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When The Hair Surgeon Loses His Hair

With one month left in my facial plastic and reconstructive surgery fellowship, I visited Las Vegas for a cosmetic surgery conference. Standing in front of the mirror in my hotel room getting ready to gel my hair before an evening of events, I noticed something peculiar on the left side of my scalp. On closer inspection it appeared as though a silver dollar sized area of hair was missing in the temporal area above my ear. It was as if mysterious aliens had created a crop circle to send a cryptic message. At first I blamed it on the haircut I received just before coming to Vegas or perhaps I just parted my hair in the wrong place. Two days later my wife arrived in Vegas and she too noticed the bald spot. Seven years ago during medical school I started developing areas of hair loss on my legs and at that time was diagnosed with alopecia areata, an autoimmune skin condition in which hair falls out in round patches anywhere on the body. At that time I tested negative for some of the associated autoimmune diseases. Patchy hair loss on the legs was easy to hide but the scalp presented a different challenge. The irony was that as my sudden scalp hair loss was developing, I was embarking on a career that would in part involve restoring other people’s hair. Unfortunately, aside from steroid injections into the bald spot, which I have since received, not much has proven to work on this condition. And while my training is in hair transplant surgery, this approach is not effective for alopecia areata. September is alopecia awareness month. People with alopecia often experience social phobia, anxiety, and depression. Its unpredictable nature and limited treatment options make it a challenging condition to live with. I have had friends ask me if I am ill after seeing the bald areas on my scalp or legs. There are many misconceptions about the disease and many of our perceptions of beauty involve gorgeous hair. Alopecia has taught me to be less judgmental and it has instilled a heightened sense of purpose for hair restoration by helping me empathize with those experiencing hair loss, no matter the cause. Sometimes we choose the same destiny that chooses us. In today’s world, selfies are the norm and terms such as “Snapchat dysmorphia” have surfaced to describe an age when instant digital alterations set the perceived ideal for one’s beauty. Equipped with these mercurial aspirations, patients visit med spas for a quick shot of neurotoxin or filler, or a cosmetic surgeon for a more lasting surgical effect. Alopecia, however, has no quick fix. No matter what you rub on it or inject it with, there are no guarantees for improvement. The options are to recoil and avoid social interactions or to own the condition, not let it define you, and go after your dreams. I choose the latter. Here’s to hoping that the self is greater than the sum of its selfies.