A new book tells young readers about alopecia areata, or hair loss, in children

It was the autumn of 2019, a few months short of the deadly attack by the dreaded C. No, not cancer, because that is the first word that comes to mind, but Covid, a freshly coined word – one that nobody had ever heard of before. In the coming months, people’s lives all over the world would turn upside down. Closer home, here in India, Ramona’s world, too, was about to turn topsy-turvy, but for a different reason.

Like trees in autumn, Ramona’s hair was shedding. Every morning, Ramona would wake up to a fresh fall. A large clump on her pillow, like a cluster of ominous black spiders with sprawled legs, ungainly clumps in the bathroom drain…hair…hair everywhere. And it was not just at night-time. It was all over the floors of her house even during the day. Anytime and every time she touched her hair, a bunch came out in her hand.

One morning, she parted her hair and stood in front of the mirror, staring in stunned horror. There was a shiny, round spot on her scalp. This couldn’t be happening! Not to her! She, who was known in her class for her beautiful, healthy mane! How could she face her friends now? Oh, the shame. The ignominy of it all! But there was no time to think or brood. The CLAT exams were knocking at her door. She wanted to pursue law as a career, and the Common Law Admission Test was the first step towards it. Besides, the board exams were also just around the corner.

“Maybe it’s the weather,” she thought distractedly. “I’ll just wear a cap to school till I figure out what to do. I’ll deal with it after the CLAT exams.” She had a vague idea that hair fall occurred during certain seasons; she just couldn’t remember when.

The cap idea was a complete flop. It was too warm, and she attracted sniggers and cocky questions to which she had no answers.

“The sky falling on your head, Chicken Little?”

“It’s about to snow, eh?”

Ramona wanted to curl up in a corner and die. The cap was discarded.

“I think I’ll talk to Mummy this weekend,” she mumbled to herself as she tried to cover up the bald patch by tying up her hair in an untidy top knot.

The weekend came and went. Ramona’s mother had to meet some clients at work, so she left early morning and came back late at night on both days. Both times, by the time she was back, Ramona was asleep in bed.

Ramona’s mother was dealing with struggles of her own. She had started a new job, and a lot of her time and energy were spent in trying to placate her unreasonable new boss.

The days passed. The weather changed, and winter arrived. The first hazy rays of the early morning sun were trying desperately to break through the winter smog. Yet the autumn in Ramona’s life remained steadfast. Another bald patch had shown up. Ramona was mortified. Alarm bells went off in her head. What followed was endless nights of crying forlornly into her pillow and going to school all bleary-eyed in the morning.

What was wrong with her? How serious was this issue with her hair? Would there be more bald patches? Or (heaven forbid!) was this a harbinger of worse things to come? Was she going to die? These questions kept churning round and round in her head, like a noisy mixer that wouldn’t stop because she just could not figure out how to press the ‘stop’ button.

Should she message her father? But he was sailing and was so far away. He would feel helpless, and it would only upset him. No, she had to get hold of her mother, somehow.

By now, Ramona had begun noticing the strange looks directed towards her by her classmates. “What is with this unruly hairstyle?” they seemed to be asking her. The questioning looks were beginning to alarm Ramona. Nobody questioned her directly, not even her best friend. And Ramona herself was too confused to broach the topic with her friends. Would they understand her fears? Or would they laugh at her? After all, there had been so many times when they had all ganged up to tease and snigger at some of their classmates for trivial and silly matters. She, too, had been a part of the gang. So, what would stop them from doing the same to her now?

On three or four occasions, the class teacher punished Ramona for disobedience. She felt Ramona had not listened to her when she asked her to comb her hair properly. Missing school was out of the question, but each morning, Ramona woke up with a sick feeling in the pit of her stomach. Her concentration went haywire as her mind was constantly wandering back to her patchy pate.

“Mummy, we need to talk urgently,” Ramona texted her mother one morning on her way to school. But as usual, her mother had left early for work even though it was a Saturday. That evening, though, she returned home earlier than usual; she had never received such a message from her daughter in all these years.

“What happened, my darling?”

As soon as she heard the concern in her mother’s voice, Ramona broke down. Bitter tears coursed down her cheeks as she parted her hair to show her mother the two shining bald patches on her head.

“How long has this been going on?” Ramona’s mother asked with a worried frown, crinkling her forehead.

“Almost a month and a half,” blubbered Ramona.

“And you took this long to tell me? You do know that we live in the same house, don’t you?”

Ramona opened her mouth to respond to her mother’s sarcastic comment, but then shut it again. From past experience, she knew that once the mother-daughter team got embroiled in a war of words, there was no stopping them.

On her part, Ramona’s mother was mortified when she thought of the many occasions when she had seen the floor of the house littered with fallen hair and had brushed any concerns she may have had under the carpet – literally. There was too much on her plate, being a single working mother for the better part of the year.

“Chop, chop. Get up, and stop looking so gloomy,” said her mother briskly as she got up to look for her phone. “I’m on the job now. You’ll be right as rain in no time. Let me fix up an appointment with a dermatologist.”

And so it began – the endless rounds from one doctor to another. One thing was clear. The hair loss that Ramona was witnessing was not due to a change in season. It now had a name, albeit a tongue-twisting name. Still, a name nonetheless: alopecia areata.

“Trust my ailment to have such an unpronounceable name,” she muttered to herself. They finally settled on Dr Prasad, a balding, middle-aged man with kind, twinkling eyes behind round, rimless glasses.

“I wonder if he has the same problem as me,” Ramona found her mind wandering as she stared idly at his receding hairline. “If he hasn’t been able to cure himself, how on earth is he going to cure me?”

But the doctor’s voice jerked her back to the present, and she began listening to him earnestly.

“Alopecia is a condition of sudden hair loss that starts with one or more bald patches in the scalp. It is an autoimmune disease. Which means the cells in one’s immune system surround and attack the hair follicles. We will start with some ointments and multivitamins and see how she responds.” Dr Prasad smiled genially as he got up to pat Ramona on the back.

“See? That wasn’t so bad, was it?” Ramona’s mother cocked an eyebrow at her as they headed back home, armed with four different tubes of ointments in varying sizes.

Excerpted with permission from ‘My Mane Concern’ by Ratna Manucha in Hug Yourself: Body Positivity and Empowerment Stories for Teenagers, edited by Vinitha, Penguin India.