What I Wish I Knew About Alopecia's Impact on Mental Health

Alopecia treatment often focuses on regrowing hair, but there are mental health effects that should be addressed too.

Alison Mann smiles, wearing a black outfit with her hand on her bald head.

Photo Courtesy of Alison Mann

Bald is a word I have been reluctant to use to describe myself for many years, but the reality is I have been fully bald since I was 6 years old. A couple years prior to being completely bald, my hair went through a battle of falling out and coming back, which is a very familiar experience of people diagnosed with alopecia areata, a form of alopecia that impacts hair follicles in a way that causes baldness. 

At the time I was diagnosed, healthcare providers suggested all sorts of treatments, such as topical steroids, steroid injections, and essential oils. You name it, I tried it. However, the one thing that a doctor never suggested to me was to seek mental health support or to find a community of others who were experiencing hair loss

As I reflect on my journey, the message I was given as a little girl is extremely clear to me: hair loss is something that we must fix; it is not something that we can just accept.

But alopecia is an autoimmune disorder that does not impact me beyond hair loss—I have always been in good health ever since my diagnosis. So why was the focus of all solutions solely on growing my hair back when I could live a perfectly healthy life bald?

This is a thought that I grappled with more and more as I got older and realized how isolating the experience of hair loss was for me. I tried a ton of suggested treatments. When none of the treatments worked, I was left to navigate the implications of growing up as a bald woman on my own. 

Now that I have had more than 18 years to process the experience of my hair loss journey, there are two things in particular that have become very apparent to me and that I wish I had known earlier in my journey. 

The first is the lack of acknowledgement of the mental health impacts of hair loss. I have felt as though society often brushes off hair as “just hair.” But this is the same society that also seems to perpetuate mass stigma and shame toward hair loss. All the evil villains we see played as bald characters in shows or movies. All the hair loss advertisements that equate hair loss with being less attractive. Not to mention the lack of representation of bald women anywhere.  

Editor’s Note: Research has found that hair loss can lead to sadness, depression, and anxiety among people with alopecia areata. People with the condition also report that the hair loss has a considerable impact on their relationships and lifestyle. For example, to hide their hair loss, people with alopecia areata might avoid everyday activities.

The second thing I wish I had known sooner is that people with alopecia are rarely given the materials or support needed to begin navigating a world filled with unrealistic beauty standards.

We become stripped of something that is such a big part of our identity and are left with nothing but an unwelcoming society ready to jump at the opportunity to make a degrading bald joke. This is why “bald” is a word I had been so reluctant to describe myself as for many years. And if I am being honest, it is still something I struggle with being called at times. 

The process of undoing all the negative messages we have received about baldness is never-ending and exhausting. And it’s an exhaustion for which no one prepares you. 

If there is a connection between mental health and hair loss, why was I only directed toward unreliable treatments for hair growth but never toward solutions that are reliable, such as community or mental health support?

Not being told about the association between mental health and hair loss or about how to successfully face a society with beauty standards I no longer fit were my main influences in becoming a therapist. These influences also inspired me to create the Hair Loss Diary, a mindfulness journal with prompts and exercises for people with hair loss.

I’ve had firsthand experience that the only reliable way to manage my alopecia that has worked for me was increased self-compassion and self-acceptance. These two things may sound simple, but they are not easy to achieve. That is why I believe mental health care for those with hair loss can be crucial in someone’s journey. Having professional guidance on self-compassion and self-acceptance from someone who knows the nuances of your lived experience is invaluable. 

I also believe finding people within the hair loss community is another huge component of healing which is often also not discussed during an alopecia diagnosis. Based on my journey, I found that the treatment focus is only on how to get ourselves out of the community rather than lean into it.

To be clear, I am thrilled about the increasing medical treatment options for alopecia. The more options the better. But different types of options are exactly what we need. And I wish I had known that one option is embracing the bald. I also wish I had known about the mental health needs that come along with losing your hair. 

Living with alopecia has so many unknowns, but one thing I have learned for certain is that I am not alone in it, and having a support system to navigate the journey has made all the difference.

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  1. National Library of Medicine: MedlinePlus. Alopecia areata.

  2. Aldhouse NVJ, Kitchen H, Knight S, et al. “‘You lose your hair, what’s the big deal?’ I was so embarrassed, I was so self-conscious, I was so depressed:” a qualitative interview study to understand the psychosocial burden of alopecia areataJ Patient Rep Outcomes. 2020;4(1):76. doi:10.1186/s41687-020-00240-7

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