At least twice a day, I find myself staring at the tops of strangers' heads on the subway, fixating on the thickness of their hair and the size of their parts. Ever since my hair started falling out in thick clumps about five years ago — due to a change in birth control — I've become obsessed with and envious of other people's thick hair.
"Hair is a sign of good health," explains Maryanne Senna, MD, a dermatologist and instructor at Harvard Medical School who specializes in hair loss. From an evolutionary perspective, having thick, luscious hair traditionally signifies youth, fitness, and health, she says. And although hair thickness is not the sole indicator of health, when you're losing your hair, it can feel like you're also losing your identity.
Depending on the cause and degree of shedding, hair loss can feel shocking, Dr. Senna says. If it's acute hair loss, and suddenly you're shedding tons of hair and you have no clue why, seeing clumps that come out all at once can be very traumatic, she says. Or some people who have hair loss on and off for a long period of time may feel frustrated. "That unpredictability, not having control over it not knowing what causes it, can be really understandably upsetting and anxiety-provoking for patients," she says.
And unlike other health conditions, which may not be visible to the public, people with hair loss are "forced to share that sort of thing, which makes you vulnerable with everybody," Dr. Senna says. "Those of us who don't currently have issues with hair loss take for granted that [hair loss] has important implications with regard to self-esteem, attractiveness, desirability, and youthfulness."
Seeing these patients all the time, I can tell you, [hair loss is] not something that necessarily takes lives. It's not life-threatening, but it's life-altering.
Maryanne Senna, MD, a dermatologist and instructor at Harvard Medical School
There's also insufficient acceptance of hair loss as a legitimate or important medical problem, so many people won't bother to seek treatment, Dr. Senna says. Or you might feel like you're vain for wanting to see a doctor for hair loss. "People are like, Well, it's hair, it's cosmetic. But is it cosmetic?" she says. Hair loss is often tied to a medical issue, like a thyroid condition or autoimmune disease, so it's important to take it seriously and let your doctors know if something seems off or different.
Given the isolating nature of hair loss, many people just turn to the internet to find answers, where there's no shortage of tempting but bogus shampoos and supplements that claim to cure hair loss. "People don't know what to believe, buy, if they should treat it, if they shouldn’t treat it, or if they're too vain going to a doctor for that," Dr. Senna says. All of this misinformation can add to people's anxiety, she says.
If you're someone who struggles with hair loss, first it's a great idea to find a dermatologist who specializes in hair loss so they can help get to the root of the problem and suggest appropriate solutions. Also, if you're someone with alopecia areata, an autoimmune form of non-scarring hair loss, you might want to connect with support groups (the National Alopecia Areata Foundation is a great resource to start) for your specific diagnosis, Dr. Senna says. And most importantly, don't discount your hair loss. "Seeing these patients all the time, I can tell you, [hair loss is] not something that necessarily takes lives. It's not life-threatening, but it's life-altering," she says.