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A Dermatologist On Ayanna Pressley's Alopecia


We're going to talk hair for a minute. And you might be thinking, you know, what about it? But for some people - for many people, actually - hairstyling and hair loss is about a lot more than vanity. It connects to issues of culture, identity and self-worth. Congresswoman Ayanna Pressley of Massachusetts made this point in dramatic fashion earlier this week when she disclosed in a video op-ed on The Root - that's a digital outlet focused on issues of particular concern to African Americans - that she is dealing with alopecia, or hair loss.

The 45-year-old freshman lawmaker has made an impression in Congress as a member of the squad and for her hairstyle, the Senegalese twist. In the video, she talks about how those twists became a part of her identity and a political statement.


AYANNA PRESSLEY: My twists have become such as synonymous and completed part of not only my personal identity and how I show up in the world but my political brand. That's why I think it's important that I'm transparent about this new normal and living with alopecia.

MARTIN: And with that, the congresswoman revealed herself as almost completely bald. This video has gone viral, so we wanted to talk about this and why it matters. We've called Dr. Crystal Aguh. She's an assistant professor of dermatology at Johns Hopkins School of Medicine. She's an authority on alopecia, and she's the director of the ethnic skin program there. And she's with us now from her office.

Dr. Aguh, thank you so much for joining us.

CRYSTAL AGUH: Absolutely. Thank you for having me.

MARTIN: Did you know this was coming? Did you have any hint that the congresswoman was about to go public in this way?

AGUH: I had no idea. I was just as surprised as everyone who watched the video when she released it.

MARTIN: And I assume that you're getting a reaction to it. Are people calling you and wanting to talk to you about it? And what are they saying?

AGUH: Absolutely. I've gotten so many messages from friends, family members. And really, everyone wants to know, hey, is this a thing? Does this happen to women? Can this happen to me? And so that - those are the types of questions that I'm fielding from people at the moment.

MARTIN: Well, tell us a little bit more about alopecia. I mean, is this common? And is this - this is not a choice, I take it. This isn't something where a person just sort of decides to shave their hair and be bald.

AGUH: As a dermatologist who specializes in hair loss disorders, this is absolutely something that I see on a regular basis. The term alopecia itself just refers generically to hair loss, so any form of hair loss is considered an alopecia. But there are many dozen different forms of hair loss.

MARTIN: The congresswoman in her video talks about how she lost the last bit of her hair on the eve of the impeachment vote of the president, which was, you know, a very serious and stressful moment. I think many people who are following her career will know that she, along with a number of the other freshman class that - the squad, in particular - that includes Representative Ilhan Omar, Representative Alexandria Ocasio-Cortez - you know, they're under all a big spotlight. Is stress a part of this? Is stress a factor in losing your hair?

AGUH: It's possible that stress was related to her hair loss. I will tell you, stress can absolutely cause you to lose your hair. But I always tell women, you really want to think more about acute stress and not chronic stress. So a lot of us have daily stressors associated with running a busy household or being a professional or just having a really busy lifestyle. But those are not the types of things that lead to rapid hair loss.

Acute stressors are things like a death in the family, a divorce, pregnancy. Those are the types of things that can lead to sudden acute hair loss. And certainly, having to be present as part of an impeachment trial could represent an acute stressor.

MARTIN: But let's talk about the - sort of the broader significance of this - I mean, the fact that the congresswoman felt the need to make this statement, the fact that so many people are interested in this statement. I see that that the video itself has been picked up on local news outlets, for example, across the country. Why do you think it's striking such a chord?

AGUH: Well, you know, I think - even as someone who treats hair loss all the time, I was taken aback by the video. I was so proud of Congresswoman Pressley for her courage and her bravery. And the thing about it is when it comes to hair loss in women, unlike men, we're taught to hide it. There are a lot of patients who, when they come and see me for the first time to visit, is full of tears. And there's so much shame associated with hair loss.

And so I think that's what spoke to a lot of women who watched Congresswoman Pressley's video. Whether or not they were suffering from hair loss, I think for a lot of them, it just spoke to the emotional impact that hair loss can have and the surprise that she was able to, you know, be so bold and open about her experience.

MARTIN: Let's talk about the symbolism of her hair. She talked in the video about how, when she first got her twists, that she first embraced that hairstyle, she says she saw herself for the first time. And she also talked about how it's inherently political. I just want to play another short clip from her video. Here it is.


PRESSLEY: Now I walk into rooms, and little girls are wearing T-shirts that say, my congresswoman wears braids. And we've received letters from all over the globe, women who talk about their own emancipation, that they feel that I've given them permission.

MARTIN: Would you unpack that a bit more for people who perhaps are not familiar with these issues? What is the political importance of a black woman's hair?

AGUH: Yeah. I think she's speaking to an experience that is largely unique to black women, and that's this idea that a black woman's hairstyle says a lot about her. And this is a type of cultural sensitivity that I spend a lot of my time as a dermatologist teaching other dermatologists about. So, for instance, if I see a woman with dreadlocks, and, you know, maybe her dreadlocks are causing a little bit of thinning of her hair, I don't push her to cut her dreadlocks because I know that dreadlocks represent something more than just a hairstyle for her.

MARTIN: That is Dr. Crystal Aguh. She's a dermatologist, and she's the director of the ethnic skin program at Johns Hopkins University. She's also the author of a number of books.

Dr. Aguh, thanks so much for talking to us.

AGUH: No problem. Thank you. Transcript provided by NPR, Copyright NPR.