matter what. I believe all this to be so and it helps me with my main "complaint" that I hated to lose my anonymity because now everyone notices and remembers me. At one time I disliked the malls. Now I don't give it much thought.
However, to me that's only part of the difficulty in adjusting to AU. The "other" side is overcoming what our culture says looks good instead of focusing on real value. The ads for the hair care industry alone can be pretty influential, all the more if you happen to be 10 for example. Some months ago a billboard ad for Pantene featuring (what else) a young woman with long hair appeared around town. And that's just one example. How to overcome that? ...... I have no idea, except for that line we are not our hair.... introspection into the real us ..... looking at values and at others not so fortunate??
Regarding everyone staring at your head rather than into your eyes - do you think you're wearing too much hair in that wig that's flagging people's attention, is it time for a different more flattering style for you? And I think it's just fine when people are checking your hairline to either ignore it or to smile and shrug and say "I made all the payments and it's mine free and clear - it is my hair" with a big smile and then ask if they have any questions or tell them about alopecia or hand out a little card about it. I find that the more straightforward I am about my scrawny hair (and hair shedding all over my clothes and sometimes theirs) with people, the more comfy we all are.
“How do you think my teenage kids and my seven year old feel about how I look? And what about their friends? Who wants to be the kids whose dad has no eyebrows? When my kids have anyone over the house, they have to make sure that I am not there without my wig and glasses. It is awkward and uncomfortable for everyone.”
“I have told my kids it is ok if they feel a little shame if their friends know. But i have told them i am not in the least embarassed. That i have done nothing wrong - didnt rob any banks (yet), was not hurtful to anyone, etc...”
One of the participants within our list server once confided how her 9 year old son was often embarrased when seen in public with his balding mother.
“While I don't go out without some kind of cover (scarf, turban, or wig) it still embarrasses him when I wear a scarf or turban. He tries to come up with excuses for me, like "She's trying to keep her hair wet (?)". Anyway, I know he's very sensitive about the whole thing and, though I haven't expressly promised I wouldn't go out without a wig, I do make an effort, particularly if I'm somewhere for him (School, Boy's Club, etc.). A few months ago, I took him to a support group meeting. (He doesn't have alopecia). It's amazing to me... my 14 year old daughter who is so VAIN, doesn't care. My son does. I don't know the best answer to this, except, I don't want my son to feel uncomfortable with his mom when we're in his environment.”
I do believe that instances such as these provide a wonderful opportunity to teach our kids the mature way to deal with life's problems. Tell them that you do not need an excuse for your baldness. You are not ashamed and you do not have to deny it. It is just a problem with your hair. People like you for who you are, not for your hair. Tell him or her that you understand what it is to feel embarrassed. Your own parents may have given you a lot of good material as a kid. Also tell him/her that if anybody did notice, have questions, or tease him, to come to you. You will gladly answer questions and talk with anybody. BOTH parents should sit with their children and tell them how proud they should be of their affected mother/father. If the parent feels comfortable with his/her condition then the problem is with the child. You can pray that this phase doesn't last but his/her being ashamed won't disappear immediately. Do not get angry. One of the ways to handle this is to create scenarios for the child where you transpose roles. Perhaps he/she should shave his head and wear a wig to see how uncomfortable it is - this one may back fire, he/she may feel it is so COOL to have his/her head shaved. Or you can appeal to him/her on the level of "what if it was you...your eye was missing and you had a false eye and I reacted with GOD!!! Don't forget your eye when you go out in public! Your going to embarrass me!" It is still hard to deal with the problem. It may bring you right back to your childhood when your own Mom had a hard time seeing you without a wig on. You can take your family members needs into consideration but sometimes you deserve to be selfish. The more you shed the wig the more you will begin to feel like your old self again, you just look different.
Just remember that while outward appearance is sometimes VERY important to teens and pre-teens, the real essence of being their parent goes way beyond what's visible. The lessons and guidance you continually provide, the example of compromise and cooperation, and the focus on the intangible values are what they'll look back on and draw from as they mature. It may help you to remember that they are children, immature, and they're striving to define their own values, outlooks, and (yes) prejudices. They look primarily to us as models to copy the parts they are comfortable with, and continually make choices (sometimes defying any logic or explanation).
“And pictures! I am not afraid of people taking them, I'm afraid of people looking at them afterwards. I see those pictures and think, ‘Everyone can see it's a wig!’ It's awful!”
“I have just gained weight along with alopecia. When I look in a mirror or see a picture, it doesn't look like me and I am not comfortable with picture taking. I resent when someone insists on taking a picture- especially if I am not prepared. How does one handle this situation? I would hope that the person taking the picture would respect my wishes, but I find that they do not. It is very disturbing to me.”
Many alopecia areata sufferers develop a fear of having their photographs taken. This fear often translates into an avoidant behavior on part of the patient, e.g., in many occassions they offer to be the photographer, this way they don't have to worry about being in the photos. The fear is based on a poor self-image and the belief that their appearance will be the object of ridicule by others. They feel embarassed and humilated by their baldness. This is true even for some patients wearing wigs. They feel unattractive, self-conscious and apologetic about wearing a wig. Sometimes they get fanatical in their efforts to stay slim and wear nice clothes- almost as if they are trying to "make up" for not having any hair... Their friends tell them that they have a pretty face and a nice figure, but all they can think about is not having any hair. Their baldness has completely ruined their self-esteem. The fact that they have had alopecia for a certain time, even years, doesn't mean that they have come to terms with it at all.
I get very sad when I look at women's magazines and see that about 95 % of the magazine is devoted to "looks" and the other 5% is about food. Losing weight, the right makeup, clothes, etc., --all with pictures of these perfect airbrushed creatures--can make us all crazy. The worst part is that we buy into it. These magazines emphasize prettiness. They deal primarily with techniques to make you look good. Beauty, on the other hand, is about being yourself. Most times prettiness can never be beautiful.
Once you accept the fact that you are bald, and being around all the same people as before, you will realize that not one of your friends or acquanitances really care about your hair at all, other than to the degree they are concerned about your reaction. It kind of hits you that it really isn't the people around you that have to be less superficial about your hair loss....YOU HAVE to be less superficial about your hair loss. You have to show some courage and character. YOU have to reinvent yourself....a little. You can find some related information in other sections of this document (e.g., self-image, psychological stages). In the meantime, just a thought from one of our members; "I too don't like the way I look in pictures and when I had my head shaved tried to avoid them. Then my wife mentioned that when she was 9 her mom died from Lupus and because of the way she looked she avoided having her picture taken. Now my wife doesn't have any pictures of her and really wishes she did even with effects of her disease."
“My little Casper head would burn in 3 minutes flat, so it stays covered unless I'm in total shade.”
Many of the patients with alopecia areata that I have counselled complain of adverse reactions to sunlight. Take the following story:
“At the moment, I confess that I am so discouraged by my own condition that I am really down. I went to Florida (I've posted several things about our trip). During the entire time that I was there, I wore clothing that covered my arms and torso. But by the time I got home, my arms were inflamed and purple. A clear reaction--but to what? The sun? At first I thought that it was that. But five days later, the reaction has spread to parts of my arms that weren't red at first and to parts of my torso that were under several layers of clothing. So now I wonder if it is an allergic reaction to the PABA that I had been taking to try to head off some of my sun sensitivity. I guess it is the accumulation of problems that is so discouraging. I could live with losing my hair and eyebrows and eyelashes, but to have my skin react to the sun to such a degree makes me wonder if I will have to spend the rest of my life indoors. And I love the beach and the outdoors. I feel like such a freak! The only good part of it is that my doctor gave me a brochure about clothing that is extremely light but protects thoroughly against the sun. It is expensive but I expect I will try it. I just wish that my joys of life weren't being chipped away a bit at a time. I have given up coffee, meat for the most part, desserts, and now sun. What next? Sex? God forbid.”
Light has a number of important beneficial and deleterious effects on the skin. Those individuals particularly predisposed to the effects of sunlight are said to suffer from photosensitivity. Although sunlight reaching the earth is composed of emissions in the ultraviolet (UV), visible, and infrared spectrum most photosensitivity phenomena are related to UV light.
The ultraviolet spectra has been arbitrarily divided into an A, B, and C portion. The UV/C spectra fails to reach the earth because it is absorbed by the ozone layer. Radiation B spectrum causes sunburn and can be screened by a pane of glass. The UV/A spectrum on the other hand, causes aging, tanning of the skin, and is responsible for most of the photosensitive reactions. A window glass that protects against sunburn will not protect against a photosensitivity reaction.
Clinicians usually divide photosensitive reaction into phototoxic and photo-allergic. Phototoxic reactions are immediate and produce redness and pain. The reaction resembles an exaggerated sunburn that peels after several days. Vesicles (blisters with a clear watery secretion) and exudation may also be present. An area of hyperpigmentation (darker skin) may remain in the affected area.
Photo-allergic reactions are delayed (often after a second or further exposure) and produce inflammatory/eczematous changes, itching, and a positive photopatch test. Photo-allergic reactions are most frequently induced by sunscreen components (PABA, PABA esters, and benzophenones), and fragance additives. The eruption is limited to sun-exposed areas. However, upon re-exposure to a challenge, the reaction time will shorten and distant flares may develop, i.e., distant sites not exposed to light may be involved. This phenomenon suggests an immune mechanism. Note: Benzocaine, a topical anesthetic agent used in sunburn preparations, is a PABA derivative. If you are sensitive to PABA you may also be reactive to benzocaine and related products (procaine, tetracaine).
Removing the offending chemical, local care of the skin (cool moist compresses), analgesics, and topical/systemic steroids are the prefered methods of treatment. Patients that exhibit photosensitivity have been advised to avoid exccessive exposure to sunlight. Wear clothing with tightly woven fabric (all colors work well), wide-brim hats (specially when working in the garden), long sleeves, and hats. Consider using suncreens except in those cases where the active ingredient is the inciting allergen.
“Right after I lost my hair I went to Florida,...I looked like a giant match head!”
“You wanna talk sunburns? I can talk sunburns. Try being AU, having vitiligo everywhere, too (no skin pigment, so no tanning ever) and not wearing a wig.”
“What I do these days is bring an REI soft hiking cap (cloth, washable, and very comfortable) when I am out at the beach or playing tennis or at a picnic. With this and sunblock 25 I can balance the amount of sun I get. Years ago when I wore a wig this was much more difficult. My face would always be more tan than my head so I would have a large white monks circle. I never could get enough sun to match.”
“I think you guys should just start a new fad...we will call it sun tatoos. What about wearing a straw hat of some sort and you will have itty bitty little tan holes....:)”
Changing seasons bring different problems to people with shaved heads. During winter they may suffer from dryness of the scalp while summers brings the prospect of a sunburn. The loss of hair in alopecia areata is accompanied by a loss of those skin appendages attached to the hair follicle, e.g., sweat glands. The end result is a reduced ability to perspire and a higher likelihood of sunburn during the summer. One way to avoid the sunburn, blisters, and oozing of the summer months is to use a sun screen lotion. One of our members was a red-head, but now she is only a red-head when she forgets her sun screen. Also get a hat to keep the sun off during peak hours or prolonged periods outdoors. As for winter months and dry scalp, use a moisturizer. Some moisturizers include additional chemicals, e.g., fragances, to which you may prove allergic. You will probably end up by trying several moisturizers before settling on a favorite one. Another positive aspect about moisturizers, besides the soothing of the skin, is the fact that it may help healing skin irritated by shaving. One of our members has recommended a product made by Aramis called New West gel. It is a menthol based blue/clear gel that not only feels great, but also keeps your skin moisturized despite constant shaving. You may also consider buying a cotton cap for sleeping in (specially during the winter), which is also ideal for when you step out of the shower- it keeps yor head warm as you dry yourself. You can purchase one from Hairline International at:
Lyons Court 1668 High Street KNOWLE West Midlands B93 OLY United Kingdom
A cotton sleep cap made of natural fiber items ("the Comfort Cap") can be obtained from:
Wittmann Textiles 11570 S.E. Dixie Highway P.O. Box 1066 Hobe Sound, FL 33475-1066
As of one year ago they were still paying for the shipping costs. They advertise that they do not rent or sell their mailing lists. Their cap will stretch out after some months, but can be rolled a bit tighter, or used as a first cap on those cold 2-cap nights. When worn out, it makes a nice car waxer. Prices as of one year ago were 6.30/each -- 3 for 13.80 -- 6 for 23.70. At that last, with the shipping paid, they were under 4 dollars each; quite a nice price I thought. The caps are kind of made like those wool watch caps, only they are soft cotton, not bulky wool. There is no elastic, the fit relies on the stretch of the cotton fabric, which is of the thickness of, say, a T-shirt.
Other alternatives include a Mambosok that can be obtained from:
The Ski Hanger Park City Ski Area Plaza PO Box 782 Park City, UT 84060 (801)649-4169 Jill Sitting (Owner)
Just in Time, Inc, PO Box 27693, Philadelphia, PA 19118 (215)247-8777 sells assorted cotton hats and turbans that look decent. As of 1994 they sold for about $22 and they have ties/scarves with them to look jazzier.
In the North, you may be lucky and obtain a long polar fleece cap, similar to the one snowboarders wear. They are really soft , so no irritation to the head either. They are so light and warm, that they should make wigs from them. You can find them in the Land's End catalogue. "Turtle fur" caps can be bought at outdoor sports stores or at any ski equipment shop. They are made from this VERY soft synthetic fabric. It is plush and thick, along the lines of polar fleece, but even softer. Terrycloth caps (kinda like a turban) can be worn at night and are even nice around the pool or beach.
“We are each responsible for our own actions and feelings. How we look at others, I think, is indicative at how we look at ourselves. About two years ago, I was in the beginnings of a relationship with a man who knew about my AU, and he told me that it didn't bother him at all. Unfortunately, I was still in the denial stage, and it bothered *ME*, so I found myself finding faults with him so that *I* wouldn't be the one hurt/dumped (or so I thought) by him. Turns out, after years of thinking about it, that the faults I found in him were the same faults I saw in myself. I had projected them on to him because it was "easier" to deal with them that way.”
“I'm 17 and a junior in high school. I don't wear a wig, and go around with nothing on my head, I'm dealing with this really well, but there's one thing that bothers me. Who wants to date a bald girl, I mean first thing they see, no hair. I know that you will all say, there's lots of guys out there, you'll only get the best, because the loosers will run before you think about them. Well I called this guy I liked, and I said hi, and he's like who's this, and I said my name, and he hung up. He knows who I am too, because everyone in the school knows me... probably as the bald-girl. But I don't see how your supposed to get to know a guy, so well, that having no hair doesn't matter. I mean I can't imagine a 17 year old guy, that would date a bald girl. Well... I take that back, somone who's got alopecia too wouldn't care. I have this feeling that everyone's scared of being the guy-who's-going-out-with-the-bald-girl. I just... just want to know it's possible... and how to do it...”
One difficult moment for one of our members was in the "Phantom of the Opera". The Phantom of course is supposed to represent ugliness of the worst sort--and as part of his costume his head is bald with tufts of hair. Alopecia areata may make your head look a bit like that. Remember that at one time the Phantom also had to uncover his head to his beloved with less than satisfactory results. Well, even if you prefer wearing a wig, there will be situations in life when you may have to uncover yourself willingly or unwillingly. In one extreme you may be in labor near delivery, in another extreme your hair may be caressed by a loved one. You are limited in some activities, and some activities are simply just no fun while wearing a wig, if you get my drift. Then... there's always the problem of "how do I tell this person that this is not my own hair?" Be honest and keep them informed about your condition- after all you may appear to them all the more interesting.
Many people develop a fear of rejection that may be unfounded. Going to a class reunion may wake up unpleasant memories of your formative years. In the majority of cases the people that you fear died a long time ago. Just as you are not the adolescent who lived back then, the adolescents that they were are long gone, replaced by adults who have been seasoned by life experiences. If anybody asks you about your wig or baldness, just be straight, short, to the point and neutral about hair loss. "While my hair never grew back, *I* have grown" and go tell them about your life now. You will be surprised by the maturity of the people.
Rejection may provide an opportunity for some introspective analysis. How long were you dating this person? How quickly did you moved romantically in this relationship vs growing the friendship first as the foundation? How would you feel about talking with this person now to get feedback from his/her angle as to what happened? I think it could be helpful in terms of seeing who that person is, whether you were acturately assessing what was happening and if both of you were in sync at one point what shifted. You need more information. It may be that your ex-partner has a pattern of fast closeness then disengagement (in which case we learn from this to do our homework upfront by gathering history with the right questions), it may be that he/she was not perceiving the relationship as building toward what you may have wanted from him/her, it may be that he was a lightweight about hair (in which case he could be saving himself some money by dating a wig and eliminating the middle person, it could be your own discomfort (if existant) he/she may have been picking up on, it could be a 101 other things. Sounds like this is a good opportunity to be assertively forthright with this person, look him/her straight in the eyes and straight on tell him/her you're confused about what happened and would like to clarify some things. A nice honest caring human moment between two human beings who may wind up good friends, which afterall is the foundation for the best of relationships.
Rejection may occasionaly come from close quarters. You may have accepted your fate, but your spouse may have problems with your condition. If the people who say they love you can't back you up, then who can you turn to? Why is anyone with alopecia made to feel it is somehow their fault? You certainly didn't ask to lose your hair. If it was up to you, your hair would be your own, long, and flowing, just like the commercials say it should be!
Your spouse may be scared. This is something they have no control over, and they don't know how to deal with it. It's up to you to make them understand your feelings about it. Otherwise, your lives are going to be miserable...and you, your children, and your husband don't deserve that.
It may sound cruel but some spouses may be what I call "external" persons. They are more concerned about how people look than what makes them tick. This problem (alopecia) becomes internalized as their own problem. They are embarrased not for you but for themselves. Remember and be thankful for those people that accept you for whom you are (hair or no hair) because they tend to be morally stronger. "External" people carry a lifestyle that breeds on insecurities. Talk to your spouse. Remind them that you wish you could have your hair back, you wish that you could win the lottery- but check out the odds on that. Provide them with a reality check. Ask them whether their expections are in keeping with reality.
In some occasions rejection may not necessarily be due to the alopecia. Some of our participants have broken up their relationships including marriages since before they had hair loss. If they had alopecia at the time, then they would have probably blamed it on the alopecia. Probably their mates would not had stayed on the relationship if they had alopecia, but then it would just have been an excuse.
When you are in love, you may not see the signs that were possibly there even before you left. What came as a surprise to you may have been building for awhile. Your alopecia may have played a small, if any, part in your friend's change of heart. That being said, if you are obsessed with your condition, you will not be the most pleasant companion to be with. As hard as it is on our psyches to get past an obvious problem, the less you pay attention to your AA, the less other people will as well. The only people who really would care about the fact that you are bald/balding due to AA are the ones who would NOT make good life mates to begin with. Surely you wouldn't want a mate who was so superficial as to change when things weren't going perfectly? What if you were in a disfiguring accident, or suffered a stroke, or got cancer that caused a limb to be amputated? If BALDING turned off that person, why in the world would they stick around for a really BIG problem? I don't know about you, but I'm better off without fair-weather friends, especially ones that I'm really emotionally attached to.
If being physically "perfect" is part of the criteria for maintaining a relationship, there are a lot of beautiful people out there who get dumped for no apparent reason. Everyone gets dumped on, some of us multiple times! I sometimes wish I could tell teenagers not to sweat the broken hearts because they'll probably have a lot of them before they find their "true love", but I'm not sure the knowledge would help. None the less, "losing at love" is something that happens to most of us. I doubt there is a person over 30 on this list server that can't tell you at least one sob story about being dumped or deserted. My list of sob stories is embarrassingly long. Most of them I consider funny now, in retrospect, the others I look back on and think, "Thank you, God, for getting me out of THAT relationship intact!" I have few regrets when I look back at the people whom I thought loved me and ultimately left.
For our younger adults remember that you have a lot of life to experience yet. Your odds of meeting someone who will fall madly in love with you are very good. You must stay open to possibilities, however, and don't worry about finding your life companion. Make sure that you are as open in your evaluation of women/men as you expect them to be about you. I don't mean you should settle for someone you don't love, but remember that the "less than physically perfect" person may actually be a better life companion than the one who all the men/women are after. Just as power corrupts, often beauty does as well. I think it is very hard for really beautiful people to maintain good perspective on what is important in life. It's not impossible, there are people who are every bit as beautiful on the inside as on the outside, but it seems they work harder to keep values in proper order.
If after awhile you don't find yourself feeling better emotionally, you may want to look at getting some help for depression. You know it is a clinical problem, and is not a sort of character weakness. With help, you can get back into life and dealing with a knotty problem like AA with an optimistic attitude and a readiness to attack the future instead of dwelling on the past. Just know you can write your friends here at any time. We understand your pain and depression. We've all been there to one degree or another. Don't ever think you are the only one who has ever felt this way, because it is just not true. Whether we've lost a loved one because of AA or because they found another lover, the pain is the same. The first thing you do is blame yourself instead of blaming the person who really caused the pain. We cannot make ourselves responsible for what someone else does. We can feel sorrow over their leaving, but don't feel that they would have stayed "if only I had hair/ were different/ had money/ were more attractive/ could stand on my head longer/ had a fancier car/etc., etc., etc." The person would probably have left, regardless. In other words, YOU'RE OK, the person who left changed or was not the person you thought they were.
On the practical side of dating is, when to tell them about your condition? Some of our members go out first. If it looks like something may develop, then in a nonchalant way, show them the spots and tell them what you know about the condition and let them decide what the next step will be. Keeping secrets is an increadible burden and one you don't need to carry. If the person is so turned off by the AA to bailout on you, just figure that they must have a lot more problems than you have and just can't take on anymore. A polite way of saying that they are too shallow and not worth any more effort. The usual reaction after giving them the news is to pull away at first, and then ask for more questions if he/she is still interested. Remember that anytime people are exposed to something new for the first time they are apprehensive. You might react the same way if the circumstances were reversed! Give him/her some time if YOU are interested.
The following is an inspirational story from our of our members:
“Last June, I was separated and divorced. Despite this, I went to the NAAF conference in July (alone), attended several group workshops discussing my condition, and mustered the courage to go wigless.
“This brought about new changes in my newly-single life. I used to conceal my hairloss until I decided it was worth the risk of telling the woman I was dating. Now, though, everything's out in the open, so to speak. My first date after being totally bare made me very nervous. But I quickly learned that the hair issue was only as big as I let it be. Sure, there were some airbrains that might think less of me because of my shiny head; but do I need that kind of person in my life? Eventually, their hair will wither, and fall out, too. I simply am more advanced than them!
“I met my new wife on a blind date. We had talked several times on the phone and were arranging a dinner meeting, when she asked what I looked like, so she could recognize me. My heart raced in panic. I decided to be honest and tell her before I was emotionally invested in the relationship.
“I explained that she would have absolutely no trouble identifying me. This got her curiosity up, so I had to explain further, saying, "I am bald... completely bald... Hairless."
“Matter-of-factly, she said, "Oh, well I've dated lots of bald men... actually, I prefer them."
“My heart never stopped racing from that point on. Our philosophies, and ideas on many things match so well that I married the lady shortly thereafter."
“So, you don't have to be attractive to everybody...just to one!"
BRAVO. The point is that people with AA/AT/AU have to "settle" for more, not less in a mate. The person who we end up with that accepts our condition and all the other aspects of who we are, is the type of person I WOULD want to be committed to. Even if I didn't have AA, I would not want to end up with someone that would find a relationship null and void over hair, or another problem, as time went by. So to keep things in perspective, yes, those of us with AA/AT/AU may not be right for some people out there, but in my mind we end up with a better person, not less of a person, who accepts us, regardless of what current "imperfection" we have. Afterall what is love? A friend of ours was married for 20 years when he lost all of his hair. Now his wife tells him she had never noticed how cute his ears were.
“Do many of you feel these little bumps on the scalp where a spot appears? They feel like little pimples on the scalp...”
The "pimples" may represent an overgrowth of sebaceous glands. The overgrowth of sebaceous glands occur surrounding hair follicles in the face or in the bald scalp. Only middle age and older adults have them. The fact that they appear in exposed area late in l