Mental Health Aid & Support Groups for Hair loss

The link between dermatological conditions and their effect on the psychological state of the patient is unique in medicine. Such an influence is seldom found in other specialties. It is proven that a patient’s positive self-image is a crucial component of healthy social functioning.

Stigmatisation, for example where others avoid touching a patient due to skin lesions, reinforces feelings of shame and may lead to social anxiety and depression. Unfortunately, downplaying this psychosocial burden or suffering in medical settings can lead to even worse medical outcomes and poorer quality of life. (1,2)

Whilst stigmatisation is commonly associated with skin disorders, hair loss is no exception and evidence confirms it to be psychologically damaging and has the ability to cause personal, social and work-related problems. (2) This post will explore the implications of hair loss on a person’s wellbeing and the support groups which are available to offer help.

The greater a person’s hair loss, the greater the level of psychological distress experienced. Similar to skin, the loss of hair alters a persons physical appearance. This is of particular significance in alopecia areata when eyelashes, eyebrows and a man’s beard are affected as they define a person’s face. This type of hair loss can be seen as a failure to conform to the normal standards of physical appearance within society. (3)

Figure 1: Alopecia Areata affecting facial hair (4)

The relationship between hair loss and psychosocial consequences can be complicated by hair loss stemming from a stressful experience or life event, which leads to further distress, anxiety, and depression (5). This is commonly seen in women who are 11 times more likely to experience hair loss when under high stress levels than those who do not report high stress levels (6).

Clinical features

Hair loss may lead to depression, anxiety and social phobia (2).

• Depression can lead to low mood, lack of interest or pleasure in activities (anhedonia), loss of energy, and sleep deprivation.

• Anxiety causes excessive worrying, difficulty in controlling those feelings, and a feeling of heightened tension. Patients may also complain of palpitations and sweating.

• Social phobia or avoidance behaviour usually follows from the experience of anxiety symptoms or a stressful event, leading to social and economic suffering.

• Social anxiety disorder is characterised by the irrational fear of humiliation or being judged negatively in social situations as well as the avoidance of such social or performance situations (7).

These symptoms can have a severe impact on an individual’s mental health, ability to work or study, and well-being.

Treatment

Anxiety and depression caused by hair loss can be treated using cognitive behavioural therapy, support groups as well as through medication such as antidepressants (8).

Psychological treatment is important for people with hair loss, but the most effective method is yet to be determined as outcomes from each treatment route will differ from patient to patient. Research has predominantly been focused on the general issues of coping with hair loss rather than on specific psychological treatment strategies.

Support Groups (9)

• Alopecia UK works to improve the lives of those affected by alopecia through aims of support, Awareness and Research. They facilitate peer support through various platforms. For more information, check their website:

• Cicatricial Alopecia Research Foundation provides information and support for patients with scarring alopecia:

www.carfintl.org

• Alopecia Scotland provides support and information for anyone suffering the effects of Alopecia in Scotland

www.alopeciascotland.co.uk

References

1. Psychosocial factors in dermatology [Internet]. 2023. Available from: https://dermnetnz.org/topics/psychosocial-factors-in-dermatology

2. Psychological effects of hair loss [Internet]. 2023. Available from: https://dermnetnz.org/topics/psychological-effects-of-hair-loss

3. Hunt N, McHale S. Reported experiences of persons with alopecia areata. [Journal] J Loss Trauma 2005; 10: 33–50. DOI: 10.1080/153250200490890633. 

4. Alopecia Areata Images [Internet]. 2023. Available from: https://dermnetnz.org/images/alopecia-areata-images

5. García-Hernández MJ, Ruiz-Doblado S, Rodriguez-Pichardo A, Camacho F. Alopecia areata, stress and psychiatric disorders: a review. [PubMed] J Dermatol 1999; 26: 625–32. DOI: 10.1111/j.1346-8138.1999.tb02063.x.  

6. York J, Nicholson T, Minors P, Duncan DF. Stressful life events and loss of hair among adult women, a case-control study. [PubMed] Psychol Rep 1998; 82: 1044–6. DOI: 10.2466/pr0.1998.82.3.1044. 

7. Schneier FR. Social anxiety disorder. [PubMed Central] BMJ 2003; 327: 515–6. DOI: 10.1136/bmj.327.7414.515.  

8. Prickitt J, McMichael AJ, Gallagher L, Kalabokes V, Boeck C. Helping patients cope with chronic alopecia areata. [PubMed] Dermatol Nurs 2004; 16: 237–41. 

9. Support Groups – British Hair and Nail Society [Internet]. 2023. Available from: https://bhns.org.uk/index.php?/support_groups.html/#:~:text=Alopecia%20UK%20works%20to%20improve,of%20Support%2C%20Awareness%20and%20Research