According to health authorities, an estimated 2,000 women, men and children here in our area cope with some degree of alopecia-related hair loss, from thin patches to complete baldness. About 1.7 percent of the population is affected, according to the National Alopecia Areata Foundation – about 5 million Americans.

Unlike more common male-pattern baldness, alopecia affects more females than males and can strike at any age, from early childhood through adulthood. Also unlike common baldness, it may reverse course, with hair occasionally growing back ... and sometimes falling out again.

The cause is unknown, and it usually cannot be cured. However, research has brought huge strides in wigs that look and feel much more natural than the hot, sometimes itchy versions of 20 years ago. One of the most exciting breakthroughs is CyberHair, a high-tech fiber developed for our new Amy’s Presence wigs. It’s ultralight and has a natural appearance indistinguishable from human hair. Best of all, the wigs can be worn during active sports and around the clock.

Alopecia areata and several closely related conditions can be devastating, especially for women and at younger ages. Angie Hansen of Fargo, now 23, has struggled with the disease since she was 16, and knows both the emotional pain it causes and the strength that it can inspire.

"I had just turned 16 when I noticed two little bald patches on top of my head," she remembers. "I loved pulling my hair back in a pony tail, so I thought that was causing it. But I’d find strands and then tangles of hair on my pillow, and by December all my hair was gone."

She tried replacing her long, thick hair with a wig but wasn’t satisfied with it, ultimately choosing to mostly wear a baseball cap for the next couple years. At 18, though, her hair came back, as mysteriously as it had left the first time.

And then, at 20, it all fell out again.

Angie turned to doctors here and at the University of Minnesota to try to find out what was happening. She tried several treatments that occasionally help, including topical creams, prednisone and cortisone injections into her scalp, but without success.

Medical researchers believe that alopecia is an autoimmune disease like lupus, multiple sclerosis, thyroid disease and some 80 other conditions. For reasons that are not yet understood, the body’s immune system attacks itself, forming antibodies that in this case damage the hair follicles. It often first appears sudden smooth round patches of hair loss, usually on the scalp, that can enlarge over time.

"It was horrifying how fast my hair thinned and then fell out," Angie says. "Everyone else had hair. I quit basketball because I couldn’t pull it back." She did continue playing softball and volleyball, where she could wear her cap. "It’s hard doing out with just a hat, though," she adds. "Everyone assumes you have cancer."

She tried several styles of the wigs available at that time. "The first one was long and heavy, and I hated it," she says. "Then we tried a suction wig that’s held on by creating a vacuum. It was created from an actual mold of my head. That’s what I wore to play sports, swim and sleep. It wasn’t comfortable, though. It didn’t breathe at all."

Every time Angie visited me, my heart would break for her. She handled it so well. After trying several more hairpieces, she has found one that she’s somewhat more satisfied with. Through it all, she has been so strong.

"You feel like everyone knows you’re wearing a wig," she says. "I realized, though, that the problem was (and is) more with me than them.

"Losing your hair really affects you. I know it’s just hair. I’m totally healthy otherwise. If God wants me to have hair, I’ll have hair. But it’s still hard sometimes."

Alopecia creates a self-esteem issue, shaking some victims’ self-confidence to the core. Since there is no cure at this time, the only alternative is to go forward, doing whatever it takes to get your confidence back.

Hair prostheses (replacements, including wigs) can help. Hairpieces have come a long way in recent years, with much greater quality and many more choices available. It’s important to look around and see what your options may be.

"Talking helps," Angie says. "Your first instinct is to hide. I used to be really shy. Now I’m a much stronger person.

"My friends are curious. ‘What does it feel like? How do you wash it?’ They know they can ask me and I’ll answer the best I can."

Today Angie is a beautiful and confident young woman. She was married in September and works as an LPN at an area clinic.

I think of her when I get first-time calls from women who are just beginning the journey of coping, sometimes bursting into tears on the telephone. Whether its cause is alopecia or chemotherapy, hair loss can be truly devastating. Hairpieces can help. Supportive friends can help.

Information can be essential for moving forward with your life. The National Alopecia Areata Foundation is a good place to start. It funds medical research into the causes and potential cures for the disease. Among its projects is a national registry of individuals and families with alopecia. To find out more about the disease and participate in its research, visit www.naaf.org.

— Violet Deilke