Therapeutic implications of psychological state in patients with alopecia areata: A qualitative study

Abstract

Hair loss can significantly impact an individual's psychological state, self-image, and can lead to numerous personal, social, and occupational problems. Although these impairments are well documented in primary studies and reviews, and the need for appropriate psychological help is emphasized, there is still a lack of knowledge for a broader and specific picture. The patient's perspective is vital while seeking to understand the content of the variables like "impaired body image" or "low self-esteem." This article advocates the need for studies involving methodologies allowing to explore the complexity and depth of experience. A better understanding of patients' states, reactions, and needs might contribute to the practice of healthcare professionals seeking the best possible help. This study aimed to explore the lived experience of people with alopecia areata in Lithuania using a phenomenological approach. Experiences of six patients with varying degrees of alopecia areata, four women and two men (mean age 27 years), were explored. Data were obtained using an unstructured interview and were analyzed based on Colaizzi's phenomenological approach. This article explores findings related to patient's psychological state covering two superordinate themes: (a) devastating loss of perceived self and (b) grieving and the process of acceptance. The insights for the appropriate therapeutic intervention were formulated.

Psychological Aspect of Alopecia

“…It is extremely important to detect possible emotional problems accompanying the disease. Because pharmacological treatments are ineffective, especially in severe forms, and psychotherapeutic approaches are needed [18,19]. In a recent study, the association with psychiatric diseases was investigated and it was found that depression, anxiety and sleep disorders often accompanied the disease.…”

“…In addition, it has been determined that both alopecia areata and psychiatric disorders mutually affect each other and lead to disease progression. The sense of identity is severely damaged, especially in women, and feelings of grief and pain emerge [19]. While sexual identity is damaged in women, social identity is damaged by loss of trust more in men.…”

Alopecia areata: A psychodermatological perspective

“…Women reported loss of traits around their own humanness and thus feelings of shame, unacceptability, and impairment of social life. Men reported greater concern about the impact on their social identity, feelings of being rejected by society 60 …”

“…Men reported greater concern about the impact on their social identity, feelings of being rejected by society. 60 A solid and better understanding of the psychological and psychopathological mechanisms associated with AA is still required as well as the associations between the immune system, stress and the physiological and psychopathological responses need to be further explored.…”

Men’s experiences of alopecia areata: A qualitative study

“…For example, it has been separately reported that men describe less use of support groups than women and fewer attempts to cover bald patches, without further elaboration on the reasons (Hunt and McHale, 2005; Welsh and Guy, 2009). In another study, Barkauskaite and Serapinas (2020) interpreted gender differences between the qualitative accounts of four women and two men with AA in their phenomenological analysis, suggesting that the men expressed more concern about the impact of AA on their ‘social identity’ whereas the women described a broader impact on their self-concept. Clearly, these analyses were limited by only involving two men.…”