Kayla Martell, crowned Miss Delaware in June, will have to prove she has the confidence and poise to become Miss America at its annual pageant next week.
But many people argue that she has already done just that by appearing in several photos and interviews with her bald head out in the open for the world to see.
Martell suffers from alopecia areata, an autoimmune disorder that attacks hair follicles and results in the loss of hair on the scalp and other parts of the body. The skin disease affects more than 4.7 million Americans and about 2 percent of the world's population. Alopecia areata will be Martell's platform in the upcoming pageant.
"I decided to use my crown to show that it is time we redefine what it really means to be beautiful," Martell wrote in an email. "To me, beauty is a part of your soul...You can be 'beautiful' on the outside and 'ugly' on the inside...But confidence and compassion are the real makeup of a beautiful person."
While some people prefer to let their baldness run its course unhidden, many people prefer to use wigs, makeup, hats and scarves to cover up.The condition is not fatal, but alopecia areata can have a major effect on a person's psychological and emotional well-being.
"Alopecia areata is not life-threatening, but it is life-altering," said Dr. Wilma Bergfeld, senior dermatologist at Cleveland Clinic and past president of the American Academy of Dermatology.
But now, as Martell steps into the limelight, not only as a person in the public eye, but also a beauty queen, many people are encouraged by her confidence as a beautiful bald woman.
"[This] lets people with alopecia areata know they are not alone and that they can do anything they want to do," said Vicki Kalabokes, president and CEO of the National Alopecia Areata Foundation.
Martell, now 22 years old, was diagnosed with the autoimmune disorder when she was in the fifth grade after noticing her hair part was becoming wider. She eventually lost all her hair.
"Kayla coming out as bald makes other people more comfortable and confident to be themselves," Bergfeld said. "People who have sudden changes in their body image tend to hide, but here is someone who is flaunting it and allowing it to be a part of their beauty."
Jamie Elmore is one of those women who once hid, but now walks around with her condition proudly.
As a Seattle-based hair stylist for more than 20 years, Elmore said she has always loved hair. When her hair started falling out after she gave birth to her daughter, Elmore, 41, said she was in denial, and struggled with depression and anxiety for years because of the loss.
"Once my hair started falling out, everything hit the fan," Elmore said. "But I had to empower myself. As a hairstylist, it was a little easier for me because I was able to have more options at my fingertips compared to the average person."
Elmore continues styling hair, and she now helps others who have lost their hair due to alopecia or chemotherapy treatments. She also holds a Seattle-based alopecia support group, where up to 20 people join each week.
There is no cure for alopecia areata and therapies are limited, Bergfeld said. Some people get alopecia areata at a very early age, while in others the disorder can strike later in their adult life.