Many laboratories are determining the role of vitamin A metabolism in various forms of hair loss, including Central Centrifugal Cicatricial Alopecia (CCCA, follicular degeneration syndrome, hot comb alopecia) and Alopecia Areata. CCCA is a permanent hair loss disease that is seen primarily in African American women. ULBP3 is turned off in normal hair follicles but turned on in alopecia areata follicles. In its activated state, ULBP3 attracts killer immune cells with a special receptor called NKG2D, which triggers an autoimmune attack. Vitiligo itself does not endanger your health, but can be associated with thyroid problems, pernicious anemia, Addison’s disease (decreased adrenal gland function) and alopecia areata (patches of hair loss). For most patients, however, the greatest risk is loss of self-esteem.