Hair loss and the image of the self

Several recent investigations elucidated the effects of hair loss on the quality of men’s and women’s lives from the perspective of psycho-social “scars” , like stress, depression and anxiety. While visible hair loss can influence in a detrimental way the social perception of a person, the most important implication relates to how people with alopecia deal with their own problem.
Hair loss follows a classic pattern that has been best illustrated by the Norwood Classification System, ranging from type 1 (minimal frontotemporal recession) to type 7 (loss of all but a small rim of hair). Using this system, for classification based on the image of male pattern alopecia, the famous researcher Cash studied three groups of men, taken as random samples: 63 year-old men with modestly visible alopecia problems; 40 year-old men with extensive alopecia problems; 42 year-old subjects without alopecia problems.  None of these subjects received any medical or surgical preliminary treatment for hair loss and none of them wore hair pieces.  Although all the published studies regarding the possible psycho-social impact of the male pattern of alopecia provide mixed conclusions, Franzoni, Anderson and Frommelt offer consistent evidence supporting Cash"s results.  They discovered that balding men may have a less favourable image of their own body than those who don’t have this problem and that the men who are conscious about alopecia may be exposed to a greater risk of being negatively affected than men who have a positive image of the self.
Cash’s subjects completed standardized tests concerning their own body image, self-esteem, social anxiety, sexual confidence, public image of the self.
But most importantly, the subjects completed surveys on the effects of hair loss (HLEQ), containing 70 possible effects of alopecia including emotional, cognitive, social and behavioural effects.
Out of the 70 possible effects listed in the HLEQ survey, men with modest baldness problems reported that their problem had a significant impact on 60% of the effects, while men with advanced baldness - an impact on 79% of the items. Compared to men with modest alopecia problems, men with advanced alopecia have reported a notable impact.  The second group experienced much more intense socio-emotional effects, greater concern and preoccupation for their problem and a much stronger behavioural efforts in order to compensate, attenuate and cope with hair loss problems.
When the subjects without balding problems were asked to imagine their reactions if they were to have such problems, only 8% said they would NOT  be disturbed by this. In order to establish if the stress of alopecia might prejudice men"s psycho-social functions, the two groups of subjects were then compared from the point of view of the personality and the image of their own body. So, we can say that from a sociological point of view, this data confirms the fact that male alopecia is an unwanted, stressful experience for most male subjects.
These results indicated that it is improbable that the pattern of male alopecia dramatically harms psycho-social functions in most men.  Differences in psycho-social referal from this point of view were not significant, with one essential exception: men with alopecia had more negative attitudes towards their own body, that means less contentment with their hair and with their whole physical appearance.
It is probable that in situations where alopecia causes considerable dissatisfaction, psycho-social adaptability also suffers.  Correlations revealed that the men who were more upset with hair loss proved to have less adaptive psycho-social functions. An alternative interpretation is, of course, that men with the weekest psycho-social premorbid adaptability may be less energetic and less flexible to the stressful effects of hair loss. Analyses have identified several other characteristics related to a deeper psychological impact of alopecia.  Among the most affected by hair loss were young men with early alopecia problems, men who expected their problem to increase noticeably, and single men.
Data also suggests that a positive image of the self and a sense of success in social or romantic relationships may attenuate the psychological impact regarding alopecia.  Men who are insecure of their personal and social worth may view balding as a threat to their already vulnerable sense of acceptability.

Table of Contents:
Alopecia among women
Hair loss and the image of the self
The Psychological Impact of Alopecia on Women