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A diagnosis of alopecia areata (AA) can lead to discussions with a dermatologist about how to best manage and treat this autoimmune condition. But being diagnosed with this incurable, sometimes lifelong form of hair loss can also bring about significant emotional aspects to consider. “Alopecia areata can be absolutely devastating for patients and their loved ones,” says Brittany Craiglow, MD , a dermatologist at Dermatology Physicians of Connecticut and associate adjunct professor of dermatology 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.’” Additionally, Pareen Sehat , clinical director at Well Beings Counselling in Vancouver, British Columbia, Canada, explains 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,” she says. “So, hair loss tends to shatter an individual’s confidence and self-esteem. “They may not feel beautiful anymore, in turn causing depression and taking a severe toll on their mental health.” In addition to following your treatment plan recommended by a dermatologist for your specific case of alopecia areata, we talked with experts about other ways you can cope on a daily basis when managing this unpredictable autoimmune condition.
Try to Manage Stress Take Steps to Manage Stress Stress isn’t a direct cause of alopecia areata, but it may be considered a trigger, as many people who have experienced a recent onset of new symptoms have also had significant stress.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291b5f6434-b7f6-4439-a88e-24690d0b1e12 “Stress can happen at any age,” says Brooke Jackson, MD , 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.” She notes that some of the stressors she has seen trigger AA in some of 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 could also potentially help you manage cycles of hair loss and regrowth.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295d9f2f9d-3d41-4ae9-b416-f57dddd57843 To help manage stress while coping with alopecia areata, Dr. Jackson recommends the following strategies: Fit in daily exercise wherever you can, such as taking a quick walk during your lunch break Incorporate relaxing activities into your day, such as yoga and meditation Work on good sleep hygiene by getting at least seven to eight hours of sleep per night, allowing 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 She also recommends creating boundaries when you can. “No one, except an infant or a dependent child or parent, needs 24-hour access to you,” Jackson says.
Consider Adopting an Anti-inflammatory Diet Change Your Diet “All disease processes are rooted in inflammation,” Jackson explains. While there’s no such thing as an AA diet, per se, she recommends decreasing inflammation in your diet. If you’re interested in getting started with an anti-inflammatory diet, Jackson recommends checking out Forks Over Knives , a plant-based eating program that focuses on whole foods. Other types of anti-inflammatory diets , which may include small amounts of fish, lean meats, and plant-based oils, include Mediterranean and DASH diets.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a3feb8c8-2445-4196-ab8a-54f6a1f09318 Additionally, 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 plan you follow, researchers also note that getting enough protein is essential in promoting overall hair health.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299080ab01-3990-4493-b05e-0467e47fcadd Other dietary strategies that could help include eating a balanced diet, avoiding restrictive or fad diets, and getting enough nutrients.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e933eb10-a3d4-4faa-ab9d-5a1f2bd997a5 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.
Protect Your Skin From the Elements Protect Your Skin 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 for developing sunburns and skin cancer.e60dc2a1-f33c-4a05-9b50-8e3e8e59762917f7919f-668d-459f-9d81-807dc562e068 You can help minimize these risks by wearing sunglasses, a scarf, and a hat when outdoors,e60dc2a1-f33c-4a05-9b50-8e3e8e597629936d449b-3bcf-488a-815b-04f874fe3599 as well as putting on sunscreen every day.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c365fb9b-65ad-4d56-9ec5-ffed3a24f7f8 Additionally, 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.e60dc2a1-f33c-4a05-9b50-8e3e8e59762991c40967-2327-46d5-a752-78f5c2640d25 It’s also important to protect your skin from the cold, by wearing layers, a scarf, a hat, and earmuffs.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294bacd8ef-1bdd-42ad-9939-64df102d88b4
Experiment With Head Accessories Don Headwear Aside from the more practical uses of headwear, such as protecting bare skin from the sun and cold temperatures, your doctor may encourage you to experiment with different accessories from a creative standpoint. This can help you feel better while building self-confidence. Popular options include wigs, hats, and scarves.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297a0a84cf-487b-4a70-963c-e401ca43d36b 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 headwear and soft headscarves, you can find hairpieces, a variety of quality wigs at variable price points, and eyelashes.
Find a Support Group Find Support 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 AA may cause.e60dc2a1-f33c-4a05-9b50-8e3e8e597629df064f0f-2f1a-46e7-85ff-af6b3caa0dc8 “Support groups provide a safe space for those coping with alopecia areata,” Sehat explains. “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 was the No. 1 recommended online resource overall by the experts we spoke with. You can find resources for support groups on their website . “The National Alopecia Areata Foundation is an excellent place to help those thinking about seeking therapy to cope with their condition,” says Sehat. “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.”
Seek Help From a Counselor or Therapist Try Therapy “Counselors are invaluable in providing support, a safe space, and suggestions for how to manage stress,” says Jackson. If you’re struggling with anxiety or depression related to alopecia areata, you may consider 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,” says Sehat. “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.” She says cognitive behavioral therapy is one possible treatment that can help, as can other psychotherapy techniques, such as eye-movement desensitization and reprocessing, Lifespan Integration, and somatic-based therapies .
Gain Hope by Learning More About Your Treatment Options Educate Yourself “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 called baricitinib (Olumiant), which the U.S. Food and Drug Administration approved in June 2022 for treating severe AA.e60dc2a1-f33c-4a05-9b50-8e3e8e59762994acda42-2884-470e-b1eb-7b7932463028 In addition to oral medications, topical and injectable corticosteroids may be treatment options for you.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a94ee1d8-0ee6-4295-81de-f07bf9f668c1 Dr. Green recommends talking to a dermatologist about additional options that may help treat AA, including platelet-rich plasma injections, minoxidil (Rogaine), finasteride (Propecia), or spironolactone. By speaking with a dermatologist about the options that are available to help treat alopecia areata, this can also take the 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. She points to the promise of JAK inhibitors as one example of a treatment that could potentially be approved as an official AA therapy. The Takeaway Alopecia areata, which can lead to permanent hair loss 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, including stress management, talking to a mental health professional, and connecting with support groups, can help.
