Living with alopecia areata (AA), an incurable, sometimes-lifelong form of hair loss, can bring about significant emotional distress.
“Alopecia areata can be absolutely devastating for patients and their loved ones,” says Brittany Craiglow, MD, a dermatologist at Dermatology Physicians of Connecticut and an associate adjunct professor at Yale School of Medicine in New Haven. “It’s important for those affected to understand that it is normal for hair loss to be very upsetting. It’s really not ‘just hair.’”
One of the best things you can do to take charge of your condition and its emotional effects is to follow the treatment plan that your dermatologist recommends for your specific case of alopecia areata. You can also try some other helpful strategies. We talked with experts about ways you can cope on a daily basis when managing this unpredictable autoimmune condition.
1. Try to Manage Stress
Experts say that many people with alopecia areata face ongoing stress, anxiety, and other mental health–related concerns.
“One’s appearance is a key factor in helping one maintain a positive self-image,” says Pareen Sehat, clinical director at Well Beings Counselling in Vancouver, British Columbia, Canada. “So, hair loss tends to shatter an individual’s confidence and self-esteem. They may not feel beautiful anymore,” says Sehat. This can take “a severe toll on their mental health” and contribute to depression risk, she adds.
Stress isn’t a direct cause of alopecia areata, but it may be considered a trigger. Many people who’ve had a recent onset of new symptoms have also had significant stress.
“Stress can happen at any age,” says Brooke Jackson, MD, a board-certified dermatologist and dermatologic surgeon in Durham, North Carolina. “I have had young children who develop AA triggered by life-changing events — a new school, a bully, a sibling at home, and parents’ divorce. Some of my adult patients have developed it due to stressors — good or bad.”
Some of the stressors that she has seen trigger AA in her adult patients include a death in the family, a family illness, making a major move, planning a wedding, and homeschooling children while working from home, just to name a few.
With AA, reducing stress might also help you manage cycles of hair loss and regrowth. To help manage stress while coping with alopecia areata, you can try the following tips recommended by Dr. Jackson:
Fit in daily exercise wherever you can, such as taking a quick walk during your lunch break.
Try relaxing activities during your day, such as yoga and meditation.
Work on good sleep hygiene by getting at least seven to eight hours of sleep per night. Give yourself time to wind down without the use of electronics or blue light–emitting devices, such as smartphones and tablets.
Learn how to say no to additional responsibilities that are not urgent or necessary.
Turn off notifications on your phone and other devices when you’re not working.
Jackson also recommends creating boundaries when you can. “No one, except an infant or a dependent child or parent, needs 24-hour access to you,” she says.
2. Consider Adopting an Anti-inflammatory Diet
“All disease processes are rooted in inflammation,” Jackson says. While there’s no such thing as an AA diet, she recommends eating fewer pro-inflammatory foods. If you’re interested in getting started with an anti-inflammatory diet, you can check out Forks Over Knives, a plant-based eating program that Jackson recommends. The program focuses on whole foods.
Other types of anti-inflammatory diets include the Mediterranean and DASH diets. These emphasize eating plenty of fruits and vegetables, as well as whole grains, lean protein, and plant-based oils.
Also, a review of dietary interventions for alopecia found possible increased hair growth in people who had both AA and celiac disease, and complemented their treatments with a gluten-free diet. No matter which eating plan you follow, try to get enough protein — it’s essential in promoting overall hair health, researchers also say.
Other things that could help include eating a balanced diet, avoiding restrictive or fad diets, and getting enough nutrients.These strategies won’t cure alopecia areata, but eating well can possibly prevent it from getting worse. And eating more nutritious foods could help you feel better overall.
What Are Potential Complications of Alopecia Areata?
Dermatologist Kristen Lo Sicco, MD, explains.
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3. Protect Your Skin From the Elements
As you work to manage stress and eat better with AA, it’s also important to protect any bare skin on your scalp and body from the sun. This may help minimize your risk of getting sunburns and skin cancer. You can help lower these risks by wearing sunglasses, a scarf, and a hat when outdoors. Be sure to put on sunscreen every day, too.
Also, if you’re losing hair in your ears or nose, you can protect these areas of skin by applying ointments, such as petroleum jelly or Aquaphor. This may help keep germs, dirt, and dust out.
It’s also important to protect your skin from the cold by wearing layers, a scarf, a hat, and earmuffs.
4. Experiment With Head Accessories
Headwear has plenty of practical uses, such as protecting bare skin from the sun and cold temperatures. But your doctor may encourage you to experiment with different headwear accessories from a creative standpoint, too. This can help you feel better while building self-confidence. Popular options include wigs, hats, and scarves.
If you’re looking for a one-stop shop for alopecia areata–related accessories, consider checking out the National Alopecia Areata Foundation’s Marketplace. In addition to finding headwear and soft headscarves, you can also search for hairpieces, a variety of quality wigs at variable price points, and eyelashes.
5. Find a Support Group
Alopecia areata is considered a common autoimmune condition, so it’s important to know you’re not alone. But it’s easy to feel isolated if you don’t know anyone else who has AA. This is where support groups can help you manage some of the psychological effects that AA may cause.
“Support groups provide a safe space for those coping with alopecia areata,” Sehat says. “It allows people to meet others who are going through the same challenges as them. What’s more is that these groups are an excellent way to help people rebuild their self-image, embrace who they are, and become confident in their own skin.”
“The National Alopecia Areata Foundation is an excellent place to help those thinking about seeking therapy to cope with their condition,” Sehat says. “The foundation has different support groups and also provides online assistance through peer mentors and phone support. It has multiple other resources to understand more about alopecia and even helps you get in touch with a therapist.”
6. Seek Help From a Counselor or a Therapist
“Counselors are invaluable in providing support, a safe space, and suggestions for how to manage stress,” Jackson says.
If you’re struggling with anxiety or depression related to alopecia areata, you may consider getting one-on-one support from a professional counselor or therapist. The exact techniques may vary between disciplines as well as by your needs. But a therapist can help you work through your struggles while also helping you come up with coping strategies.
“When working with clients, the goal is always to treat the root of the issue,” Sehat says. “Therefore, in this type of situation, we would like to address and treat the anxiety and stress that is causing the hair loss. Also, if we want to get deeper into the root cause, I would suggest addressing where the anxiety stems from. In my clinical experience, most of the anxieties that we experience as adults stem from childhood experiences.”
A type of talk therapy called cognitive behavioral therapy (CBT) focuses on changing unhelpful thinking patterns. According to a research review, getting CBT can lead to improvements in quality of life in people with chronic skin conditions, including alopecia areata.
Other psychotherapy techniques — such as eye-movement desensitization and reprocessing, Lifespan Integration, and somatic-based therapies — can also be helpful, Sehat says.
7. Gain Hope by Learning More About Your Treatment Options
“It can be disheartening to suddenly start losing hair, but there are many treatment options to combat hair loss and regrow your hair,” says Michele Green, MD, a New York City–based cosmetic dermatologist.
One potential option: a Janus kinase (JAK) inhibitor, which decreases inflammation by modifying the immune system, and thus promoting hair growth. Since June 2022, the U.S. Food and Drug Administration has approved three JAK inhibitors for severe alopecia areata: baricitinib (Olumiant), ritlecitinib (Litfulo), and deuruxolitinib (Leqselvi).
In addition to oral medications, topical and injectable corticosteroids may be treatment options for you. Dr. Green recommends talking to a dermatologist about options including platelet-rich plasma injections or minoxidil (Rogaine).
Speaking with a dermatologist about the various treatments for alopecia areata can also take your focus away from the more-frustrating aspects of this condition. Also, you can ask about potential future treatments that you should be on the lookout for.
“Learning about the exciting treatments on the horizon can also provide much-needed hope and optimism,” says Dr. Craiglow.
The Takeaway
Alopecia areata, which can lead to hair loss over the full scalp or body in some cases, can cause significant emotional challenges.
Many people with alopecia areata face ongoing stress, anxiety, and other mental health–related concerns.
Some strategies that can help include stress management, talking with a mental health professional, and connecting with support groups.
EDITORIAL SOURCES
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She completed her medical training at University of Illinois at Chicago College of Medicine, during which time she also completed a year of research at the National Institutes of Health. She completed her internship at George Washington University, and then her residency training at the Harvard dermatology program, where she served as chief resident in her final year.
She specializes in hair loss and scalp disorders, as well as pigmentary disorders in patients of color. She has spoken at multiple national conferences. Outside of medicine, she enjoys writing short stories, as well as writing and performing spoken word poetry.
Kristeen Cherney, PhD, is a freelance writer, essayist, author, and poet with more than 15 years of health writing experience for digital platforms such as Healthline, The Mighty, and LiveStrong. She’s covered nutrition, women’s and children’s wellness issues, as well as specialized topics ranging from diabetes and thyroid disease to anxiety, depression, asthma, allergies, and skin conditions.
With a doctorate in English (rhetoric and composition), Dr. Cherney focuses her academic scholarship on the intersection between disability and literacy. She also holds a Master of Arts in English and a Bachelor of Arts in communication.
Cherney has contributed to the books The Wiley Handbook on Violence in Education: Forms, Factors, and Preventions, Composing in Four Acts: Readings for Writers, and Georgia State University's Guide to First-Year Writing, as well as to scholarly journals like Praxis, the Journal of Teaching Writing, and the Journal of Dracula Studies.
Cherney enjoys running, meditating, hiking, and paddleboarding.
