When it comes to hair loss, many docs overlook this critical factor
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Hair loss in men and women negatively impacts the psychological aspect of our humanity.
—Ken Williams Jr., DO, surgeon and founder of Orange County Hair Restoration
Screening for anxiety, depression, and body dysmorphic disorder at baseline improves treatment outcomes.
—Adam Friedman, MD, professor and chair of dermatology at George Washington University
When a patient presents with hair loss, addressing the physical condition is just one aspect of care. For many dermatologists, a patient's psychological care is also critical.
"Hair loss can profoundly affect self-image, intimacy, work performance, and social engagement," says Adam Friedman, MD, professor and chair of dermatology at George Washington University. "Depression, anxiety, and body dysmorphic disorder occur at higher rates in this population."
For patients with scarring alopecia, there’s also a grief element, knowing the loss is permanent without surgery, according to Dr. Friedman.
The link between dermatology and psychology
On the face of it, psychology and dermatology may seem to be distinct fields of medicine, but Dr. Friedman argues the two have an intrinsic link.
The two specialities always been inseparable in cases where appearance impacts mental health, he explains. Screening for anxiety, depression, and body dysmorphic disorder at baseline improves treatment outcomes.
“Collaborating with mental health professionals, through very warm handoffs or integrated clinics, ensures patients receive both the physical and emotional care they need," Dr. Friedman says.
Androgenetic alopecia is one common cause of hair loss for both sexes. It may also be referred to as male pattern baldness or female pattern hair loss. []
It impacts roughly 50 million men and 30 million women in the US. More than half of men ages 50 and older have some hair loss. For women, hair loss is most likely to occur following menopause. []
Related: Lots of women experience hair loss, but one linked it to this unexpected healthy habitThe emotional toll of hair loss
Experts say the experience of losing hair can have a significant impact on self-esteem.
“Hair loss in men and women negatively impacts the psychological aspect of our humanity,” says Ken Williams, Jr., DO, FISHRS, ABHRS, surgeon and founder of Orange County Hair Restoration in Irvine, CA. “I have seen both men and women who have lost their confidence because of their hair loss. Some patients even become depressed and suicidal.”
Social media and marketing has a potential for a negative effect upon the culture and psychological well-being of patients, according to Dr. Williams.
"A well-trained physician will understand the balance between mental health and physical health," he says. "Doctors who understand how patients internalize their physical problems will be better situated to treat their patients.”
Related: Hair loss supplements that actually workWhat can dermatologists do?
While some patients may benefit from seeing a psychologist when dealing with hair loss, experts say dermatologists also have a significant role to play in addressing the psychological impact of hair loss in patients.
"Psychological impacts of dermatologic diseases have always been a big part of our field," says Carolyn Goh, MD, FAAD, associate clinical professor in dermatology at UCLA. “As dermatologists, we hope that our dermatologic treatments help patients feel better about themselves, but psychological disorders can impact how we look at ourselves and how we can handle changes to our health and our appearance. It is a really good thing for this to be better recognized.”
Engaging in empathic communication and offering appropriate therapies are some of the strategies physicians can use to best support the physical and mental health of patients with hair loss, according to Dr. Friedman.
“Validate their feelings, acknowledge the disruption to their life, and offer quick wins like camouflage products, hairstyling strategies, or micropigmentation referrals," he says. "Start evidence-based treatment right away. Schedule close follow-ups but explain why—you want the patient to feel supported during the slow hair regrowth process, but be clear it is slow."
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