Hair loss is more than a physical phenomenon. It is a psychological journey that more than 80 million Americans must navigate on a daily basis. Despite the prevalence of hair loss, its emotional toll often goes unrecognized, pushed into the shadows by a society that demands we keep up appearances both physically and emotionally. However, beneath the surface lies a complex interplay of emotions, from grief and fear to anger and hope.
Hair is Everything: The Significance of Hair
Hair loss wields tremendous power over us because hair itself holds tremendous power in our world. As one of the main physical features that people notice about others, hair is intricately tied to notions of beauty and attractiveness. Watch an episode of any TV makeover show. More often than not, the person being made over will receive a fresh haircut. This is because both cosmetologists and TV producers understand that hair can significantly impact the perception of facial features. The right hairstyle can draw attention to your eyes or your cheekbones by framing them in an alluring way. Well-styled hair can also contribute to facial symmetry, which is often associated with greater attractiveness.
Beyond what it does for our physical appearance, hair also communicates messages about who and where we are in life. Changes in hairstyle often coincide with significant life transitions or milestones. Whether it's cutting off long locks after a breakup as a symbol of renewal and independence, or embracing gray hair as a celebration of aging and wisdom, hairstyles can mark important moments in one's life journey. The choices we make with our hair can also reveal different aspects of our personality, lifestyle, and identity. For example, a sleek bun might convey an air of professionalism and sophistication, while tousled waves might suggest a more carefree and relaxed attitude.
Strong, lustrous hair may symbolize physical health and vitality, while dull, brittle hair may be associated with illness or neglect.
An Overview of Hair Loss
Due to the various meanings and associations tied to hair, hair loss has enormous psychosocial ramifications. At its core, however, hair loss is just a sign that the hair growth cycle is not working as it should.
Losing hair is a natural part of the hair growth cycle. In order for new hair to grow in, old hair has to fall out. On average, we lose between 50 to 100 strands of hair per day. Sometimes, however, the cycle doesn’t function properly, and hair falls out faster than it can be replaced. This is when normal hair loss transitions into abnormal hair loss. Hair loss can manifest in many different ways, but these are the most common forms of hair loss:
- Androgenetic alopecia: Also known as male-pattern or female-pattern baldness, androgenetic alopecia is the most common cause of hair loss in the United States. Androgenetic alopecia is characterized by
- Alopecia areata: Alopecia areata is an autoimmune condition that causes hair to fall out in patches. Alopecia areata, or AA, prevents hair from growing by attacking the hair follicles.
- Telogen effluvium: Telogen effluvium is a form of temporary hair loss characterized by excessive shedding of hair during the resting phase of the hair growth cycle. It can be triggered by physical or emotional stress, hormonal changes, medications, or nutritional deficiencies. Telogen effluvium usually resolves on its own once the underlying cause is addressed.
- Anagen effluvium: Anagen effluvium is a type of hair loss that occurs during the growing phase of the hair growth cycle. It is triggered by medical treatments like chemotherapy and radiation therapy. Anagen effluvium typically results in sudden and extensive hair loss, including the loss of eyebrows, eyelashes, and body hair.
Understanding the basic ins and outs of hair loss is essential for effective management and treatment. Hair loss has many sources, but the most significant contributors are genetics, hormones, and stress.
Genetics
- As mentioned above, androgenetic alopecia is the most common cause of hair loss, and it is attributed largely to genetics. Men who are genetically predisposed to androgenetic alopecia will typically start to lose their hair in their 30s, though hair loss can start as early as the teen years. Genetically predisposed women will start to see their hair thin out in their 40s.
Hormones
- Fluctuations or imbalances in hormones can disrupt the hair growth cycle, leading to temporary or permanent hair loss. For example, many women experience hair loss both during and after pregnancy.
Stress and trauma
- Physical and psychological stress can trigger hair loss. Hair loss is a common side effect of many medications and treatments. For example, chemotherapy and radiation therapy are known for triggering anagen effluvium.
By familiarizing yourself with the types and causes of hair loss, you can take proactive steps to preserve hair health and mitigate the psychological impact of hair loss.
The Psychological Toll of Hair Loss
When shiny, voluminous hair is the norm, anything less than that can feel like a personal failing. For many of us, the onset of hair loss can trigger a cascade of negative emotions, ranging from sadness and frustration to profound grief and despair. It is therefore not surprising that feelings of depression, anxiety, and diminished self-worth often accompany hair loss.
Depression
Hair loss can be a deeply distressing experience for many individuals. As individuals struggle to cope with the changes in their appearance, they may find themselves overwhelmed by feelings of sadness, anger, and hopelessness. Trying to reconcile the changes in their appearance with societal beauty standards can exacerbate these feelings, leading to a pervasive sense of hopelessness and worthlessness, and despair. This was the case for Lauren Robbins, a woman who was diagnosed with androgenetic alopecia in 2021. In an interview with Dove, Robbins said, “I felt hopeless, lost, and depressed, and went into a really dark place mentally, crying for days.”
Body Image and Sense of Self
Because hair is a symbol of beauty and vitality, losing it can evoke intense feelings of shame and inadequacy. For many people, hair loss erodes their self-image, which in turn prompts them to engage in negative self-talk and self-criticism. Over time, this criticism creates a distorted view of the self. In severe cases, these cognitive distortions can manifest into Body Dysmorphic Disorder. Known as BDD, Body Dysmorphic Disorder is a mental health condition characterized by an obsessive preoccupation with perceived flaws in one’s physical appearance.
Social Withdrawal and Isolation
The highly visible nature of hair loss means it can easily draw unwanted attention and scrutiny from others. Perceived judgment can stir up feelings of anxiety and shame, causing individuals to limit social interactions and avoid public settings. This was the case for Drew Greenwell, who, like Robbins, spoke with Dove about her struggles with hair loss. She said, “I had thick, luxurious curly hair and I felt very lost without it. I turned down work opportunities that required large social interactions, withdrew from friends and family and stopped being as present at my kids’ school functions.”
By instilling a fear of judgment and rejection from others, hair loss pushes individuals to isolate themselves as they attempt to conceal or cope with their hair loss. This isolation, in turn, damages relationships, career opportunities, and overall quality of life.
Gendered Differences in Psychological Effects of Hair Loss
Gender plays a significant role in shaping the psychosocial effects of hair loss. While both men and women may experience feelings of depression and low self-esteem due to hair loss, women often face greater pressure to “do something” about it due to the premium placed on their physical appearance. This pressure to keep up appearances is one reason why women experiencing hair loss exhibit higher levels of social anxiety, social avoidance, and depression than men.
Men also experience a sense of loss over their changing appearance, but they do not face as much pressure to keep up appearances. Furthermore, societal norms surrounding masculinity provide them with more avenues for coping. For example, many men choose to shave their head once they see their hair starting to thin or recede. Though embracing baldness is an option available to women as well, it is not as socially acceptable for women to do so.
That is not to say that men do not experience emotional distress from losing their hair. On the contrary, hair loss has been shown to have a significant impact on men’s sense of their own worth, attractiveness, and masculinity. The loss of facial hair, in particular, causes great emotional distress as many men see it as a sign of declining strength and virility.
Treatment and Coping Strategies
Hair loss can be so discouraging and debilitating that you may not want to seek treatment, but Dr. Shari Lusskin encourages those struggling with hair loss to be proactive as it is an issue “you can quickly and easily do something about.” Lauren Howard, a clinical social worker and psychotherapist who specializes in women’s mental health issues, adds, “If you are concerned about your appearance, don’t feel shallow about it, or ashamed of it; give yourself permission to care and to feel bad about your hair loss, then get a handle on the situation and do something about it.”
By seeking professional counseling and therapy or exploring medical interventions and self-care practices, individuals are empowered to reclaim agency over their mental well-being.
Therapy and Support Groups
While therapy cannot reverse hair loss, it can provide vital support to those struggling with feelings of depression and anxiety as a result of their condition. Therapists can help individuals grapple with the complicated feelings that come with hair loss by offering new perspectives and challenging cognitive distortions. Studies have found that therapy can be quite effective in treating depression, especially when used in conjunction with other treatments like medication.
Support groups are another great resource. Many people who experience hair loss struggle to carry the weight of their hair loss by themselves. Support groups can provide a safe space to talk about the psychological nuances of losing hair with people experiencing similar symptoms and emotions.
Medical Interventions
Medications like minoxidil and finasteride have been effective in treating certain forms of hair loss. Minoxidil is a medication that was originally developed to treat high blood pressure. Today it is commonly used as a topical medication for hair loss. Minoxidil works by widening blood vessels, which improves blood flow to the hair follicles. While it has been found to promote hair growth , minoxidil comes with several adverse side effects, including scalp irritation, unwanted hair growth, and dizziness.
Finasteride is a medication primarily used to treat androgenetic alopecia in men. Finasteride works by inhibiting the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT). DHT is a hormone that contributes to hair loss by shrinking hair follicles over time. By blocking the conversion of testosterone to DHT, finasteride helps to slow down the progression of hair loss and promotes hair regrowth in some individuals. However, finasteride has also been found to cause significant side effects like depression and anxiety, allergic reactions, and sexual dysfunction.
Some less common medical interventions include hair transplants and PRP therapy. Platelet-rich plasma therapy, or PRP, is a medical treatment in which blood is drawn, spun in a centrifuge, and reinjected into an injured part of the body. The sample that is reinjected contains a high concentration of platelets, which contain growth factors that can trigger cell reproduction and stimulate tissue regeneration. Commonly used to treat injured ligaments and tendons, PRP therapy is also used to treat hair loss.
If you are interested in pursuing any of these interventions, reach out to your healthcare provider for a consultation. Talk with your doctor to ensure that the treatment you choose is safe and appropriate for you.
Lifestyle Choices as Acts of Self-Care
It's important to explore a multitude of strategies that resonate personally when it comes to addressing hair loss. Experimenting with wigs, hair extensions, and hair pieces is a quick and easy way to bolster confidence for those who are able and willing to invest in them. In one study, individuals experiencing hair loss reported that using hair pieces encouraged them to go out more by alleviating some of their social anxiety.
Taking supplements is another good way to boost confidence and exercise self-care, especially for individuals who would prefer to avoid intensive treatments or medication side effects. Designed to provide targeted support for specific health goals, supplements can help you help yourself in a simple, gentle, and natural way. Bomme’s Root Renewal Supplements, for example, encourage healthy hair growth through the antioxidant and anti-inflammatory powers of persimmon leaf, green tea, and sophora fruit extract. Protect and nourish your body by taking a supplement.
Engaging in activities that bring joy and fulfillment, such as painting, gardening, reading, or listening to music, can provide a much-needed distraction from overwhelming thoughts and cultivate a sense of purpose and enjoyment. By incorporating these self-care habits into daily life, individuals can enhance their confidence, resilience, and overall well-being while navigating the psychological effects of hair loss.
Closing Thoughts
By fostering greater awareness and understanding of the psychological dimensions of hair loss, we pave the way for a more compassionate and inclusive society, where individuals are supported and celebrated for their inherent worth and beauty, regardless of external appearances. While you may not be able to control the fact that you're losing your hair, there are things you can control, such as how you choose to respond to it. Focus on being kind to yourself by eating healthily, reaching out for support, and practicing self-care activities that make you feel good.
