It is important to recognize that two patients with identical amounts of hair loss can be affected to dramatically different degrees.
As I sit across from my patients, I reflect on these AEIOU’s of patient quality of life. How is the patient affected today? Is it different from the last visit? What can be done to assist this patient in these domains?
The letter “A” is for appearance and anxiety. Patients with hair loss may be concerned that their appearance has changed. Some feel that hair loss has made them less attractive. They may be anxious about what will happen in the short term as well as in the long term. They are anxious about what others may think and anxious about what treatments will be needed.
The letter “E” is for esteem, embarrassment and employment. Hair loss can impact self-esteem and self-confidence. Some people just don’t feel as good about themselves. They don’t stand quite as tall. Some are embarrassed and that type of feeling can limit social interactions and work issues. Studies from the past have taught us that some worry about how their work and job will be affected.
The letter “I” is for identity and interactions. Hair loss affects self-identity and how people feel about themselves. It may impact several domains of self-identity including self-image, masculinity, femininity and sexuality. Social interactions of all kinds can be affected. Studies in patient quality of life teach us that interactions with family, spouses, partners, friends and relationships of all kinds can be affected by hair loss.
The letter “O” is for old, older and others. Some patients with hair loss feel their hair loss makes them look older and some worry about how things will be in the future when they become older. This creates anxiety. Some patients with hair loss not only focus on themselves – but focus on others too. This includes attention given to how others might feel about the patient having hair loss. It also includes feelings of jealousy and frequent examination of other people’s hair. This is incredibly common among patients with hair loss and should be viewed as a normal response in many cases.
The letter “U” is for unhappy. Hair loss can make patients unhappy and have depressive type feelings. This may be short term as in a grief reaction or prolonged negative emotions. The impact of hair loss can be significant in some.
Hair loss affects people in a wide variety of different ways.
