Losing Control: The Psychological Impact of Hair Loss

A recent study by Wolfgang Harth and Ulrike Blume-Peytavi titled, “Psychotrichology: psychosomatic aspects of hair diseases,” is getting considerable attention and it is well deserved. The study examines the psychological effects of hair loss, recognizing that losing one’s hair not only influences an individual’s appearance but also can often lead to an enormous emotional burden with low self-confidence, impaired quality of life and even psychological disorders.

Of course, social and cultural factors are crucial to determining psychological impacts. Hart and Blume-Peytavi point out that feelings about hair change over time, are subject to trends in fashion and depend on individual style.

“For centuries the hair has been considered a symbol of fertility as well as the seat of mental, physical, and sexual life force. Wild hair is often interpreted as representing raw and untamed behavior, while short hair is considered a sign of sophistication and signals a willingness to live by the rules of civilization.

“As a sexual symbol, letting the hair down is considered a seduction ritual, often also interpreted as a symbol of uninhibited sexuality. Cutting the hair off is often understood as a symbol of submission or humiliation. Or, as is the case with skinheads, it may be used to represent fearlessness and dangerousness; the shaved head is intended to show that a person has nothing more to lose or is invincible.”

As described by the study, approximately four out of five men deal with hair loss over the course of their lifetime as a result of aging, genetics and androgens. Hart and Blume-Peytavi say there is no question that this “physiological aging process” impairs one's quality of life.

As many of my patients can tell you, hair loss can make a man appear older, which is why many men wish to fight it.

Another 2009 study out of Old Dominion University, “Attitudes, behaviors, and expectations of men seeking medical treatment for male pattern hair loss: results of a multinational survey,” found that three out of four men between age of 25 and 49 were concerned, very concerned, or extremely concerned about their hair loss. It also determined that 84 percent of those men take measures to prevent their hair loss.

A 1992 study from Old Dominion University, “The psychological effects of androgenetic alopecia in men,” found that especially at younger ages hair loss is associated with a feeling of being unattractive, lower self-esteem, increased introversion, higher rates of depression and more marked neuroticism compared with control groups.

Ultimately these negative feelings about one’s appearance sometimes lead to very serious problems, including depressive disorders, anxiety disorders, disorders affecting social behavior, somatoform disorders, obsessive-compulsive disorders, and body dysmorphic disorders. In many cases, patients feel they are not in control and that feeling compounds their feelings of helplessness.

Hart and Blume-Peytavi are correct that much of this depends of social and cultural norms. The good news is that attitudes and behaviors related to hair transplants appear to be slowly changing. When older techniques were used and hair transplants lacked the natural undetectable results, there was a stigma attached to the procedure. However, as with cosmetic surgery in general, there is greater acceptance of surgical hair transplants as a way to restore a patient’s natural hair, and modern techniques are undetectable.

Medical and surgical hair loss treatments can put the patient back in control and restore their confidence.

Many thanks and congratulations to Harth and Blume-Peytavi for continuing to advance our profession’s collective understanding of the side effects of hair loss. With this knowledge, those of us involved in hair restoration can better serve our patients.

Harth is with the Department of Dermatology and Allergology at Vivantes Clinic Berlin-Spandau in Berlin, Germany. Blume-Peytavi is with the Department of Dermatology, Venereology, and Allergology at CharitÈ Universitätsmedizin in Berlin, Germany.