Sadly, the most famous moment at this year’s Oscars was when Will Smith walked onto the stage and assaulted Chris Rock for joking about Jada Pinkett Smith’s hair. As Smith himself has acknowledged in a public apology to Rock, “Violence in all forms is poisonous and destructive.” The incident was confusing to many observers, but it was not about a haircut. Jada Pinkett Smith suffers from the autoimmune condition alopecia areata. While mocking people’s appearance and bodies is always in poor taste and Rock may well not have known about Smith’s condition, there is something strange and dark about the way women’s hair loss is treated in society.
While other celebrities are reported to have suffered from hair loss, what sets Jada Pinkett Smith apart is her courage to speak openly about her battle with the condition. In the past she has described it as “terrifying.” Her haircut (which, objectively, looks amazing) is not a straightforward choice—it’s a styling decision elicited by an illness.
Her condition, alopecia areata, is one of a cluster of autoimmune conditions that can afflict men and women of any age. Areata involves the loss of patches of hair on the head and is often linked to stress and hormonal changes in the body. The patches can grow so that the conditions develops into alopecia totalis (loss of hair on the scalp) or, more rarely, alopecia universalis (the whole body). Other forms of medical hair loss include the genetic condition androgenic alopecia or age-related hair loss, which can start when a patient is in their early twenties.
While there is no shortage of expensive supplements, shampoos, topical ointments like minoxidil, and internet marketed snake oil that claim to regrow hair, they are almost always ineffective. More successful options include steroid injections into the scalp (which, take it from me, is quite uncomfortable) and oral steroids. A new slate of JAK inhibitors (immune suppressing medications) are currently in various stages of study at Columbia, Yale, and Mount Sinai. Dr. Emma Guttmann, head of dermatology at Mount Sinai, is currently trialing the eczema drug Dupilimab with great success. None of these new treatments are for the faint hearted: JAK inhibitors carry an increased risk of cancer and sometimes produce temporary results. Dupilimab, while safer, is injected subcutaneously on a weekly basis. Then there’s the expense: these drugs are currently used off-label to treat alopecia and, thus, are not covered by insurance.