Can you pull it off? Appearance modifying behaviours adopted by wig users with alopecia in social interactions

Wiggins, Sally; Moore-Millar, Karena; Thomson, Avril

doi:10.1016/j.bodyim.2014.01.004

Cited by 22 publications

(30 citation statements)

References 19 publications

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“…Although they were accurately identified by others as having a disease, participants nonetheless felt unentitled to the sympathy offered, or to their own distressing feelings, because AA is a disease of 'just hair' unlike the 'life-threatening' cancer so frequently assumed by sympathizers. As found in previous studies, 5,13 the use of wigs and other products to camouflage hair loss often exacerbated feelings of inauthenticity, leading to anxiety that this 'fraud' (e.g. P77, female) would be exposed.…”

Section: Discussionsupporting

confidence: 55%

“…The provision of effective support for people with AA requires an understanding of what it is like to live with the condition. Few qualitative or mixed methods studies have explored the psychological impact of AA, but the literature that exists highlights the distress and threats to identity associated with unpredictable, often rapid, hair loss . Feelings of shame and isolation have been reported, alongside struggles to develop effective coping strategies .…”

mentioning

confidence: 99%

“…It has been suggested that good social support may help to ameliorate the psychological impact of AA, but this can be difficult to access as AA is associated with impaired social functioning, and unsupportive responses from doctors have been reported . Wigs and make‐up are commonly used to conceal hair loss, but the psychological effects of such practices are complex; masking of hair loss can increase self‐confidence but concerns about wigs being noticed or coming off can simultaneously increase anxiety, create feelings of inauthenticity and affect interactions with others, leading to avoidance of social activities . Therefore, the social context may be significant in understanding both distress and coping in people with AA.…”

mentioning

confidence: 99%

“…Few qualitative or mixed methods studies have explored the psychological impact of AA, but the literature that exists highlights the distress and threats to identity associated with unpredictable, often rapid, hair loss. [9][10][11][12][13] Feelings of shame and isolation have been reported, 9,14 alongside struggles to develop effective coping strategies. 10,15 It has been suggested that good social support may help to ameliorate the psychological impact of AA, 14 but this can be difficult to access as AA is associated with impaired social functioning, 16 and unsupportive responses from doctors have been reported.…”

mentioning

confidence: 99%

“…9 Wigs and make-up are commonly used to conceal hair loss, but the psychological effects of such practices are complex; masking of hair loss can increase self-confidence but concerns about wigs being noticed or coming off can simultaneously increase anxiety, create feelings of inauthenticity and affect interactions with others, leading to avoidance of social activities. 5,13 Therefore, the social context may be significant in understanding both distress and coping in people with AA.…”

mentioning

confidence: 99%

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Living with alopecia areata: an online qualitative survey study

2019

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Summary Background Living with alopecia areata (AA) totalis and universalis (collectively referred to here as AA) involves unpredictable, sometimes rapid hair loss. There is currently no effective treatment and patients describe feelings of shock, loss, trauma and disrupted identity. Cultural meanings attached to hair and hair loss, including associations between hair and femininity, and hair loss and cancer may exacerbate distress. Consequently, wigs and make‐up are frequently used as camouflage, but this can produce feelings of inauthenticity, shame and anxiety. Objectives This article explores how meanings associated with hair and hair loss influence experiences of living with AA. We also aim to identify how this understanding might inform practice by healthcare professionals to best support patients to cope with the condition. Methods A total of 95 participants with AA completed an online qualitative survey about their experiences of living with the condition. Data were subjected to thematic analysis within a critical realist theoretical framework. Results The following four themes were identified: (i) It's (not) only hair; (ii) A restricted life; (iii) Abandon hope all ye who lose their hair and (iv) Seeking support in ‘a highly personal journey’. Conclusions Findings suggest that negative cultural meanings of hair and hair loss are pervasive and may drive social avoidance and camouflage behaviours in people with AA. Normalizing social interactions with healthcare practitioners, significant others and peers were cited as pivotal to positive adjustment. Support groups and online forums were highly valued particularly as few had been offered specialist psychological support. Future research should develop and evaluate psychological support in order to address the specific challenges of living with AA.

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Section: Discussionsupporting

confidence: 55%

mentioning

confidence: 99%

mentioning

confidence: 99%