After over a year of silence...I am back.

Dear readers and fellow mankind,

It's been over a year of complete silence on this Blog. I am thankful that I am back here.

Yes, I still have Alopecia Universalis and I always have this instant connection whenever I see, read or meet someone else with the same condition.

I couldn't help but to share this post when I came across this today.

We as Alopecians will continue to live our life to the fullest and whoever out there who also suffers the same condition like I do or Tommy...you are not alone and never will be. Reach out to any of us if you are having a tough time.

Here's the post I'm sharing...

Brave little kid Tommy! Truly an inspiration!

Part 2 - 10th Christmas of a Remarkable Journey

I would like to dedicate the song "The Heart of Christmas" to all my loved ones (You know who you are) and to all out there who are trying to find the meaning of life again, trying to discover hope again and trying to believe in love again.

The Heart of Christmas

"The Heart Of Christmas"

I’m gonna make a wish this Christmas
I’m gonna say a little prayer
I’m gonna stop here for a moment
Before the moment disappears

The world’s in a hurry this December
City streets and shopping malls
I wish we could slow down and remember
The meaning of it all

Wherever you are, no matter how far
Come back to the heart, the heart of Christmas
Live while you can, cherish the moment
The ones that you love, make sure they know it
Don’t miss it, the heart of Christmas

Let’s make it feel the way it used to
Let’s find that wonder of a child
You can see the magic all around you
Come on, and open up your eyes

You can find it in the warm embrace of your family
Or calling up a long lost friend
You can even find it in the eyes of stranger
When you reach out a helping hand

Wherever you are, no matter how far
Come back to the heart, the heart of Christmas
Live while you can, cherish the moment
The ones that you love, make sure they know it
Don’t miss it, the heart of Christmas

In the shadow of a steeple
In a star that lights the way
You will find Him in a manger
The heart of Christmas has a name

I’m gonna make a wish this Christmas
I’m gonna say a little prayer

Wherever you are, no matter how far
Come back to the heart, the heart of Christmas
Live while you can and cherish the moment
The ones that you love, make sure they know it

Wherever you are, no matter how far
Come back to the heart, the heart of Christmas
Live while you can, cherish the moment
The ones that you love, make sure they know it
Don’t miss it, the heart of Christmas

----------------------------------------------------------------------------

Christmas is a time when all of us should be reminded on all things that truly matters in life.

Let's light a candle,

for peace we pray for every nation,

for joy we pray for every child

for faith we pray for every man

for hope we pray for the world

for love we pray for every heart

My Christmas Tree 2011

Lin's Christmas Tree 2011

Lin's Christmas Cake 2011

My window decoration Christmas 2013 (At night)

My home decoration (Christmas 2013)

Blessed Christmas to everyone and to all people that God loved so much that He gave His only Begotten Son Jesus Christ, that who so ever believe in Him shall not perish but have eternal life.

Come back to the Heart of Christmas which is Christ our saviour.

Joshua

Part 1 - 10th Anniversary of a Wonderful Journey

Hi everyone,

1st November 2013 is a significant milestone in my journey of life, as it marks the 10th Anniversary of the beginning of a remarkable chapter of my life.

I have Alopecia Areata since young and then it rapidly developed to Alopecia Universalis within a several months just before my 17th birthday in 2001. The hair on my scalp fell off significantly (>90%) followed by my eyebrows, eyelashes, arm hairs and the rest is history.

It was extremely tough to deal with the sudden massive hairloss psychologically and socially as I retreat myself in the comfort of my house and a baseball cap whenever there is a need for me to go outdoor. I never know why I loss my hair, never know that there were people out there who shared my condition for almost two full years until 1st November 2003.

1st November 2003 was the day when I first discovered and officially get in touch a wonderful group of people sharing my condition on a support website called "Alopecia Areata Support Community".

From the online community I've met a group of wonderful people where the seeds of friendship were planted into our hearts and lives.

From then, friendships have been blooming like spring. Many thousands of miles have been traveled to spend quality time together including special events like, group gathering, wedding, New Year's celebration and Christmas Day.

Sunflower is symbol of my friendships and it has been my favourite flower since. The Lord has been kind enough bless my life with so many people that has never fail to touch of my heart many times.

There is so much share on this milestone and days till Christmas 2013. A very special Christmas indeed as it marked the 10th Christmas together in spirits and thoughts with my friends from all around the world.

Joshua

My love for the flower began when one of dear friends Dotty sent me some sunflower seeds from the United States.

This teddy is named "Josh". It reminds me of a very dear couple of my life- Uncle Wilf & Aunty Kath. Aunty Kath has since gone home to be with the Lord in 2012.

Celebrating the 10th Year of "Hairlessness" Part 2

In my Part 1 "Celebrating the 10th Year of Hairlessness" blog, I briefly talked about my alopecia and also re-tell and re-explain what Alopecia Areata is. However in the blog posting, I would like to talk more about my journey with Alopecia Areata (AA), not my entire life journey but more or less the summary direct to my alopecia journey.

As again I have AA since young but it remained only small patches of hair loss which could be "hide" by keeping longer hair. However, AA takes a turn to its most severe form "Alopecia Universalis" or AU on November 2001 when I was a month away from my 17th Birthday. So at my 17th birthday, my hair loss no longer happened only to the scalp as it progress to other parts of the body, from legs to arms, to eyebrows...etc. and the last to go was my eye lashes.

Now at 27, I am still having AU but there are a few strands of hair scattered here and there, so technically speaking, I am not 100% hairless...hahaha.

2001/2002 at 17. Being an alopecian (a person with alopecia) at the end of my high school years was tough, many of my friends were lost and do not know what to say. While I remained in a state of shock waking up every morning seeing clumps of hair on the pillow, losings clumps during shower and seeing the progressive baldness in the mirror, I stayed determine to complete my high school examination. While I displayed a strong personality at school about my ever "growing bald spots", I have not only invited stares and talks, nicknames like "baldy, baldness, monk" also surfaced. At the age of 17, one is not only concern about his/her studies, arguing with parents but also discovering the wonders of the "birds and bees", obviously the exploration of the wonders of the "birds and bees" has to be stopped abruptly at the dawn of AU (and it was really automatic). There were happenings at school and school assemblies (when I started wearing a baseball cap to cover my baldness) that remains "dark histories" in my life that I myself would not want to revisit at this point.

After I graduated high school and while waiting for a place in college, I just kept my feelings, disappointments and bitterness while I find comfort and strength in poetries, computer games and of course my pet dog, I could walk my dog for hours in the dark before going home.

Also at that point, my journey in faith has begun to take "root", it has been all "growing on the surface" when I first accepted Christ at the age of 11 or 12. "Almost" daily personal Bible reading and prayer has also started to happen, but guess what? Eventhough I want my hair back, I hardly pray for hair and I do not really know why I did not. Other areas of life had taken a turn for the worst, and so my journey with alopecia universalis began with God and my pets (animals). You'll be suprised that I trained my dog to wait till I say grace to thank God for the dog food!...hahaha.

I no longer spend time with my usual highschool friends, I don't go out without a baseball cap, my social life completely broken down until I gained entry into university to study a pre-veterinary science course which I "had to" social with my classmates. Except for occasional thoughts and covering my baldness (with a few patches of long hair here and there) with a baseball cap in class, or in the public, I turn "numb" towards my alopecia and "enjoyed" my time in university (which the environment has been less hostile to me compared to my final months in highschool)....until October 2003.

wait for my third blog posting...:) on what happened in October 2003 that changed my life forever...

Have a good day everyone

God bless us alll

Joshua

Celebrating the 10th Year of "Hairlessness" Part 1

...10th...

November 2001 was the time when my hair was falling rapidly, within months I lost about 80% of the hair on my scalp, then it progressed to my eyebrows, arm and leg hairs, eyelashes and the rest of the body and this condition is termed as ''Alopecia Universalis"- a severe form of Alopecia Areata.

It's been 10 years and I still love to tell others about alopecia areata. So, what is alopecia areata (AA)? In short and lay-man explaination: The white blood cells in my body attacks my hair roots and there is no cure yet. And I cannot die from having Alopecia Areata. It is widely believed and accepted by both scientist and dermatologist it is one to the Autoimmune diseases.

Now, in the 10th year of living with alopecia universalis (AU), instead of sobbing about my "still hairlessness" and still being a "weirdo" to some people in the society, I want to celebrate it. Without alopecia, I will never be the person I am today.

Being AU also marked the beginning of a blessed life.

Before I speak furthermore on how AU has affected my life, to all who is new to AA or AU, you are most welcome to learn about it through my previous blog postings (clicking on the topic will link you to the post):

1. Explaining Alopecia Areata and Auto-immune disease
2. Understanding the role of T-Cytotoxic & T-Helper Lymphocytes
3. Alopecia Areata as an Auto-immune disease
4. Should Alopecia Areata patients strengthen their immune systems?
5. Wouldn't the T-Lymphocytes around the hair follicle of an AA patients die?

There is no cure yet eventhough there are various form of treatments available, from the immunosuppresants to acupuncture to ayuverdic. The success of these treatments are not consistent for every patient with AA, I have personally know people living with AA have spontaneous regrowth and complete recovery with any form of treatment at all.

So, thats the end of Part 1 of a series of blog postings in Celebration of my 10th Year of "Hairlessness". This post explain what Alopecia Areata is. Future blogs will talk about living with alopecia.

God bless everyone.

Joshua

A Proud Alopecian :)

p/s: You can post me a comment if you would like to talk to me in private or visit http://www.alopeciaworld.com/ for more advice or support on alopecia areata.

Bullying...

Recently, radio channels in Malaysia are broadcasting awareness messages against bullying and it caught my attention when one radio announcer mentioned that although bullying makes the bullied person stronger and more courages over the years, but the pain can still be felt...

I believe it is true, thinking back of the bad experiences being an alopecian back in high/secondary school, being the only guy with freak bald patches all over the scalp...

Will need make some time and do some research on the topic of "bullying". Research into the minds of a bully and the bullied...

God bless us all.

God makes us for a reason and nothing is in vain, we were made for so much more because there's a place for us...:)

Joshua

p/s: visit my other blog There's a place for us... or simply watch the youtube below and read the lyrics...

The lyrics of the song performed by Carrie Underwood- There's a place for us



There's a place out there for us

More than just a prayer or anything you've ever dreamed of

So when you feel like giving up, 'cause you don't fit in down here

Fear is crashing in, close your eyes and take my hand, yeah

We can be the kings and queens of anything if we believe

It's written in the stars that shine above

A world where you and I belong where, faith and love will keep us strong

Exactly who we are is just enough

There's a place for us

There's a place for us

When the water meets the sky

Where your heart is free and hope comes back to life

When these broken hands are whole again

We'll find what we've been waiting for, we were made for so much more

We can be the kings and queens of anything if we believe

It's written in the stars that shine above

A world where you and I belong, where faith and love will keep us strong

Exactly who we are is just enough

There's a place for us

There's a place for us

So hold on, hold on

There's a place for us

We can be the kings and queens of anything if we believe

It's written in the stars that shine above

A world where you and I belong, where faith and love will keep us strong

Exactly who we are is just enough

Exactly who we are is just enough

There's a place for us

Alopecia Girls

My fellow alopecians and friends at the NAAF Conference 2011 Talent show...

Kiah is truly an amazing girl, I wish I have half of her courage and strength...





God bless us all, including all the alopecians like me :)

Proud to be an alopecian :)

Joshua

Some extra time to think about alopecia

Hi everyone,

It is funny that now I'm waiting for the official news/words from a few potential employers...suddenly, I have so much time for my own...couple of hours of packing or helping others to pack, some jogging, sit-ups and push up...here and there, watch my favourite sitcoms "Everybody loves Raymond"...I still have plenty of time to spare.

Well, it gives me time to think of my alopecia more often, its like I feel more aware of my alopecia than before I was still a full-time student ( happy to say that I WAS a full-time student). So, after so many years of schooling and dealing with alopecia universalis. Now, i'm in the transition period to become a full-time working adult. So, where am I at coping with alopecia? Full acceptance?- I dont think so, its pretty impossible when everyone around you pay so much attention to their hair or people staring at my smooth legs. But I'm not sad with my alopecia but rather I am proud of it. Alopecia has not only define how I look but also how I live my life. A life blessed with so many friends/ angels sent by God.

If God asked me today: would I trade off my friends for my hair back/ a couple of inches taller?....My answer would be an affirmative: NO!

A couple of reasons why I said "NO"...

1. NO. Because beauty comes from within, I may look better with hair and a couple of inches taller...but what do I get in the end of life? No matter what, our body will return to dust one day. 100 years from now, people will not remember how good looking I was but rather how many friends that cherished and celebrate a person's life.

2. NO. Alopecia may have lead me to my friends and how could I abandon my friends just have my hair back? The amount of love, support, prayers and even money pour into shaping who I am today can never be replaced with a full head of hair which would turn gray and decay one day.

So, at the end of the day. I must admit to the fact that world put more/ over emphasis on physical appearance and outward beauty but I will not surrender anything that truly matters in life for physical appearance. A very tough war! And time will only tell that I have make the correct answer...as we all should go for things that will stand the test of time. :)...hair may come and go but genuine friendship will always have a place in your heart and spirit. :)

So, God...I thank YOU for who I am today!

God bless everyone.

Joshua

"Young sisters who lost their hair cast off their wigs and go to school bald..."

This is must read beautiful article. As an alopecia areata patient, I feel inspired and extremely proud of these two beautiful girls and yes I am thankful to know them and their family personally.

"Together promoting Alopecia Awareness., we're humans too."

Please click on the topic for the article " Young sisters who lost their hair cast off their wigs and go to school bald..."

Emily and Faye, you both are truly pretty and brave heroes!

God bless

Joshua

This post is actually my comment to a blogpost featured on Alopecia World forum

"Normally, hair growth have three to four phases. The anagen (active growing phase), catagen ( involuting/ regressing phase) and telogen (arrested phase) and less notible exogen (shedding phase)UNDER NORMAL CIRCUMSTANCES. At any time most of the hair (about 90%) is in the anagen phase, a few % in catagen, and about 10% in telogen phase.The hair on our head have long anagen phase (several years) and short telogen phase ( a few months) while our eyebrows have shorter anagen phase (several months) and longer telogen phase (more than a few months). This explains why our hair in much longer and actively growing on our head while our eyebrows are shorter.Many studies have related alopecia areata with the hair growth phases/cycle. Many results suggest that the T-lymphocytes have held the hair follicle arrested for a much longer period (abnormal) in the telogen phase, as well as catagen phase (which then is related to exogen...when the hair shed).So basically, for people like me with alopecia universalis. I have about 80% of the hair on my scalp under abnormally long telogen phase or catagen phase while only a few dozen strands scattered across my head with normal hair growth phases. Thats why I still need to shave my head at least once every two days to keep my head clean.While we still couldn't predict our hair loss, we still know what is happening to our hair.You can check more information about what happened to our hair follicle as in alopecia areata at my blog @ http://joshuablogspace.blogspot.com/ and click onto the alopecia archive/label starting on February 17th ( a series of article about alopecia areata) which I have written a few months earlier.Hope you'll find it useful and informative.Take care.jt"

Joshua

God made everyone for a reason.

A blog adapted from Alopecia World (http://www.alopeciaworld.com/) posted by Alex "Did things change or am I just noticing them more?"

"I've had Alopecia for as long as I can remember. My entire life I've dealt with the stares and double takes, just like everyone else. For the most part, it didn't bother me...at all. I would brush it off and not take any notice to it anymore. Walking through the mall or anywhere else, I expected people to look, so I almost stopped realizing when this happened. Why then, is it starting to bother me all of a sudden? It doesn't make any sense.

Since I was little I've always gotten compliments. People constantly tell me how they wish they could be as confident as I am. Strong and confident. Am I strong? Confident? Does not caring what other people think make me confident? Or does it just help me mask the reality of living with a disease that is not "acceptable" (for lack of a better word) in today's superficial world? I don't know anymore.

And who do I talk to? Of course I have everyone on this website and people that I've met at the conventions over the years, but words just don't seem to cut it anymore. What is there to do? I have beautiful wigs, but that's not me. I don't feel like I should hide who I am to please other people. Then what is it?

Maybe it has nothing to do with Alopecia. Maybe it's just me. Maybe I'm depressed and don't know why. Maybe this is my scapegoat. Again, why? I have a great life: family, friends (I think), a home, clothes, food. I have more than some people unfortunately can only dream about. What am I missing that is making me feel so miserable lately?

Music is my therapy. I just sit and listen. I think about the words and how I can relate or not relate. As I was writing this I had my iTunes on shuffle (I cannot even think without some background music.). "Lucky" by Britney Spears just came on, and I think that is pretty much how I feel right now. "She's so lucky, she's a star, but she cry, cry, cries in her lonely heart thinking, if there's nothing missing in my life, then why do these tears come at night?" This pretty much sums up everything I'm feeling right now. "

My reply to Alex is:

"Hi Alex,

I might have too much to say again. Nope, reading your blog has not bored me to death, how could it be if one of my alopecian friends needed a pair of listening ears?

I agree that the society has placed too much on superficial look than it actually worths, and it doesn't mean that when most part of the society is wrong, we should also adhere to the value.

If there is people judging us by how we look or what we have or not have physically, then I feel sorry for them. As I have said in my earlier reply to another post, the works and values of people who hold on in their life will stand the test of time, for they will be remembered for decades, centuries because of their works and inspirations. I couldn't think of one person who is remembered for centuries to come because of their physical attractiveness. Even the prettiest girls and handsomest boys cannot escape the reality of aging and eventually meets death.

Let me set you a story, tulips and roses are planted in city gardens where many people can adore. They bloom into glorious beauty and colour under the breath of spring. People in the city and by the road, would stop by, complimenting the flowers and take pictures of the flowers...etc...but soon enough they fade away and be forgotten.

However, the fruit trees are different. For example, the apple trees, they are not planted in city streets where many people can come and adore, a fruit tree may look like an ordinary tree where people does not appreciate, but when it blooms and bear fruit...the apple tree is the most beautiful of all...and it does not stop just there, the fruits supply nutrients and become food that feed the hunger and provide to the poor, countless people benefit from it.

The society may not think that alopecians are beautiful, we may not be the jewel of city, we may not be "attractive" to a big part of the society. But do not be disheartened and discouraged because I am sure then, when the time comes...you'll realize you're better than many "superficial" people out there.

Talking about Britney Spears, she had all the she has or a person could ever ask for, famous, rich, pretty, a partner, a family but yet it all meant nothing to her because of her poor choices.

At the end of the day, it is the choices we make in life will change everything and not whether we have alopecia or not.

Joshua "

God made everyone for a reason, and everyone is important! Remember that! If you're not a beautiful tulip, you might very well be a blossoming fruit tree!

Joshua

Correlation between Alopecia areata & smoking?

This post is adapted from Alopecia World forum

and this is what I replied to the discussion:

"There is no scientific paper suggest that there is a significant correlation between smoking & alopecia areata yet, I am not aware of any test/ survey being done on the matter also.

1. It is widely accepted both by alopecia patients and scientists/ dermatologists that alopecia areata can be triggered by stress. Stress also comes in various form, physical/ physiological, psychological, pathological or any combinations of the mentioned..etc. Eventhough there is no scientific evidence on the connection between smoking & alopecia, I believe that smoking can be a predisposing factor to alopecia areata. (As per any foreign event/ particles in the body could induce an auto-immunity state). In short, smoking is a form of physical stress of the body indirectly and to the lungs directly.

2. Smoking as a mean to relax the mind and mental/emotional state, statement is valid & factual. One thing for sure, it is not relaxing to the lung and also the heart. While you're relaxing your mind and resting your brain at one time, at the same time you're also comprising the well being of the other vital organs of the body. Why don't you find other means to relax your mind without comprising the health of the other parts of your body. Just as much as you love your mental status/mind/brain, you must love your lungs and heart as well (in addition to the liver and kidney which made up the 5 vital organs of the body).

3. a little more fact about the lung, the lung surface are generally and mostly covered with thin pneumocytes type I (Lung cell type 1) which is responsible for gas exchange (Oxygen-Carbon dioxide exchange), oxygenated blood subsequently distributed by the heart to the entire body. Pneumocytes type II, on the other hand produce surfactant that provide integrity to the lung (thus preventing it from collapsing-atelectasis). Pneumocytes type I eventhough are plenty, their biological component is that it is higly susceptible to toxic insults/ infiltration and they do not regenerate/ or replicate, meaning these cells responsible for gas exchange does not regenerate after the cells die. The lack of cells for gas exchange, will result in lacking of oxygenation, and the tissues send signals to the body to increase breathing rate and heart rate, in order to restore the constant and adequate oxygenation to all body tissues. Well, it is true, some have smoke heavily for decades and yet still healthy, we must praise God that He had created reserve "lung tissues"- functional reserve to sustain our living, our lung's functional reserve is at least 50%-75%, meaning we can still live healthily with one side of the lung removed. So what, some may say, like my own grandfather, who smoked for over 70 years and he is now 97 years old.

I believe, those who smoke and still live long, could live even much longer if they didnt smoke.In conclusion (everyone at this time will say, Praise the Lord...lol). It doesnt matter much if smoking worsens alopecia areata or not, because it matters more that smoking actually add burden to the lung directly and the heart indirectly. Well, the lung and the heart are definitely more important than my hair.

Hair is just another ascessory tissues (play some role) to the skin, while the lung and the heart are major vital organs that sustain the quality of life and eventually life itself! Only if the heart and the lungs are visible on the outside of our body, the society then will pay a lot more attention to them!I dont mean to give you a lecture, I presume your occasional cigar would be more like a weekly habit rather than a daily habit.

I agree that smoking does add to the fact that can provide some form of calmness to the mind and relieve anxiety and ease emotional stress. My motto "I love my lung and my heart just as much as I love being calm to my mind", so I'll find another way to relax. If you're not thinking of quitting smoking, my next advice would be "Moderation is the key".

Take care and God bless."

Joshua

Response to intensive 3 months of prednisone treatment for AA

My response to three months of prednisone treatment for Alopecia areata. (As posted on Alopecia World website)



I am going to voice my opinion as brief as possible into three aspect Physiologically, Philosophically & Psychologically. I'm into veterinary medicine and we even use prednisone for animals but never longer than 7 days. However, I need more specification/ details in term of the dosage of prednisone and the route of administration. However, my response is based on the recommended prednisone dosage being used over this three months of treatment (given systemically).

The physiological aspect:

Side effects of Prednisone:
Major
1. Risk of developing diabetes
2. Weight gain (also increased risk of Cushing's syndrome- hyperadrenocortism)
3. Facial swelling / ascites/ edematous
4. Depression, euphoria, or behavioral changes
5. Fatigue or lethargic
6. Vision impairment
7. Ulcers / Mouth sores
8. Osteoporosis
9. Insomnia
10. Joints & abdominal pain
11. Cataracts
12. Anxiety
13. Blood vessels diseases

Minor
1. Rash
2. Diarrhea
3. Frequent urination

In short, I am strongly against the use of Prednisone for more than 7 days as recommended for the treatment of Alopecia areata and what more for 3 months. ( Again, very dosage dependent)

The philosophical aspect:
One must set priority right, naturally and normally in our body as designed by God. Hair is just a part of the body, when we are compromising the conditions of other major organs and vital organs and the IMMUNE SYSTEM in the sake of getting our hair back, I seriously urge people to re-examine their thoughts and decision. The compromises made would probably led to one the side effects mentioned above (Under recommendation, the use of prednisone is not more than 7 days or give and take 14 days). Three months is almost 12 folds higher. One must be compromising their quality of life and even their LIFE if agree to be subjected to the treatment regime. In short, it is philosophically unwise when one opt to regain a non-vital part of the body by compromising other vital organs and even LIFE itself!

The psychological aspect:It would be thrilling and exciting to have my hair back. It would be perfect and awesomely great if I can have my hair back just with a simple faith without compromising my quality of life and my loved ones around me. I have been living with AA for more than 20 years and with AU for more than 6 years. I would definitely sacrifice alot for my hair to grow back as long as my sacrifices are practical, logical and sensible (i.e the more people I help, the more hair I get...etc) In short, our psychology needs to grow through proper thoughts and knowledge together with practicality and wisdom.

AT THE END I STRONGLY OPPOSE TO THE ABOVE TREATMENT REGIME & WOULD NEVER RECOMMEND IT TO ANYONE EVEN IF THE TREATMENT CAN WORK 100% EFFECTIVELY.

I couldn't read all the response to this discussion but I have read that some are willing to take this kind of treatment regime and some are trying for more than a few weeks already. I would like to add that some are taking calcium supplements to prevent the side effects of having osteoporosis while treating alopecia with long-duration of prednisone. Let me remind everyone to remember the amount of burden one is putting on the kidney. Kidney has to work extra hard for drug elimination and calcium mineral. The liver has to work extra hard for drug metabolism. The heart has to work extra hard due to the increase of blood viscosity due to the effect of drug, calcium supplements together with the ongoing comprimising of liver and kidney.

AGAIN, I AM STRONGLY AGAINST THE USE OF PREDNISONE FOR MORE THAN ONE MONTH (INJECTABLE into the body system) /TWO MONTHS (ORALLY) FOR THE TREATMENT OF ALOPECIA AREATA. * Local subcutaneous injection on the scalp are still acceptable once every two months (three times = six months)

SOME MAY DISAGREE WITH ME BUT THIS IS TOTALLY MY OWN OPINION. NO INTENTION TO OFFEND ANYONE. THANK YOU.

Joshua

Wouldn't the T-lymphocytes around the hair follicle die?

Hello,

I receive a question that what if the excessive T-lymphocytes around the hair follicles of a patient with Alopecia areata dies or will they live forever?

We're alive today because our body is alive, our tissues are alive and so does our cells (We're living organism because we're composed of living cells)

Yes, eventually all cells have to die however the life span of each type of cell varies. (Normally our red blood cells live about 120 days, they lost their membrane integrity due to wear and tear, and eventually destroyed by the spleen.)

T-lymphocytes also have its life-span. In human, the T-lymphocytes (Special/ specific Soldier) can survive between 3 to 6 months (The more wear and tear, the shorter the life-span) and B-Lymphocytes can survive between 1 to 2 months).

In my previous blog, I talked on the functions of T-lymphocytyes (the Cytotoxic and Helper cells), I was merely talking about effector Lymphocytes (Special/ specific Soldier). The second type of lymphocytes by function is memory Lymphocytes (Special/ specific Messenger). Memory lymphocytes stayed in the periphery tissues and blood circulation for an extended period, responding quicker upon the same specific exposure of antigen by providing instant information to the effector Lymphocytes (In this case, we're talking about the self-antigen of the hair-follicle).

Memory lymphocytes (T & B cells) live somewhere between 3 months to 5 years with 1% of the memory lymphocytes living up to 20 years (Vaccination that we get annually? or once every five years i.e. hepatitis A, B as booster?...much related to memory lymphocytes).

With the word memory alone, the dysfunctional T-lymphocytes found around the hair follicle or an Alopecia areata patient, kept on producing a specific dysfunctional response against the hair follicle.

Theoratically, (Memory Cells with the time element) we can now basically explain why some Alopecia areata patients:

1. Experience little regrowth but then fall off again...

2. Have a very long duration of disease...

3. Believed to be of genetic basis...

More details...(Wait for the next blog or post me a question)

Joshua

A letter response to Jon's ex-school

Hi everyone, I am brought to the attention that a highschool kid with alopecia areata has quit school due to the school/ district authority refused to allow him to wear a head gear even with official writing from dermatologists.

Below is my written response to the school's authority (sent on early February 2009) based on the kid's mom letter/discussion on an alopecia forum.

__________________________________________________________________________

5^th February 2009

Our Ref. No.: aasc/asia/oletter/01FEB09-01

Mrs. A., Principal
West Seneca East Senior High School

UNITED STATES

Mrs. A.,

Hello. It is brought to my attention (from a letter written by Sharon Lesakowski- attached for our reference) that a student has quit your school due to the school authority’s refusal to allow him to wear a head covering even though he is diagnosed with alopecia areata (Hairloss due to a medical condition).

The excuse given by the school authority is almost absurd, laughable and mostly unprofessional as per the context given by Mr. Wiley, Assistant Superintendent on a return phone call to Sharon Lesakowski that Jonathan’s way of dealing with his affliction (wearing a bandana) was not acceptable.

This may not be a perfect analogy but it is good enough to reflect a medically illiterate faux pas. It provides an impression that as if the school will penalize a student for flashing gang signs where as the student is actually deaf and communicating in sign language. In this case, it is a student being penalized for promoting gang image where as the student is actually suffering alopecia and requires a head covering to protect his scalp. I believe that you are aware or at least read about alopecia areata. Even though alopecia areata is not a life-threatening or infectious disease itself, covering the hairless area especially the scalp is more than just a psychological comfort to the alopecia patient. Technically, Jonathan’s option of wearing a bandana has physiological reasons behind it. The physiological aspects, a bandana:

1. Keep the head warm during winter.

2. Keep the head (skin) from over exposed with UV during summer.

3. Keep the sweat from going into the eyes due to the loss of eyebrows and eyelashes.

As long as the attire does not offend others in the school, a bandana (with no offensive symbols or design) is not a violation a dress code or district policy given a medically certified condition as what Jonathan has. The school’s policy in Jonathan’s case (his rights) is itself a violation of the United States Constitution’s Bills of Right. In addition, the school’s policy discriminate alopecia patients (in general) of the right to protect their scalp with a bandana. About 2% of the human population and up to 5 million peoples in the United States are affected by alopecia areata (Sources by National Alopecia Areata Foundation, NAAF and National Institute of Arthritis, Musculo skeletal and Skin diseases, NIAMS).

As an education institution, the school has failed to provide a comfortable environment where knowledge is to be imparted without partiality and favour, in this case to Jonathan (for wearing a bandana to protect his head). As an alopecia patient myself, I felt insulted and discriminated by the excuse given by the school authority. Equating bandana wearing in general to promote gang image itself is an unacceptable reason and an insult to community of alopecia patients and patients suffering hair loss due to secondary effect (like hormonal problems, burnt victims, cancer patients).

Personally, I hope that the school authority and responsible personnel to provide a full public apology to Jonathan and his family, nothing short of a personal apology and also issue a public apology via local media. I strongly believe that being in the education profession, one should be courageous enough to admit and apologize for the mistake done whether by moral obligation or work ethics.

I am also affected by alopecia areata and have lost all my hair on my scalp. If I were to come to your school to seek education and I chose not to wear anything to cover up my baldness, would I later be “accused” or “penalized” for promoting the skinhead gang because I appeared bald at school? Therefore, I urge the school’s policies/ school district policies in particular the out-dated attire policy to be reviewed immediately in line with proper sensitivity to the medically unwell and needy patients, upholding the Bill of Rights as enshrined in the United States Constitution and finally to function as a school to provide education and conducive environment for students to receive education to avoid unacceptable mistakes like Jonathan’s situation in the future. All kind of responses is most welcome. Thank you.

Yours sincerely,

_________________

Should Alopecia areata patients strengthen their immune system?

Basically, the ultimate cure for Alopecia Areata would be to "tell" or "inform" the T-lymphocytes of our body (Specifically those who are targeting our hair follicles) that the "social security number" of hair follicle tissues are of our own body and NOT foreign.

So, should we strengthen our immune system?

Yes, the T-lymphocytes still plays a great role in our well being and defense mechanism against specific bacteria, viruses and prevent rapid proliferation of mutated cells (cancerous).

Therefore, systemic steroidal treatments are not encouraged to treat Alopecia Areata in long term, as it would "weaken" the ENTIRE Immune System. Its like, SHUTTING off the COUNTRY's entire police force because a few police made a mistake and arrested THE COUNTRY's own citizens as illegal immigrants.

Joshua

Alopecia Areata as Auto-immune disease

In my previous blogs, I talked about the immune system in relation to alopecia areata and then I talked about the normal functions of T-lymphocytes.

Why is Alopecia areata considered as an autoimmune disease?

Each different cells/tissue of the body has their own "social security number" / receptors (non antigenic) and the T-lymphocytes normally identify the "social security numbers" that does not belong to the normal tissues found in one own's body and attack them. For example, the immune system, including lymphocytes is triggered to attack the foreign infectious agents and abnormal proteins found in the normal body. (Different "social security numbers" of the various pathogenic bacteria, viruses...etc)

In Alopecia Areata, the T-lymphocytes somehow identify the specific "social security number" (self antigen) of the hair follicles as foreign infectious agents/ non self and could not distinguish it for being of the part of own body and start "arresting and attacking" the hair follicles....and now the person suffers from Alopecia Areata.

Medical definition for:

Antigen- Any substances which is capable, under appropriate conditions, of inducing a specific immune response..

Self antigen- Any constituents of body's own tissue capable of stimulating a specific immune response/ autoimmunity.

(Its like the police arrest you as for being an illegal immigrant when you're actually a citizen of the country)

Joshua

(For information on Alopecia & Support, pls visit AASC-i or join Alopecia Areata Support Community)

Understanding T-Cytotoxic & T-Helper Lymphocytes

Hello everyone,

From my previous blog (Explaining Alopecia Areata & Autoimmune Disease), I talked briefly about Alopecia Areata and then proceed to the discussion of the Immune System.

I have touched on the microscopic presence of T-Cytotoxic and T-Helper lymphocytes excessively on the hair follicles of a skin biopsy taken from a patient with Alopecia Areata.

Before I go on further to explain why Alopecia Areata is recognized to be an autoimmune condition. Let us watch the videos below to understand the normal function of T-Cytotoxic and T-Helper lymphocytes in our body's immune system.


T-Cytotoxic (Lymphocytes)
*Note: Antigens are proteins that are able to produce an immune response (E.g. proteins of bacteria, viruses)

-function to eliminate antigens by releasing cytoxic properties/substances.

T-Helper (Lymphocytes)

-function to eliminate antigens by signalling other immune cells.

Thats all for today, I shall talk about Alopecia Areata as an Autoimmune Disease at a later date. (I shall continue our discussion in about a week from now)

At the end of this series of blog, if the people who read and learned about Alopecia areata still behaved rudely and even jeer at people suffering from Alopecia areata. I shall make an official declaration on this kind of people.

As for the rest, thank you very much for your support, patience and interest in Alopecia areata.

Joshua

Explaning Alopecia areata & Autoimmune disease.

I would like to begin my first official blog by posting a subject that is not life-threatening but life-altering. The subject is Alopecia Areata (Widely believed to be an autoimmune disease).

As an Alopecia areata patient, I have been laughed, stared, commented rudely and even be labelled as a member of the skinhead gang in the public multiple times. I've even heard from the public calling women with alopecia totalis, alopecia universalis, crazy womens, Alopecia universalis patients as freaks who shaved their eyebrows and pulled off their eyelashes.

Children are being laughed and jeered as baldy, alien or even hairless monsters! Enough is enough! If we are not bound by the Rule of Law but rather the Law of the jungle, I would have given a smack or two slaps on the faces on people who laughed at children with Alopecia areata.

• So, to whoever (on condition that you're civilized, with brains in the body, I don't care where your brains is, as long as you have one in your body) want or have showed rudeness, ignorance to children and women with alopecia especially and also to my fellow brothers. You are welcome to read my blog.

To those who live with Alopecia areata or live with/know someone you loved with Alopecia areata, you are most welcome to read my blog.

• First of all, Immune system and Autoimmune system does not exist separately. The term "Autoimmune System" does not even exist whether in scientific or medical definition. There is only Immune system and Autoimmune disease/condition (One of many ways the immune system can breakdown).

• However, "Autoimmune disorder, Autoimmune conditions, Autoimmune diseases" are often used interchangeably and Autoimmune disorder/conditions/diseases is merely the failure of the body Immune system to recognize one own self (cells and tissues) and therefore "attack" (produce an immune response against) the host's (e.g human) own cells and tissues that makes up the normal structure of the physical body.

• Let us not discuss in depth into scientific terms but rather an explanation based on basic science.

The immune system in general, works in two general pathways:

1. Non-specific immunity (innate pathway)- eg. the physical barrier of skin, acid in the stomach, phagocytics cells in blood that eats up bacteria in general...etc
2. Specific immunity (pathway)

Alopecia areata falls into the minor malfunction of the Specific immunity (pathway).Under Specific Immunity, it further subdivides into two components:

1. Passive immunity- (e.g transfer of antibodies from mother's milk to baby)
   and Alopecia Areata (Autoimmnue condition) is narrowed down to the minor malfunction of the Active immunity.
2. Active immunity- response upon stimulation (e.g vaccination, exposure of disease, infection)

Under Active immunity, it further divides into two categories:

1. Humoral immunity ( produced by B-lymphocytes)- e.g production of antibodies like Immunoglobulins, IgM, IgG, IgE...etc.
2. Cell-mediated immunity (T-lymphocytes)

* Another type of lymphocytes besides B and T-lymphocytes is Natural Killer Cells (NK) which is part of the Non-specific (Innate pathway) immune system.

and the identified culprit (agreed by most) for Alopecia areata is the T-lymphocyte cells (T-Cytotoxic cells which destroys cells) and (T-Helper cell which tells the other white blood cells to destroy cells and enhance the B-lymphocytes to produce antibodies specifically)

Under the microscope: a skin biopsy of a patient with Alopecia Areata shows

• Extensive T-Cytotoxic and T-Helper cells are present surrounding the hair follicles, "attacking" them, so in laymen term the hair follicle is "under siege". Hence, the hair follicle cannot produce any hair, and the nutrients supplied for hair growth is BLOCKED by these T-lymphocytes cells and their allies.

So, above the surface of the skin, no hair is present (Alopecia= a clinical symptom of absence of hair on skin where they normally are/ should be).

Why is Alopecia Areata often starts as circular patches extending outwardly? What's wrong with the presence lymphocytes around the hair follicle and why Autoimmune disease?

I will discuss that in my next blog. Thank you for reading.

Joshua

p/s: You may want to visit Alopecia Areata Support Community or read about Alopecia Areata at AASC-i if you find my blog interesting.