Psychological Impact of Alopecia & Its Treatment

Alopecia pronounced as (al-oh-pee-shah) is a certain type of medical condition where there is a sudden loss of hair in round patches. It does not happen to everyone but about 1 in 5 people experience it. The hair may fall out from the scalp or from elsewhere in the body. Alopecia can affect both men and women irrespective of age. Generally, it is seen that alopecia has two points of beginning, one in childhood and others during adulthood. It is non-communicable in nature. About 6.8 million people in the United States are affected by Alopecia. It is a sudden medical condition which may arise over just a few days.

Alopecia is an autoimmune disorder¹. Autoimmune disease is a medical condition which arises when the body’s immune system attacks the healthy cells present in the body. Therefore, in Alopecia white blood cells present in the body attack the cells in hair follicles (small holes in the skin from which hair grows) which causes it to wither, ultimately leading to slow hair building. There is no permanent damage to hair follicles. Injections may help hair to regrow. The reason is still not known as to why our immune system attacks hair follicles. Several factors such as hormonal, physical or chemical, and congenital diseases can cause Alopecia. Alopecia is a genetic disease. A person whose family member has been affected by alopecia is also more likely to be affected by it. Other cause may be thyroid or vitiligo. Vitiligo is a disease wherein there is a loss of skin color in blotches. Various other autoimmune diseases are the corollaries to Alopecia. Alopecia also affects people who have asthma and allergies like atopic dermatitis (a red itchy inflammation of the skin) and hay fever allergy. People having type-1 diabetes may also become the target of alopecia. Some people do not go outside or go to work for fear of being mocked. Women, in particular, are described to have problems, perhaps because of the importance of hair to a women’s notion of self and identity. Children and adolescents also face problems, not just because they might be bullied at school, but because they are the ones going through stages of establishing identity. If an individual’s physical appearance drastically changes at this point, then it can have a catastrophic impact and consequences. Often the question is raised whether stress can cause hair loss. Yes, stress might lead to hair loss. Appalling stress can contribute to hair loss.

There hasn’t been much of the research done regarding the psychological impact on people due to alopecia. It is treated as a secondary concern and not much importance is given to it but people should know that the psychological changes that happen in the body due to alopecia may one day become a great threat to the health of that person. Hair loss does not practically cause problems; it is the visually important part of a physical appearance for both men and women. It is seen that people who have had experience of alopecia, later suffer from psychological problems like enormous emotional suffering³. Alopecia also causes conflict with the social life of the person. They might isolate themselves from their friends because of embarrassment; this would gradually result in depression. Though, initially importance wasn’t given to psychological problems faced by people experiencing Alopecia now many researchers are putting their efforts to know about the psychological impact and its treatment. In one research, it was found that the stress level experienced by patients with Alopecia is similar to be at the level of chronic and life-threatening diseases. Alopecia might also interfere with work life. People suffering from alopecia might stop going to work, thus reducing their day-to-day activities, ultimately affecting their physical health. The psychological impact of Alopecia is more severe in the case of women. Hair is one of the most important constituents of the physical appearance of women. One’s identity is not just personal but bound up in the physical and social world. These issues surrounding relationships demonstrate the importance of identity and selfhood.

The importance of physical appearance for people with alopecia is always heightened. Their experiences, particularly when eyebrow and lashes are affected, can be compared with those who have facial disfigurement. It is probable that there is a differential impact on men, women and children. Women suffering from alopecia are highly affected which interferes with their marital life. People suffering from intense hair loss are likely to suffer from psychological affliction. People suffering from alopecia face psychiatric disorders like anxiety², social phobia, depression and may sometimes be paranoid. As a result of alopecia, people experience lower self-esteem. Men who suffer from loss of beard might be teased by other people. Men who are young and aren’t in any romantic relationship feel insecure and they think that physical appearance is essential for their self-esteem.

People find alopecia as an embarrassing situation and often spend much time and money on its treatment. People facing hair loss on eyebrow or eyelash might experience the change in facial features which pose problems like identity change. Women who experience high stress are 11 times more likely to experience hair loss than those who do not report high stress. People might feel unwanted and left out in society because of changes brought into their physical appearance due to loss of hair.

Bald women are not generally accepted in the society but bald men are. Hence, women have more tendencies to facing psychological consequences than men. Though in some cases hair may regrow yet once the psychological damage is done then it becomes difficult for an individual to cope up with it easily. Psychologists should provide psychological support to people suffering from alopecia so that they might come out in society. Society should also accept bald women. Social relationships and social support severely impact upon coping the changes in appearance, which may lead to identity change. Despite the availability of limited evidence, it is evident that alopecia causes profound effect on a person’s life. Further researches are highly required leading towards a good psychological understanding of implications of alopecia.

Various symptoms manifest that one may have alopecia but the most crucial symptom is hair loss. If there are small patches of hair falling off from the scalp or hair falling off from eyebrows, eyelash and even nose hair and sometimes even beard in case of men indicates that one might suffer from alopecia. However, hair fall in patches at the beginning of this medical condition does not stipulate grievousness of the condition. There may be regrowth of hair but in some cases, hair may again fall out in future and this cycle keeps on repeating. People may also suffer from itching or burning sensations. Around 14% of people suffering from alopecia might experience itching. Evident changes in fingernails and toenails may sometimes indicate an early stage of alopecia. The changes in fingernails and toenails can be in the form of white spots, rough texture, loss of shine and thinning of nails. Breaking of hair even before reaching the skin surface and growth of white hair in place of hair loss are also some signs that indicate alopecia. Generally, doctors can easily diagnose alopecia from the above-mentioned symptoms but sometimes if doctors fail to do so then they go for a skin biopsy or a blood test.

Alopecia is a disease which affects age group from 12 to 40 years where the hair from all over the body- partially or fully starts falling off in a clear circular area even from the eyebrows and eyelashes. The hair can grow back but eventually does not stay overtime. It is a chronic dermatological disorder which causes no pain neither it is life threatening but it can cause some irritation on the skin.

The loss of hair on the body- eyebrows and eyelashes leads to identity problems as these features help to identify a person’s face. Especially for women where hair serves as a symbol of femininity, sexuality, attractiveness, and personality, it’s noted that maximum women face career problems and the rest marital problems due to alopecia. This in turn causes psychological damage like intense emotional sufferings and leads to personal, social and work-related problems.

It is noted that psychiatric disorder is mainly seen in people suffering from alopecia compared to common people as they are at a higher risk of experiencing serious depressive episodes, anxiety disorder, paranoid disorder and/or social phobia. Some of them go through a continuous feeling of loss, lower self-esteem or inferior complexity, poorer quality of life and poorer body image. The patients affected are mainly worried, depressed, hysteric, and experience conflicts in daily interaction with other people.

Suicidal tendencies are high in these people. According to psychological research, the most important change that leads to mental illnesses in skin disorder is deformation.
Stressful life events are directly responsible for the cause of alopecia and then again the horror of the disease causes further distress. Alopecia is also termed as a disfiguring disorder as it leads to issues of self and identity. The patient goes through unacceptable body image in the society which creates a space of loneliness and frustrations as he/she feels different from the crowd. Today, treatments are improved as we see cancer patients with alopecia as the side effects of chemotherapy, leading a happy life. It is surveyed that single people have more severe anxiety problem with the loss of hair than the ones married.

There is no definite treatment of the psychological problems faced by the alopecia patients as it’s all on oneself how the individual cope up with it. Though several initiated groups of counselors are taking up the opportunity to talk to them about their problems no major effects have been concluded on their effort. Dealing with psychological matters of alopecia should be handled very carefully. One should be strong enough to accept the fact that no medical treatment can cure them as most of them are ineffective. Family and friends play a major role in making them feel better about their situation. Some patients try to manage their condition with camouflage techniques such as a hairpiece or a wig which reduces the anxiety about self-image.

Depressions can be helped. Doctors and patients should understand that there is more psychological harm involved in alopecia than the positive effects of medical treatment. The patient should be fully informed about his conditions and the psychological changes that he will go through eventually. Change in the identity of a person due to hair loss is ought to bring frustrations and mental distress which cannot be mended but can be brought under control with the cooperation and coordination of close and near people within whom the patient can confide in. a positive approach towards life should be cultivated within the patient. Nevertheless, psychologists have largely neglected the psychological effects of alopecia which included limited research and surveys on the matter.

Hence, to conclude, alopecia is a condition wherein people might experience hair loss. Scalp, eyebrow and eyelash hair may fall out if one suffers from alopecia. There are various causes of alopecia like thyroid, asthma, autoimmune diseases, etc. Certain symptoms also point out that one may be suffering from alopecia and one such symptom is hair loss in patches. There are various treatments that help to solve the problem of alopecia. People suffering from alopecia should ensure that they should not suffer from psychological problems easily. Women should be brave enough to fight this problem and come out in society even though they suffer from Alopecia. Besides work life, marital life of women is also affected.

References:  

Also Read:

• Alopecia Areata (AA): Causes, Patterns, Investigations, Treatment
• Can Alopecia Be Treated Naturally
• Is Alopecia Areata Permanent?