One morning, Xi Ren Yang looked in the mirror and noticed two small bald patches at the front of her head.

“I was scared,” recalls Yang, who was 35 years old at the time. “I didn’t know how the bald patches came about. There were no symptoms.”

She dismissed them. But then she started to lose more hair. The patches got worse, to a point where colleagues were noticing and asking her if she was okay. 

It was only then that she went to the doctor, who diagnosed her with alopecia areata, an autoimmune disease that occurs when the body’s immune system attacks its own cells, in this case the hair follicles, which results in patchy hair loss. The cause? It can be a genetic predisposition, but environmental triggers are also thought to play a role, including stress, though more research is required to establish a clear connection between alopecia and stress. 

Yang had been under a lot of stress just prior to experiencing the hair loss, not only professionally but with her caretaking responsibilities. On top of a job in HR, Yang’s mother was suffering from dementia and her father was due to undergo heart surgery.

“I had asked my manager if I could work from home for a period of two weeks so I could keep an eye on my parents,” says Yang. “I was shocked by her reply. She said, ‘Tell me about your longer-term plan and if I need to find someone to replace you’. She had no empathy and I knew I could not work for such a manager. It made me think about my career.” 

With 13 years of HR experience under her belt at that time, Yang knew that if she had her own company, she would have the flexibility to look after her parents, and so she set herself that goal. Every evening, after a long day at work, she chipped away at what was needed to set up on her own. To do this, she sacrificed sleep. She was also eating poorly and, to try and counter that would exercise excessively—often late at night. 

It was then that she started to experience hair loss. While it began in patches, the hair loss quickly accelerated. Yang’s alopecia areata, a condition that is more frequently diagnosed in women though it does affect both genders, was the most severe form where all hair-bearing parts of the body are impacted.

“The amount of hair I lost each day was uncountable and scary. The floor would be full of hair. Any chair I sat on would be covered with hair. Bunches of hair would come out when I combed or washed my hair. After four months of losing so much hair every day, I barely had any left. So, I made the painful decision to shave my head,” says Yang, who went on to spend four years wearing various wigs. 

Yang tried a number of medical treatments, from steroid injections to acupuncture, but she found that none of them were helping with her hair regrowth—and they were not addressing the root cause. Yang believes that it was a mindset shift that eventually saw her condition turn around.

“It was a really difficult period for me, the lowest point in my life. As a perfectionist, seeing myself in the mirror without hair, eyebrows or eyelashes was a big blow to my self-esteem, But, I accepted it. My worth is not defined by my appearance. I picked myself up with positivity. I acknowledged my emotions and managed them. I reframed my mind to focus on the positives. And there are positives—I was alive. Every day I told myself positive things. Thankfully, I am naturally a positive person. But, all along, I knew positivity as something theoretical, until my experience with alopecia. It pushed me to put into practice all that I knew. And it worked. My hair started to grow back, which is why I have so much conviction to speak about positivity.”