If you’re starting to notice more hair in your hairbrush, sink or shower drain, you’re not alone. Men can begin losing hair as young as 21, and by the age of 35, roughly 66 percent of American men will experience some hair loss. By the time men reach 50, about 85 percent will see noticeable hair loss. Many of us mistakenly believe only men experience visible hair loss, but women also experience it. By the age of 40, about 40 percent of women will have noticeable hair loss. With so much attention and treatment options geared toward men, women who experience hair loss tend to suffer more emotional trauma than men. Hair is frequently associated with youth, attractiveness and vitality in our society, so when we notice thinner hair or bald patches, we can feel anxious and depressed. The American Hair Loss Association is just one of many organizations that recognize hair loss is more than a physical concern. In this post, we’re going to delve into the psychological effects of hair loss — and what you can do about it.
Most Common Reason for Hair Loss
We lose hair for a variety of reasons — some cause permanent hair loss, whereas others are temporary. The most common reason for permanent hair loss is a condition called androgenetic alopecia (AGA), which affects both men and women. AGA, aka male or female pattern baldness, has a strong hereditary component, meaning that you’re far more likely to experience AGA if either or both of your biological parents experienced pattern baldness. You might have heard that men inherit their thinning hair from their maternal grandfather. While there is a well-known gene related to hair loss on the X chromosome (the “female” chromosome), recent research has found that AGA has multiple genetic components not located on gender-specific (aka sex) chromosomes. These other variants predict AGA development better than the variants on the sex chromosomes.
AGA occurs when hair follicles (tiny capsules under the skin that grow hair strands) are sensitive to an element called dihydrotestosterone (DHT), a derivative or byproduct of testosterone. Our hair follicles have receptors that respond to hormones and substances in our blood. Each hair follicle contains an oil, aka sebaceous gland, which helps keep the scalp and hair moisturized and healthy. The enzyme type II 5-alpha reductase lies in the oil gland and helps convert testosterone into DHT.
Men’s bodies contain more testosterone than women, but women’s bodies contain a little. Researchers believe the level of testosterone doesn’t directly impact hair loss — those of us who develop AGA have hair follicle receptors that bind to DHT at higher levels than those who do not. DHT causes our hair follicles to shrink, so they can no longer grow thick, healthy strands of hair. Eventually, they shrink to the point that they can no longer produce any hair. Hair falls out regularly as part of its growth pattern, but once hair has fallen out of an inactive follicle, it does not grow back. We can have elevated levels of DHT without losing our hair — in this scenario, our follicles aren’t binding to DHT at excessive rates.
The hair pattern loss is different in men and women. Men tend to experience receding hairlines, leaving them with an “M” shaped forehead, or along the top or crown of the head. Women tend to lose hair along the part and often in a diffused pattern all over the head, leaving them with thinner hair all over. Hair loss treatment specialists use different scales to classify the degree of hair loss in men and women.
AGA leads to permanent hair loss, but if you begin treatment before you lose a lot of hair, you can regrow some of your lost hair. Regular use of an FDA-approved treatment containing the drug Minoxidil helps people regrow lost hair. When used early in the hair loss cycle, Minoxidil helps stimulate and prolong the growth cycle of hair follicles. The FDA has approved an oral drug called Finasteride, which aids in preventing DHT from binding to hair follicles. Only men can take Finasteride —and it can cause unpleasant side effects, including impotence, low libido and erectile dysfunction. Some patients continue to experience these side effects even after stopping the medication. If you’re wary of Finasteride or you’re female, you can use shampoos and treatments that contain plant derivatives such as saw palmetto extract, which has shown effectiveness in blocking DHT.
Check out ScalpMED’s line of shampoos, conditioners and supplements that contain saw palmetto and other nutrients that reduce hair loss and promote growth.
Other Reasons for Hair Loss
We can lose our hair temporarily for a multitude of reasons. Medications, fungal infections, autoimmune disorders such as HIV, emotional or physical trauma, pregnancy, surgery, nutritional deficiencies, birth control pills and other hormonal changes, illnesses, diabetes, some cancers, lupus, thyroid disorders, kidney and liver disease, syphilis, smoking, chemotherapy and radiation treatments, tight hairstyles and psychiatric disorders can all cause our hair to fall out. A common autoimmune disorder called alopecia areata occurs when our immune system attacks the hair follicles, rendering them unable to grow healthy hair strands. Depending on the triggering event, hair loss can be gradual, occurring over several months or even years. Learn more about why we lose our hair in our post, Six Steps to Combat Hair Loss.
Or, hair loss can be sudden, causing as much as 90 percent of our hair to fall out within six weeks to three months after the triggering event. Hair growth occurs in three phases, an active, resting and a shedding stage. Typically, about 80 to 90 percent of our hair follicles are in the active phase. With sudden hair loss, aka telogen alopecia, an abnormal number of hair follicles shifts into the shedding phase. Experiencing extensive and sudden hair loss on top of a physically or emotionally stressful event can feel like a double whammy. The good news is that often, once the illness or triggering event has passed, our hair can grow back. As with AGA, patented, FDA-approved topical treatments can promote regrowth in many of these situations.
Non-AGA permanent hair loss is less common, but burns, infections and physical injuries to hair follicles cause permanent hair loss. Once a follicle is damaged, hair can’t grow. Hair transplant surgeries can help people who have suffered permanent hair loss, either from AGA or from trauma.
How Hair Loss Affects Our Mental Health
Regardless of the reason for our hair loss, it can be devastating, especially if we’re in our younger adult years. Some of us assume we can’t do anything to combat AGA and our hair loss is inevitable, which can make us feel powerless. Or we spend hundreds or thousands of dollars on expensive treatments, only to be disappointed with the results. Whether we choose to treat our hair loss or unhappily accept it, many of us feel psychological distress.
Hair Loss Affects Our Appearance & Sense of Well-Being
If we’re experiencing hair loss due to AGA, we fear it makes us look older, less attractive or unhealthy. The higher the amount of hair loss, the more likely we are to feel distressed. Our hair’s appearance is often intricately tied to how we think about ourselves, which affects our personal and professional relationships. Healthy, luxurious hair has been associated with power, sexuality and beauty since biblical times. If hair loss is sudden, this can be even more upsetting because sudden hair loss occurs after a stressful event. We may still be recovering from whatever physical or psychological event triggered the loss.
Hair Loss Can Impact Our Careers
Hair loss can also result in lost opportunities and income. If your thinning locks make you appear less confident, successful and persuasive, you may not perform as well in situations where you must speak publicly or present to clients, investors or superiors. Since baldness is associated with aging, subtle age discrimination can come into play too, meaning you may be skipped over for a promotion or a project.
Hair Loss Increases Risk of Psychiatric Disorders
Research has shown that those who experience hair loss have an increased prevalence of psychiatric disorders. Hair loss due to aging can signal the end of our youth, which can make us yearn for the past and fear the future. Several studies found that generalized anxiety disorder, major depression, social phobia and paranoid disorder occurred in significantly higher numbers than the general population in patients who were suffering from alopecia areata (hair loss autoimmune disorder).
- Generalized Anxiety Disorder: Symptoms include excessive, ongoing worry and tension, unrealistic view of problems, irritability, restlessness, muscle aches, headaches, difficulty concentrating and sweating.
- Depression (aka Major Depressive Disorder): Symptoms include feelings of hopelessness, sadness and emptiness, irritability, loss of interest in pleasurable activities, insomnia or sleeping too much, lack of energy, weight gain or loss, difficulty concentrating and suicidal thoughts.
- Social Phobia (aka Social Anxiety Disorder): The primary characteristic of social phobia is an intense fear of being judged, rejected or negatively evaluated in a social or performance setting. Sufferers avoid social situations — and when a situation is unavoidable, they experience significant stress and anxiety, which may be accompanied by sweating, nausea and rapid heartbeat.
- Paranoid Disorder: People suffering from paranoid disorder display a relentless mistrust and suspicion of others, and believe others are trying to threaten, harm or demean them even when there is no evidence.
How to Cope with Hair Loss
If you’re experiencing any of the severe symptoms above, you should see a doctor as soon as possible. Your hair loss may be tied to underlying health problems that are also contributing to your psychological distress. In the meantime, you can take some steps to try to cope with your hair loss.
Give Yourself to Permission to Care about Your Hair Loss
Hair loss can rob us our self-esteem, but it can also make us feel ashamed and guilty that we care so much about our appearance. We may also hesitate to seek help. Acknowledge that losing something that makes us feel young, sexy and attractive is no fun — and it’s OK to grieve the loss.
Put Hair Loss into Perspective
Hair loss isn’t life-threatening — and you are not your hair. Remind yourself of your other attributes and that your real friends and family won’t change their feelings about you. If your hair loss is temporary, put it into perspective in the overall span of your life. A few months or even a few years of thinning hair don’t define your life.
Cognitive-behavioral therapy (CBT) is a highly effective and lasting treatment for anxiety and depression. It helps patients identify, understand and change problematic thoughts and behavior patterns. CBT is just one of many options. This infographic from the Anxiety and Depression Association of America outlines different therapies, including mobile apps, “telemental” health, group therapy and one-on-one.
Try a Topical Treatment
If your hair loss isn’t due to permanent follicle damage, the right kind of topical treatments and supplements are often an easy first step to helping regrow lost hair. Look for ones that contain FDA-approved Minoxidil, which has been studied and proven to produce results for millions of people. Hair-thickening shampoos and treatments that contain ingredients such as saw palmetto can help block DHT from binding to hair follicles (remember, DHT is what causes follicles to shrink). You won’t see results right away, as it takes a few months for the new growth to be visible.
For men only, doctors can prescribe the oral drug, Finasteride, which is marketed under the names Proscar or Propecia, to limit DHT’s influence on hair follicles. The problem with Finasteride is its side effects — many patients report reduced sex drive and erectile dysfunction, among other unwelcome side effects.
Seek Help from a Hairstylist
Your hairstylist may be able to style your hair in ways that make it appear thicker. Shorter hair tends to look thicker than longer, and a light pomade can give hair lift. Don’t rule out wigs or hair extensions — wig technology has come a long way, and wigs and extensions can look very natural. Avoid growing the sides and back long and combing hair over your bald spot — you’ll only draw more attention to it and open yourself up to ridicule.
Embrace the Bald
Shaving our head is usually easier for men than women — but countless celebrity men such as Bruce Willis, Samuel L. Jackson, Vin Diesel, Dwayne Johnson, Sean Connery, numerous NBA stars and other athletes have been flaunting a shiny head for decades. After struggling with an unattractive “horseshoe” hair pattern, many men are pleasantly surprised to find that shaving their head or keeping their remaining hair very short looks far better. Many women undergoing chemotherapy opt to go bald or use beautiful headscarves until their hair grows back.
Revamp the Rest of Your Appearance
If you’re overweight, appear unhealthy or out of shape, this can also affect your self-esteem and how others perceive you. If you’re physically fit and healthy, you’ll naturally appear younger, more energetic and edgier even with a bald head — again, think about celebrities and athletes who embrace the bald. Updating your wardrobe can give you a fresher, more hip appearance too (just don’t go overboard or you’ll cause the opposite effect)!
Consider Scalp Micro-pigmentation (SMP)
Light reflecting off our bare scalp is what makes our thinning hair more noticeable. In SMP, a trained technician creates the illusion of fuller hair by injecting pigment into the scalp that resembles hair follicles. After numbing the treatment areas, SMP techs use electric micro-needles similar to what tattooists use, although the needles don’t penetrate as deeply. The technician creates tiny, layered dots in different dark hues across bald areas. SMP can hide scars, including ones from hair transplant surgery. Women can benefit from SMP too, even if they wear their hair long.
Each treatment takes four to five hours, and most patients need three or four treatments. The cost varies by how many treatments you need, but on average, expect to pay between $400 to $1,000 per treatment. The dots will fade over time as the skin cells turnover, but most treatments last seven to eight years.
Consider Surgical Treatments
Hair restoration or hair transplant surgeries are another, more costly and riskier option to treat permanent hair loss. Most hair transplant surgeries use one of two methods, follicular unit transplant (FUT) or follicular unit extraction (FUE). Sometimes doctors will use a combination of both. Both methods involve removing healthy hair follicles from one area of the scalp and embedding them into balding areas.
In FUT, a strip of hair-bearing scalp is removed, usually from the back or sides of the head where hair is still abundant. After stitching the wound closed, the doctor divides the strip into tiny sections called grafts. The doctor makes tiny holes or slits in the balding areas and then carefully embeds each graft. FUE is a similar procedure, but instead of removing a strip of scalp, the doctor removes hundreds or even thousands of individual healthy follicles from across a wide area. Although the recovery from the procedure only takes a few weeks, the transplanted hair falls out about a month later. New growth starts several weeks or months afterward — and it can take up to 12 months to see the full results.
Hair transplant surgery doesn’t come cheap — expect to pay between $4,000 and $25,000 in the U.S. and Europe, depending on the size of the area that requires treatment, geographic location and the reputation of the practice. Countries such as Turkey, Mexico and India have become hot spots for patients seeking lower-cost surgery, but the risks are often higher. Learn more about hair restoration surgery in our post, "Read This Before Having Hair Transplant Surgery".
The Takeaway on Dealing with Hair Loss
Hair loss affects us in different ways. Some of us can accept and make peace with our hair loss and opt to go bald (or close to it). Others chose treatment options that minimize hair loss and make hair appear thicker, like the full range of patented, FDA-approved ScalpMED® treatments. For some of us, we’ve either lost too much hair or we want more dramatic results, so we opt for scalp micro-pigmentation or hair restoration surgery.
Hair loss is a very personal experience, so don’t feel like you must choose the same treatments (or lack thereof) of your friends, family or others. If you decide to have a medical procedure, be sure to do your research before selecting a practitioner. Treating hair loss via medical procedures is a very lucrative industry for the practitioners — and unfortunately, unqualified or unscrupulous ones are waiting to take your money.