What Is Alopecia Areata? Jada Pinkett Smith's Condition That Caused Her Hair Loss

Alopecia areata is a skin disorder that causes hair loss, usually in patches, most often in the scalp, and in which the bald patches appear suddenly and affect only a limited area.

New Delhi: Actor Will Smith slapped comedian Chris Rock on the stage at the 94th Academy Awards on Sunday evening after Rock made a joke about Smith’s wife Jada Pinkett Smith.

Smith’s wife suffers from a hair loss condition called alopecia areata, because of which she dons a shaved hairdo. Apparently referring to her tightly cropped hair, Rock said at the event: "Jada, can't wait for GI Jane 2”. 

In the 1997 film GI Jane, actor Demi Moore played the protagonist with a buzzcut, and Rock was apparently comparing Jada Pinkett Smith’s hairstyle to that of the titular character of the movie. 

This did not go well with her husband, who walked up to the stage and hit Rock. Before returning to his seat, Smith shouted: "Keep my wife's name out of your [expletive] mouth."

Later, Smith won the Best Actor award for his performance in King Richard (2021), where he plays the father of tennis legends Venus and Serena Williams.

What Is Alopecia Areata?

Alopecia areata is a skin disorder that causes hair loss, usually in patches, most often in the scalp, and in which the bald patches appear suddenly and affect only a limited area. "Alopecia" is a Latin term which means baldness, and "areata" refers to the patchy nature of the hair loss associated with this condition.

The hair falls out in small, round patches, in most people with alopecia areata. This leaves out coin-sized areas of bare skin. The areas include the frontal or parietal scalp. Though the patchy hair loss occurs most often on the scalp, it can affect other parts of the body as well. 

The hair usually grows back within 12 months or less. However, for some people, the problem can last longer and be more severe, causing total baldness or total loss of body hair, referred to as alopecia totalis and alopecia universalis respectively. 

A few short hairs may be present in the bald spot that taper and lose pigment as they approach the scalp. These hairs are known as "exclamation hairs", according to an article published by University of Texas Medical Branch.

What Are The Causes Of Alopecia Areata?

An autoimmune reaction is the probable cause of alopecia areata, according to an article published by Harvard Medical School. An autoimmune reaction is one in which the body's immune system incorrectly attacks the body's own cells. In the case of alopecia areata, the cells in the hair follicles are under attack, especially the follicles within the scalp. This stops hair growth. However, alopecia areata does not permanently damage the follicles, because of which hair may grow later.

Lymphocytic infiltration (a rare skin condition that may be characterised by non-cancerous buildup of white blood cells, which present as lesions or lumps on the skin) around the hair follicles can cause hair loss in alopecia areata. IgG antibodies against the hair follicles are also found in people with alopecia areata, according to an article published by Glasgow Caledonian University, Scotland.

A combination of factors, including changes in many genes that function in the hair and skin and in the immune system, could be responsible for alopecia areata. These include several genes belonging to a gene family called the human leukocyte antigen (HLA) complex, which helps the immune system distinguish the body's own proteins from proteins made by foreign invaders. According to an article published by the United States National Library of Medicine article, certain variations in HLA genes likely cause an inappropriate immune response targeting hair follicles which leads to alopecia areata. Several genes involved in inflammation have also been associated with alopecia areata.

Environmental factors, such as emotional stress, physical injury, or illness could also provoke an abnormal immune response in certain people, leading to alopecia areata.

How Are People With Alopecia Areata Affected?

People of all age groups can be affected by this condition. However, it most commonly appears in adolescence or early adulthood. Though the hair usually grows back after several months, it may fall out again, and in some cases, unpredictable cycles of hair loss followed by regrowth can last for years. Some affected individuals have fingernail and toenail abnormalities, such as pits on the surface of the nails, according to the National Library of Medicine article. 

Though the hair loss associated with alopecia areata is not painful or disabling, it causes changes in a person's appearance that can profoundly affect quality of life and self-esteem. The condition can also lead to depression, anxiety, and other emotional or psychological issues in some people. 

Alopecia areata, tinea capitis, and traumatic alopecia, which includes trichotillomania, are the three most common causes of hair loss in children. In order to differentiate tinea capitis from alopecia areata, a potassium hydroxide preparation and a fungal culture can be used. Meanwhile, trichotillomania can be distinguished from alopecia areata by broken hairs and scalp petechiae, which are tiny purple, red or brown spots on the skin.

Treatment For Alopecia Areata

Treatment for this condition is optional, with local therapy involving intralesional or topical steroids, anthralin, minoxidil, and combinations. These have helped with short-term regrowth, but do not alter the long-term clini]cal course of the disease, according to the University of Texas Medical Branch article. 

What Is The Frequency Of Occurrence Of The Disorder?

Alopecia areata affects one in every 500 to 1,000 people in the United States, and is one of the many recognised forms of alopecia, the National Library of Medicine article said.

Alopecia areata is the second most common form of androgenetic alopecia, which is male-pattern baldness in men and female-pattern baldness in women, and affects men and women equally.