.png)
Pregnancy-Induced Alopecia Areata: Emily's Unexpected Hair Loss Journey
This is not intended to provide medical advice. The interview has been edited for clarity and length. Please consult your doctor for any health-related concerns.
When Emily imagined her pregnancy, she never envisioned standing in front of a mirror, clippers in hand, shaving off what remained of her once-thick brown hair. Yet at 32 weeks pregnant, that's exactly where she found herself.
"I wouldn't wish it on my worst enemy," Emily says, recalling the moment. "I don't have any enemies, but I really wouldn't wish it on anyone."
"I cannot believe this happened. I cannot believe I am bald. I cannot believe my hair fell out."
A High-Stakes Start to Pregnancy
Emily's path to motherhood was already complicated. At 32, she was considered high-risk due to a history of ulcerative colitis and previous abdominal surgeries.
"I was really worried about [pregnancy] because I had ulcerative colitis when I was starting off in college," she explains. A past surgery raised concerns about potential fertility issues. "The biggest risk for that surgery as a woman is that there can be scar tissue that forms around your fallopian tubes. It can make it hard for you to get pregnant naturally."
Despite her concerns, Emily conceived naturally. "I was anxious about that, was grateful and excited and like nervous when I found out I was pregnant," she shares.
The Plot Twist at Week 30
For 29 weeks, Emily sailed through her pregnancy. "I had like a very easy first and second trimester," she recalls. But week 30 brought a shocking turn of events.
"At 29 weeks, I was saying to myself, this is so easy. I could do this 10 more times," Emily remembers. "Week 30 hit and like that's when everything changed."
It started with full-body hives, then progressed to an unsettling sensation on her scalp. "I would notice like that at night when I was getting ready for bed, I would feel this like kind of like itchy burning prickling on my scalp," she describes.
Within days, clumps of Emily's hair began falling out. The speed was staggering. "By like six days from when I first started noticing the hair shedding, it was like most of this was gone," Emily shares. "There were like wisps in the back. Every time I touched it, more would come out."
In just six days, most of the hair on Emily's head was gone.
Diagnosis and Early Delivery
Doctors diagnosed Emily with alopecia areata, an autoimmune condition causing hair loss. Alopecia areata is a condition where the immune system attacks hair follicles, leading to hair loss. Hair follicles are the structures in the skin responsible for producing hair.
The same week that Emily's hair fell out, an ultrasound revealed her baby's growth had slowed significantly and her health may be impacting her baby.
"We went in to get him scanned and he had, his growth had pretty much plateaued," Emily explains. "So I went on steroids and that really helped the, the goal of the steroids was like, had some different parts to it. One was to help him grow and kind of calm down whatever inflammatory response was going on in my body that was impacting him."
At this point, Emily still had her eyebrows and lashes. Her doctor believed that delivery might mitigate any additional hair loss.
"It was scary to think about whatever was happening to my body, like, was affecting the baby and that, just how like, how totally random this felt," says Emily. Faced with these unpredictable challenges, the decision was made to deliver at 37 weeks.
"I think there was such fear, like when it first started falling out, like what will happen if I'm bald?"
"At that point it was full term, but it would get my body out of whatever pregnancy stress response was going on," says Emily. "And then it would make it so that I could go on whatever medication I wanted to for the alopecia to grow hair back because it wouldn't be safe to be on it with the baby."
New Mom, New Identity: Emily's Postpartum Journey
The birth of her son, Rhodes, brought joy tinged with some sadness. Emily found herself grappling with postpartum depression and anxiety, compounded by her hair loss.
"I was just so, so sad and, and so anxious," Emily shares. She increased her antidepressant dosage and leaned heavily on therapy. "I think there was such fear, like when it first started falling out, like what will happen if I'm bald?"
Emily credits her friends and family for helping her to find her footing. She has opted not to go on any medications to regrow her hair and will likely remain hairless. She has since lost her eyelashes, eyebrows and all body hair due to alopecia areata.
"My understanding is that if it progresses to full body hair loss, it's less likely to come back," explains Emily. "And I think it is less likely to come back if you don't go on the medication. And I know also that the medication is more effective if you go on it sooner. So that's why we delivered the baby a little early in case that time frame made a difference. I think the more time passes, like the less likely it would be, but I don't know. I don't really hold out hope for it. Not in a pessimistic way, but really want to work on making peace with what is right now."
Redefining Feminine Identity
Despite the trauma, Emily has discovered unexpected positives in her journey. "I really like having a blank canvas to work with," she says of her new look. She's explored wigs, false eyelashes, and creative makeup techniques.
"My hair has always been such a big piece of my feminine identity and as I lost that. I gained this other element of my feminine identity. That's being a mom."
More profoundly, she's found a new appreciation for unconditional love. "I get the opportunity to be really loved and really held by the people who love me when I'm in that, in any form," Emily reflects. "My hair has always been such a big piece of my feminine identity and as I lost that. I gained this other element of my feminine identity. That's being a mom."
Today, Emily is embracing her role as Rhodes' mom and a grief and trauma therapist. "He is just like the light of our lives," she beams.
"Lucky in so many ways"
Emily emphasizes the importance of self-advocacy, especially for women. She says, "I have benefited from being surrounded by people who encourage me to advocate for myself in a healthcare setting. I have a lot of socioeconomic and racial privilege. I am not someone who has ever felt unheard or dismissed by my medical providers." She encourages others to ask questions and be proactive about their health concerns, underscoring the significance of personal health histories in pregnancy and beyond.
Reflecting on her journey with alopecia and postpartum, Emily acknowledges the challenges she faces but also highlights the power of support networks and self-acceptance. Emily remarks, "It's so unfair that I lost my hair, but I am so lucky in so many ways. And this whole experience has help to solidify that feeling so much more."
