By Shannon Lane @shannonroselane
Scroll down for the full story
Videographer / director: Anjin Herndon
Producer: Shannon Lane, Ruby Coote
Editor: Beth Angus
Sierra Dawn from Washington state was diagnosed with alopecia totalis in 2013.
She told Barcroft TV: “Alopecia is an auto immune disorder that causes your body’s immune system to somehow for whatever reason think that your hair is a foreign body or virus.
"I remember the doctor looking at that spot and telling me it looks a lot like alopecia, and I had never heard of that word before and at that time I struggled to even pronounce it."
The young woman first noticed something wasn’t right when her hair began falling out at high school.
She said: “I remember very clearly the first day it happen. It was the very end of my 8th year and I was in gym class. We were running around the track and it was quite a hot day in California.
"I ended up sweating a lot on my head and with sweat it would get a little bit itchy. I remember reaching behind my head and I scratched one spot that was quite irritated at the time. And then I noticed I felt something almost release from my scalp.
"It was such an odd feeling. It was almost like something was plucked out of me. And I withdrew my hand and I looked down and I saw at least 8 hairs within my hand. And all of them had the entirety of the hair root.
"I just brushed it off at that time. However I didn't realise that it was going to get much, much worse from there. My hair continued to fall out in that same exact spot over and over.
"Every time I washed my head, whenever I scratched it, whenever I just brushed it or with my hand, more and more would come out just from that particular spot. And what was a pea-sized bald spot became the size of a tangerine.”
Due to her condition, Sierra, who is currently out of work, felt segregated from her school peers and lost her confidence.
She said: "I didn’t necessarily get bullied. It was more like I was shunned and pushed away from people. They didn’t necessarily interact with me and it was like I was given the silent treatment for most of my high school life.
"I think people assumed that I was doing this for attention because I never did cover my head with wigs or hats.”
Unfortunately there is currently no treatment for alopecia, only creams that aid the discomfort.
Sierra said: “When I feel irritation on my scalp, I usually look in the mirror and sometimes there is a lot of visibility with the irritation where I could see raised redness or there's just a lot of red spots.
"I just apply this cream, this is betamethasone dipropionate.”
When Sierra was 18, she sought refuge in an online forum - where she met, now fiancé, Zane.
Sierra said: "I wanted to be able to go to a place even if it was online where I just felt normal for once, I didn’t want to feel like I was the spectacle of the world so I found an online platform that I joined.
“So I had the ability of people looking me from the inside and me being able to express, oh I like these things and this is who I am instead of people just seeing me as the bald one.
“So I joined that and he was actually one of the first people on there, he was on the very top of the list and when I looked at you I thought that you were super cute.
"I remember the feeling I had when I first Skyped him as well, I was very scared because I didn’t really inform him about what I looked like, I didn’t tell him that I was losing all my hair.
"I was kind of looking at you waiting for you to say something but you never did and that was the first time ever, ever since my condition started that someone didn’t even question it, “ Sierra said to Zane.
Zane added: “When I first saw her in the video chat I thought she was really cute. And I did notice her baldness. I didn't care whether it was something wrong with her physiologically or whether it was a fashion statement. It didn't bother me.”
After meeting Zane in person, Sierra began living with him for months at a time - and finally decided to move from her family home in California to live with him in Washington state.
The couple are now engaged, and Sierra is thankful that her fiancé has helped her learn to love her bald head.
Zane said: “She thanks me all the time for treating her like a normal human being and being a good partner and every time I ask her why she is thanking me for doing something that comes so naturally like, it is not a big deal and never has been.
“You are a spectacle to be sure but not for the reason you think you are.”
Sierra added: "You helped me feel like my true self and who I want to be and who I strive to be and I don’t need artificial means and I don’t need to manipulate myself in order to be something I am not, and I thank you so much for that.
"I just have to come to terms with the fact that I’m bald again and I will probably be bald or balding for the rest of my life and I have to just buck up and deal with it and you know, I’m just lucky to be alive in a society where people are mostly accepting and don’t bat an eye."