Some people would feel naked if they didn't have hair.
But when senior Lindsay Kosmala wears a bandana, she feels like she is hiding something.
Before Kosmala came to MSU, she considered trying another round of treatment to regrow the hair on her head.
After growing up with no hair on her entire body since age 4, Kosmala worried she would be pretending to be someone else.
"What would I see in the mirror when I looked at myself with hair?" she asked. "It kind of makes me grin because - wow, that sounds like fun. But it sounds really scary."
Kosmala has alopecia areata, a disease that normally starts with a few patches of hair loss, and affects about 4.7 million people in the United States, according to the National Alopecia Areata Foundation, or NAAF.
A person's immune system attacks the hair sockets, forces the hair out and halts future growth. Sometimes people with alopecia are mistaken for having cancer, but besides losing their hair, alopecia has no negative health effects.
It usually begins in the childhood years, affecting both sexes and all ethnic groups. It occurs in three different forms ranging from patchy bald spots on the scalp to hair loss on the entire body.
There is no cure and the success of available treatments varies depending on the person. Treatments include injections, pills and ointments containing steroids. Hair can grow back on its own, but also could fall out again.
Kosmala, who is studying anthropology, education and English, admits the disease has played a part in shaping her life, but it isn't how she identifies herself.
"I know enough about people and about myself to know that part of it is how I treat the situation," she said.
Head dress
Inside Lansing's Another Look Hair Institute last month, Sandy Krumm removed a bright blonde wig from Amanda James' head, revealing her smooth, bald scalp.
"Isn't she pretty without it?" Krumm said.
After applying a cream to James' head, Krumm covered it with a new white-streaked wig that suctioned in place.
"What do you think, lady?" Krumm asked.
"It looks fabulous," replied James, as she fixed her hair in the mirror. James started losing her hair after high school, and it was gone within three months.
James, a pediatric nursing junior at Lansing Community College, owns five wigs. They are made of human hair and can be styled and swam in. Wigs of this type can cost up to $3,000 and $400 to refill the cap with more strands of hair.
Laurie Nash, owner of Another Look Hair Institute, 1020 E. Saginaw St. in Lansing, said the number of clients with alopecia has increased throughout the 35 years of the business' existence. Out of her 1,500 clients, 50 have alopecia.
The salon, which mostly deals with hair-replacement methods, recently hired a makeup artist who specializes in permanent tattooing, such as drawing on eyebrows.
"So many people take for granted what hair does physically and mentally," Nash said. "I haven't had alopecia, but I almost wish I could to understand."
Lisa Gallagher, spokeswoman for the National Alopecia Areata Foundation, said the organization funds about $60,000 in research grants each year to help advance treatment and research.
She said although awareness has increased throughout the years, many people with the disease don't seek treatment because they attribute the hair loss to other factors in their life such as stress and allergies.
"When the public isn't aware of it, it's easy to assume that you need to hide it," Gallagher said. "It is a huge life change, and many individuals just need to learn how they're going to begin the acceptance process."
The National Alopecia Areata Foundation helps push legislation to assist people with alopecia insurance coverage.
At least five packages of bills have been introduced into Michigan Legislature and U.S. Congress since 1995 regarding the coverage of hair pieces for alopecia patients, according to the Southeast Michigan NAAF Support Group. But none of the legislation has passed. Insurance companies and state legislators often view wigs as cosmetic, Gallagher said.
"Generally we do not pay for wigs," said Helen Stojic, spokeswoman for Blue Cross Blue Shield of Michigan. "We pay for treatments for the underlying medical condition that results in alopecia."
Stojic said some employers request plans that provide wigs for children younger than 18 years of age who lose their hair from cancer treatments.
"Insurance covers many things, but it doesn't cover everything," she said. "This is just one of those things that we historically haven't covered."
Kosmala said although she doesn't wear a hair piece, there are people with alopecia that could have a better quality of life with one.
"If people are going to have life-long struggles with this, they could pay for 20 years of therapy, or they can pay for a wig," she said.
Culture of beauty
Kosmala doesn't believe society pushes people without hair to feel as though they need to wear a wig.
But she said the standards of beauty that do not represent the majority of the population should be re-examined.
"The culture of beauty in America really bothers me as a woman and as a human, but not as a bald person," Kosmala said. "We all don't fit into those for some reason or other, whether it's my tummy or my arms or my hair."
Kosmala's parents said the battle against cultural images of beauty is something women deal with more than men.
"As a culture, we are sending incredibly wrong messages to young women, with or without hair," Joseph Kosmala said. "Girls are forced into this mold that's really wrong, and certainly it affects somebody with a condition like Lindsay."
Kosmala said she jokes about the disease on a daily basis, but often forgets she is bald.
"How many short, bald girls on campus are there?" she said. "If you can look at me and forget that I don't have hair, that's pretty significant."
