Stephanie Yuen was just your average teenager trying to make it through middle school — when she was diagnosed with alopecia at age 13. Terrified and unsure where to turn for help, she quickly withdrew from the world.
“I still went to school, but I locked myself in my room every day,” Yuen said. “I put a towel over my mirror to hide my reflection.”
Yuen struggled with low self-esteem but didn’t feel like she could talk to anyone about it. “Mental health was not a topic that was fondly talked about, especially growing up in an Asian
household,” she said. “Therapy could have ruined our ‘reputation.’”
Now an adult and a nursing student at Rutgers, Yuen has grown to accept her condition — and herself. But she still faces occasional challenges to her mental well-being. “It has been a series of ups and downs,” she said.
More than half of women will deal with noticeable hair loss (alopecia) at some point during their lives. One of the most common forms, alopecia areata, is an autoimmune disease that occurs when the immune system attacks hair follicles.
The effects of alopecia often go far beyond hair loss, impacting a person’s mental and physical well-being. Understanding these effects may help you learn how to cope with them.
Hair loss raises risk of mental health issues
The first stage of processing an alopecia diagnosis is often denial, said Mina Guirguis, M.D., a clinical psychologist at the Emotional Wellness Center for Skin Disorders in California. “Many women will go from one dermatologist to another, hoping that their diagnosis was a mistake,” Guirguis said. After the denial stage, more mental health challenges may follow.
“Many will also experience periods of anger and frustration, and might become depressed,” Guirguis said.
Rates of psychiatric disorders such as anxiety and depression are two to three times higher among people with alopecia areata than in the general population, according to a recent review of nearly 40 scientific studies. And more than 1 in 3 patients showed warning signs that could develop into disorders.
The emotional distress caused by hair loss can also affect relationships with family and friends. People may try to hide their alopecia from others, or hold back on sharing their condition with potential partners until they reach a certain level of closeness.
“Many will wonder how others will view them — will they be accepted by others? Many will make assumptions that others will reject them because of their alopecia,” Guirguis said.
“The first year or two after receiving my diagnosis, all I wanted to do was to avoid the world,” Yuen said.
Hair loss affects professional life
Hair loss can also have a major impact on your professional life. In one study, researchers followed more than 5,000 adults with a new diagnosis of alopecia areata for two years. They found that people with alopecia were 56% more likely to take time off work and 82% more likely to be unemployed compared to those without the disorder.
Working with patients as a nursing student, Yuen is constantly dealing with other people’s assumptions about her hair loss. “I constantly have patients ask me if I have cancer,” Yuen said. “I always try to use these moments as opportunities to educate others.”
Physical side effects of hair loss
Hair loss can affect physical well-being, too. It can lead to problems with temperature control and exposure to the elements. And people with alopecia areata are more prone to a wide range of diseases and disorders that cause physical symptoms, including thyroid disease and lupus.
One review that used information from the National Alopecia Areata Registry found that nearly 1 in 5 people with alopecia areata also have at least one other autoimmune condition. This means women with alopecia are often dealing with multiple conditions, many of which cause painful and hard-to-treat symptoms.
Stress of hair loss hits some cultures harder
In many cultures, hair represents youth, strength, health and beauty. Throughout history and around the world, hairstyles have been associated with religious background, social status, sexuality, politics and more.
When your community places a lot of value on hair, losing yours can be especially difficult. The history and politics surrounding Black hair, for example, mean hair is closely linked to heritage and identity.
But almost half of Black women deal with hair loss at some point in their lives. And finding a healthcare provider who can help may be challenging — one study found only about 3 in 10 Black women who saw a doctor about hair issues felt their doctor understood Black hair.
Across cultures, stigma surrounding hair loss can be deeply traumatizing for women. “How I show up in the world as a bald Black woman is disruptive for many people,” Congressperson Ayanna Pressley told the Washington Post in 2022. “It challenges conventional and societal norms of what is professional, of what is pretty, what is feminine, what is acceptable … some days are harder than others. … I have freed myself of the secret, but I have not freed myself from the shame.”
“When you look at social media or TV programing, [there are always a lot of] hair commercials where you see women with full and long hair in the advertisement,” Guirguis said. He added that women with alopecia who feel they don’t fit cultural expectations of how they should look may experience significant psychological difficulties and emotional trauma as a result.
“Hair is put on such a high pedestal in our society, and it sucks,” Yuen said.
Connection helps women cope
Coping with the impact of hair loss on your emotional and physical well-being can be a challenge — but it doesn’t have to be lonely. “Talk with someone. Reach out. It’s hard to go through it alone,” Yuen said.”There are so many women experiencing alopecia. They can offer words of wisdom, words of comfort, or just be that person to lean on.”
There are many resources available to help you process what you’re going through, and to connect you with others who share your experience. The National Alopecia Areata Foundation (NAAF) provides information about support groups and peer mentors, as well as general mental health resources.
Yuen also encourages women with alopecia to work on loving themselves as they are. She said that when she was first diagnosed, she only wanted to change herself to be like everybody else. These days, she has a different attitude.
“I’m beautiful with or without hair and if someone cannot see that, they are not worth my time.”
This resource was created with support from Eli Lilly.