Some types of hair loss can be more obvious than others. Nonetheless, facing hair loss for any reason can be distressing. Unwanted comments from both strangers and loved ones can make the experience of hair loss even more stressful. And so, it’s common for people to be sensitive about their hair loss, says John Browning, MD, a dermatologist with Texas Dermatology and Laser Specialists in San Antonio. If you have a friend, family member, acquaintance, or coworker who has alopecia, it’s important to be sensitive to their feelings and needs. Here are five things you should never say to someone with alopecia:
1. ‘Do You Have Cancer?’
Certain types of hair loss such as alopecia areata can result in total baldness, according to the American Academy of Dermatology (AAD). Alopecia areata is an autoimmune condition where the body attacks the hair follicles, leading to bald patches on the scalp or, for men, in the beard area. It’s also true that certain chemotherapy drugs can cause hair loss and eventually total baldness, per Mayo Clinic. Any variations of “Do you have cancer?” or “Are you getting chemo?” are questions that some people with hair loss face from individuals who are unfamiliar with their situation, says Dr. Browning. Even if you are coming from a well-meaning place, questions like these are invasive on multiple levels — personal and medical included — no matter the reason for their hair loss.
2. ‘At Least You’re Not Dying’
Because there are such strong images of cancer patients and hair loss, people with conditions that specifically cause hair loss, such as alopecia areata, are assumed to be sick or have cancer, notes one letter to the editor in the Journal of the American Academy of Dermatology. Given that, people may also tell those with alopecia to “keep up the fight” or that they will be included in their prayers, the authors write. If someone with alopecia areata then reveals that they are not sick, they may be dismissed with “at least you’re not dying” or “it’s just hair.” These types of dismissals can even come from their medical team. That ignores just how difficult emotionally and socially the experience of hair loss can be — and no matter why someone’s lost their hair — their feelings surrounding it are valid.
3. ‘Is It Just So Much Easier to Get Ready Now?’
Maybe you’ve said this to someone whose hair is visibly thinning in an effort to look on the bright side, but this is another insensitive comment. That’s especially true when you realize just how emotionally impactful hair loss can be. “Multiple studies have shown that hair loss is associated with higher rates of depression and anxiety, especially in women,” says Shoshana Marmon, MD, PhD, assistant professor and director of clinical research in the department of dermatology at New York Medical College in New York City. For example, a review of 73 reports including more than 414,000 participants with alopecia areata, published in July 2021 the Journal of the American Academy of Dermatology, found the autoimmune condition is strongly linked to mental health disorders such as depression and anxiety. Simply put, presenting yourself to the world when you have alopecia is hard enough on its own, but these types of unsolicited comments can make it even harder mentally and emotionally.
4. ‘You Should Wear a Wig!’
One study found that 47.5 percent of people with hair loss reported having social anxiety. Those findings come from a survey of 228 people with alopecia, most of whom were white women with alopecia areata. Indeed, wearing a wig can be a wonderful coping tool for dealing with hair loss. Nearly half of people in the study said that wearing a wig to hide this hair loss improved their social confidence. The reasons? A wig decreased the chance that other people would make wayward comments about their hair or give them pitying glances. Ultimately, wigs helped in part because people don’t want others to comment, stare, or even shout at them about being bald. Because this subject can be triggering, refrain from making comments about wigs, even if you think doing so would be helpful. Chances are, the person facing hair loss has heard about or researched wigs on their own, anyway.
5. ‘My Friend Did Such-and-Such to Grow Their Hair Back!’
This comment is unhelpful at best. Besides, unless you’re a medical professional who treats hair loss, it’s unlikely you know what will work for the person you’re speaking to. What’s more, if you’re suggesting a remedy that lacks scientific evidence or isn’t suited to the person’s hair loss, you could be providing harmful advice. The best option for someone who is distressed by their hair loss is to see a board-certified dermatologist who can talk about the range of treatments available for hair loss — and what’s appropriate for the person’s particular situation, including the type of hair loss they’re dealing with. Also consider that some people might be okay with being bald — and this style might be their choice in reaction to losing their hair — and that’s completely fine. But it’s the dermatologist and the person facing alopecia, not you, who are qualified to have this conversation.
