This topic is a little different than this newsletter’s regular content—I created a video about my experience with alopecia (hair loss) and I wanted to share the notes that I wrote down just before recording—but I also have some info about the companies selling medications that have been approoved by the FDA for treating alopecia appended to the end.
working on recording video footage November 29, 2023 for the alopecia areata video
Cleveland Clinic page on the subject of alopecia:
“Alopecia areata is an autoimmune disease that causes patchy hair loss anywhere on your body but it most commonly affects the hair on the skin that covers your head (scalp).”
another hair loss diagnosis is telogen effluvium
my experience
after a haircut in mid-September 2022, my wife had noticed a small patch or two missing on the back of the head where the hair was shaved kind of short; we didn’t know if it was just some minor thing or a haircut error
I noticed rather suddenly one day in the later half of October when brushing hair in the morning that I was missing two patches of hair on the top of my scalp
I started noticing large amounts of hair falling out overnight onto my pillow
I thought that way more hair than normal seemed to be coming out when running my hands or a brush through my hair
as November went along I started losing large clumps of the hair
I made medical appointments and saw a physician at my HMO in early December
—I went to the appointment at a point when I had some ribbons of long hair left but many large gaps
I was examined and diagnosed with alopecia by the doctor
they prescribed topical steroids (from what I read, a fairly mild strain of steroid, known as corticosteroids): did use
they also prescribed Rogaine: didn’t use
Over time the hair fell out to the point where most of it was gone by a few weeks into the New Year of 2023; beard hair started falling out in patches as well
After that I started to notice loss of eyebrows and eyelashes
As 2023 went on I started growing wispy white hairs on my scalp and other places where hair had been lost
By the end of summer I had much of my head covered in this white hair—and I have a genetic propensity (based on observing my older relatives) on my Mom’s side to have hair go shock-white rather than gray, so I didn’t know if that was what my hair was like now
As summer ended in 2023 and fall began I started growing darker hairs in some spots that had earlier sported the wispy white hairs
By now in the late fall I have patches again, but instead of patches of long hair and patches of bald I have patches of wispy white hairs interspersed with areas of darker hair that has regrown
As is usually the case on this kind of topic, I can’t predict the course of future events. For now I am cropping the hair short and letting the two types of hair exist side by side
I could see why some people shave their heads when undergoing this kind of thing; it’s also important to point out how much people react to this kind of (involuntary) appearance change
people tend to treat the onset of alopecia as a grave health crisis; first of all, it just looks worrying and it’s a normal reaction to be concerned for someone you know undergoing sudden appearance changes; but also, hair loss has become inextricably intertwined with chemotherapy and while the appearance of a chemo patient and an alopecia patient may have some potential overlap, it is important to remember that the hair loss is caused by the treatment (a side effect of chemotherapy) and almost always not by the cancer
these type of issues have to be so much more acute with women—at least here in America, we are very hung up on the (always shifting) expectations about women and their personal appearance; I can buzz or shave my head and still look fashionable with the right overall look; while we have seen some progress over the years this is still a harder issue to navigate for women (and it’s probably very hard for men in cultures where they are expected to have a beard or mustache where women might cover their heads)
I don’t think I have anything much new to say about this subject but it’s one of those health issues that a significant amount of people deal with and I want to offer my position
YOU ARE MORE THAN YOUR APPEARANCE
You can handle hair loss in yourself and in people you care about; just remember that everyone experiences this stuff differently so different approaches are most likely going to work for helping yourself or others
There are numerous reasons hair can fall out, so it’s usually best to consult your medical provider if you are experiencing that—but if you do have alopecia areata, keep in mind that the hair is just falling out, there usually isn’t actually damage to the hair follicles so re-growth, while not promised at all, is plausible
In just the last few years a few drugs have been approved to treat alopecia areata. As with any medication, side effects and unintended consequences should be considered before using. Given FDA clearance only in 2022, baricitinib is marketed as by Lilly (LLY) and Incyte (INCY) as Olumiant. The recent most drug to enter the market is ritlecitinib owned by Pfizer (PFE) and branded as Litfulo.
Disclosure: Through personal holdings that I control and through investment LLCs in which I am a partner, I buy, hold, and sell stocks, bonds, ETFs, options, NFTs, and cryptocurrencies, not limited to but including some of those discussed in this newsletter.