Psychology

The data confirmed that experiencing hair loss is psychologically devastating, causes great emotional distress, and frequently leads to problems with self, society, and employment. The available evidence supports the notion that the experience of hair loss is psychologically devastating, causing intense emotional suffering, and leading to personal, social, and work-related problems.

There is a significant connection between hair and identity, particularly for women. About 40% of women who suffer from alopecia report having marriage problems as a result, and approximately 63% report having work-related problems.

The degree of hair loss is one predictor of psychological distress. This relationship between alopecia and
psychosocial consequences may be complicated, as alopecia may arise as the result of a stressful experience, which in turn causes additional distress.
Clearly, although alopecia may have a psychosocial impact, it is possible there are also psychosocial consequences resulting from treatment itself.

The link between hair loss and psychosocial consequences can be complicated by hair loss occurring as
the consequence of a stressful experience or life event, thereby leading to additional distress, anxiety, and depression .
Even if it has limited effects on an individuals physical health, hair loss may result in substantial psychological
consequences and significantly interfere with their quality of life.
Compared to the general population, individuals who suffer from hair loss experience a higher prevalence of mental disorders, including a major depressive episode, anxiety disorder, social phobia, or paranoid disorder . Compared with the general population, increased prevalence rates of mental disorders are associated with alopecia (Koo et al., 1994) suggesting that individuals with alopecia may be at increased risk of developing a major depressive episode, anxiety disorder, social phobia, or paranoid disorder. Individuals may experience significant problems with self-esteem. One limitation of research is that associations between alopecia and depression or anxiety can be muddied by stressful life events, which may cause both alopecia and depression or anxiety.
Those who suffer from male pattern baldness or another form of alopecia can experience problems with self-esteem, or even conditions like body dysmorphic disorder. Those with thinning or balding hair are more likely to experience serious mental health issues, including depression and anxiety. Studies have found that significant hair loss can result in lack of self- esteem, as well as a variety of other mental health issues, from stress and anxiety, to, in extreme cases, suicidal tendencies.
Those suffering from significant hair loss are more likely to suffer from negative psychological side effects, like
depression or lower self-esteem, compared with those who experience no hair loss or little. Many who suffer from progressive hair loss are able to cope, but for others, hair loss can take a devastating toll, leading to depression and anxiety.
Ironically, hair loss may be causing the anxiety, but the same condition may be trigger–or make the hair loss worse–leading to a vicious cycle.
Hair loss frequently causes heightened psycho-emotional and psychosocial distress, especially with regards to anxiety, depression, social phobias, and personality disorders. Individuals who suffer from a limited amount of hair loss are better able to mask their losses with remaining hair, and are therefore less likely to suffer from psychological problems, such as PTSD (with alopecia being a painful traumatic event), anxiety, or depression. Diffuse hair loss may also occur due to alopecia areata, medications, and a variety of systemic diseases including anaemia, hyperandrogenism, and thyroid disease.
There are also more serious versions of alopecia such as Alopecia Areata (AA), which refers to the loss of hair in patches on the scalp, as opposed to overall thinning. As a result, men with androgenetic alopecia typically experience a receding hairline that may progress to partial or total baldness, whereas women typically experience a hair loss at the top and sides of the scalp. Another cause of alopecia is telogen effluvium, where patients may lose significant amounts of hair all at once, typically after three to six months following a psychologically or physically stressful event.
Other causes of hair loss include traction alopecia — hair loss caused by hairstyles that pull at your hair — and alopecia areata, where your body’s immune system attacks your own hair follicles, leaving bald, flattened patches on your scalp. Beyond the physical effects, which might not be as apparent at first, losing hair for many causes devastating physiological effects such as anxiety, stress, and depression. Research published in The BMJ has shown that losing hair can cause an overall sense of being ugly, and can even, in some extreme cases, cause a form of body dysmorphic disorder, in which an individual has an overwhelming amount of anxiety over how they look.
A 1992 study in the Journal of the American Academy of Dermatology showed that women suffered more emotionally and psychologically, and were more likely to have negative body images, as a result of losing their hair, than men dealing with the same problem. Body hair loss seemed to pose less problems to patients compared to hair loss on the scalp and face, as it is less noticeable to others, however, one male described feeling less masculine without his leg hair.

A study published in Brazilian journal Anais Brasilerios de Dermatologia noted that those suffering from androgenetic alopecia (male- or female-patterned baldness) had lower quality of life compared with those suffering patchy hair loss, or no hair loss whatsoever.
Loss of hair, another female trait, among women undergoing mastectomy has been reported to cause greater psychological effects compared with alopecia related to chemotherapy for lung cancer . In medical terms, loss of hair may induce antisocial personality disorder, PTSD, generalized anxiety disorder, major depression, adjustment disorder, obsessive-compulsive disorder, panic disorder, and social phobia.
Anxiety and depression caused by hair loss may be treated with cognitive behavioural therapy and support groups, and medications, such as antidepressants . A solid theoretical understanding of the psychological effects of alopecia is required, including an awareness of the immune system, the stress response, and the psychological responses to hair loss.
Knowing that medical treatments are limited in their effectiveness will influence how psychologists approach alopecia, as this is usually a matter of helping a person learn how to live with the alopecia, not seeking some means to make the hair grow back.