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Effects of Alopecia Are More Than Skin Deep

Alopecia areata is an autoimmune skin disease that affects more than 6.5 million people in the United States. The disease typically begins with a small patches of balding and can continue to complete loss of hair on the scalp (alopecia totalis) or body hair (alopecia universalis). It is a disease that does not have a singular outline; and eruption and cycles are unique for each patient. 

Alopecia is more than just a medical condition. The challenge with this disease is that it also cosmetic, social, and psychological. Common experiences include feelings of anger, embarrassment, and hopelessness. Sufferers often deal with self-blame for the instigation of the disease and negative impacts on family life. Health care professionals should not restrict their understanding of this disease to simply the medical issues. Understanding the stressors that affect quality of life are equally significant to helping patients of alopecia areata.

It’s important to think of the areas of life that are actually affected when we say “quality of life.” Here are some of those areas:

The Work Place 
The value placed on appearance in the work place means that a change in appearance can make an individual feel that they are lesser in value. Sharing with to coworkers about the disease usually means educating them. Helpful and self-protective ways to do this should be shared with patients.

Children can be cruel, especially to those people whose appearance is different or out of the ordinary. Children with alopecia may require special, additional counseling in order to know how to navigate social situations with their peers.

Many adults have established themselves and their identities in society before the onset of their disease. The establishment of how they see themselves and how they relate to the world is then drastically shifted by the loss of their hair. Alopecia areata can deeply affect the self-esteem of the patient within society in their friendships, and also their romantic relationships. There is not only a drastic shift in the life of the patient, but also the life of the patient’s partner. The guilt is felt on both sides of this relationship. The patient feels guilty for their partner having to bear the burden of the disease, and the partner feels guilty for their own feelings of disappointment or change.

The chance of a patient’s child having Alopecia later in life is 1 in 5. There are also parents with Alopecia who have had more than 5 children, none of whom had the disease. Regardless, the chance of producing a child that could develop alopecia is a part of the Alopecia patient’s life.

Many patients feel alone in the depression and trauma that comes along with the disease. The experience of change and loss is in fact traumatic. It is important for patients to have a place in which their sadness and sense of loss can be processed. Docs and PAs can look to the fact that patients have become a social minority. All the societal transgressions that come along with being visually different affect their patients daily.

Something that is helpful for patients with alopecia areata is an understanding that they are not alone. Group therapy or support groups can be a meaningful place where patients feel free to express their hears and see that they are not the only ones suffering from alopecia. Patients may benefit from counseling and support; be sure to have a list of therapists or support groups in your area. A great first step is to send your patients to the National Alopecia Areata Foundation where they can become a member, find resources, and join in the nation-wide community.


Image: Carolyn P Speranza

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