Female Baldness

Genetics researcher Angela Christiano may have a full head of hair now, but for several years the same disease caused large clumps of her hair to fall out.

"It's terrifying actually to discover that you're losing your hair suddenly," says Christiano, a molecular geneticist at Columbia University Medical Center. "It's not just a cosmetic disease, it has profound psychological affects on the individuals who are affected."

Angela Christiano

In alopecia areata, the affected hair follicles are mistakenly attacked by a person's own immune system, stopping the hair from continuing its growth cycle. It usually starts with one, or more small, round bald patches on the scalp and can progress to complete hair loss.

"Once you start losing your hair it really does become a preoccupation," Christiano explains. "Every morning you wake up and check your hair, look in the mirror, check your hair in the shower. It's a day-long thing. It's constantly in the back of your mind."

Christiano and her team use a technique called comparative genetics or genomics, which maps human disease genes and traces them back to known gene mutations in animals, like the hairless mouse. "Comparative genetics is really a fancy word for something that we've been doing for a long time," she says. "It's simply the ability to take one organism's genome and compare it computationally to another one."

So far they've cracked the genetic code, not for alopecia, but for three other rare, inherited forms of hair loss.

"It's not clear yet, at least not obviously clear, how the genes that we've discovered will lead to treatments for hair loss for patients with alopecia," Christiano says.

Hairless mouse

She says diseases like alopecia areata are much more complex genetic diseases, but her wish is that 50 years from now, when someone comes in with the disease for the first time, the doctor can say, "We know exactly what this is and we can treat it so that it will never come back again." Something that Christiano hopes her work will help accomplish.

"There's a sense of hopefulness, not false hope, but real hope," she says. "We get emails from around the world just from grateful patients saying 'thank you' for devoting your life's work to this disease."

Goh, who is studying to be a dermatologist, also hopes that she may one day help patients with treatments she never had.

"I think overall it's almost like I'm lucky to have this disease. It sounds funny to say, but a lot people have diseases that are much worse — they don't even compare. So for me to have something that affects me, but still be able to be as successful as I want to be, is very lucky," she says.

Ironically, Christiano's work on hair loss could one day also help people with too much hair. "Interestingly, several of the genes we've found are actually wonderful targets for hair removal," she says.

She points out that as many people are challenged with excessive hair growth as with too little.

The hair follicles are also home to stem cells, so Christiano's work may also offer insight into the biology of adult stem cells. "When you think of an adult source of stem cells that's easily accessible, that could provide donor tissue for differentiating into many other cell types, there's enormous interest now in the hair follicle itself, as the home of the stem cells in the skin," she says.