Ayanna Pressley announced she had alopecia, and bald women everywhere exhaled | Elizabeth Wellington

When a dermatologist informed Nakea Fuller that her once-thick, shoulder-length hair — which, because of a form of alopecia, was thinning and falling out in patches — was never going to grow back, she went home and shaved it off that very night.

All of it.

“I divorced my hair,” Fuller, 45, of Philadelphia, said about the decision she made 10 years ago. “My hair didn’t want a relationship with me, so I let it go. And I’ve felt free ever since.”

Last week Fuller and many other women who suffer from the autoimmune disorder that causes hair loss watched U.S. Rep. Ayanna Pressley’s emotional video on the Root about the condition that’s left her bald. Some cried, some nodded in understanding. And all of them felt relieved. Here was someone giving a public voice to an often-private suffering.

Pressley, a 45-year-old Democrat from Massachusetts, is known in fashion and political circles for her elegant Senegalese twists, extensions that matched the texture of her own hair.

Those long twists, Pressley says in the seven-minute video, weren’t just a part of her personal identity. They helped define her political brand. Not to mention, she always heard from girls she inspired to be proud of the hair God gave them. That says a lot in a world that puts a premium on little black girls having long, straight hair. But now, with alopecia, there wasn’t any hair in which to even attach the two-strand-twist extensions anymore.

So, last Thursday, wearing a stunning black-and-gold blouse, Pressley informed us of her new reality as a bald woman.

“I’m ready now,” Pressley said, her lips a bold shade of red, her brows perfectly penciled in. “I want to be freed from the secret and the shame that it carries with it. I’m not here to occupy space. I’m here to create it.”

Talk about being embracing strength and vulnerability at the same time.

Cue exhale here.

Hair loss, although common, can be devastating to women because so often we connect our beauty and femininity to our manes. Baldies are for boys. When our hair falls out, we blame ourselves. Society make jokes when wigs fall off or too much tension from braids cause edges to get scraggly and our manes to get thin. Losing our hair — whether because of cancer or lupus, a finicky thyroid, or yes, alopecia — can cripple our self-esteem. So we end up spending more time trying to hide our thinning mane or see-through strands or missing patches under wigs or weaves or floral-printed scarves than we do living.

“Our hair means so much to women,” said Tanisha C. Ford, a professor of history at CUNY Graduate Center and author of Dressed in Dreams: A Black Girl’s Love Letter to the Power of Fashion. “But there is another conversation that needs to be had. No matter how much we protect things from happening to our health, sometimes we can’t save our hair. So I applaud her. I admire her for bringing this into the forefront and giving women the courage to live in their truth.”

The irony, though, is that there can be relief in the baldness.

Jennifer Marquette, 37, was diagnosed with breast cancer in June and is currently undergoing chemotherapy. Before chemotherapy, she had a stylist give her a buzz cut, although that didn’t stop her hair from falling out in clumps.

“Once I buzzed it off, I breathed a sigh of relief,” Marquette, of Philadelphia, said. “I’ve been bald for almost a year and I’ve really leaned into it. People tell me I have a pretty-shaped head. People tell me I’m pretty. Things that were stressful just aren’t anymore.”

According to the National Alopecia Areata Foundation, approximately 6.8 million people in the United States — 147 million worldwide — will develop alopecia at some point in their lives.

And according to a 2019 study in the Journal of the American Academy of Dermatology, black people have a greater chance of developing alopecia. But the reasons for the disparity, said George Cotsarelis, a dermatologist and chair of dermatology at the University of Pennsylvania, are not fully understood.

There are three kinds of alopecia areata, Cotsarelis explained, which is the kind where hair can eventually grow back. The least severe is basic alopecia areata, where only a few patches are lost. Alopecia areata totalis is more advanced and causes complete hair loss. That is the kind, Cotsarelis said, that Pressley most likely has. Finally, there is alopecia areata universalis, and that is when body hair also falls out.

Over the years, many celebrities, from Viola Davis to Neve Campbell, have had bouts of alopecia areata. In 2018, Jada Pinkett Smith dedicated most of an episode of her Facebook Live show to discussing alopecia.

Black women, Cotsarelis said, are likely to suffer from traction alopecia. These are bald spots that result from too much tension from braids or twists, glue from weaves, or using harsh chemical relaxers. But if a woman stops those practices, the hair can and often does grow back.

The alopecia that causes scarring in the follicles and permanent hair loss is called central centrifugal cicatricial alopecia or CCCA. This form of alopecia, says dermatologist Susan Taylor, occurs almost exclusively in black women and is genetic. “What is particularly troubling is that alopecia represents another inequity in medicine in that there is essentially no funding to study hair loss in black women,” said Taylor, who said she has been trying for years.

Fuller, who has CCCA alopecia, noticed that she was losing her hair while she was in college. By the time she was in her late 20s, she was wearing wigs. “I tried everything: Nioxin, Rogaine, and I just kept losing it,” Fuller said. “I had hair down my shoulders, but in the middle it looked like George Jefferson."

One weekend, she said, she had had enough, so she cut it off. “Once I assured people I was OK, everyone was fine with it.

“But really it shouldn’t matter that I’m sick or not. If you want to tell a woman that she’s beautiful without hair, tell her. It’s OK to tell a bald woman she’s beautiful. Because she is.”