Wwhen my hair started falling out, it came out in handfuls – and I mean handfuls. It was all over my fingers when I washed it, wrapping around them, this big ball of hair that I had to look at and deal with. I couldn’t stand it.
I had been working on hair loss for five years; I owned a hair extension company and had developed a program offering bonding extensions that cancer patients could safely use after chemotherapy. So I knew how emotional losing your hair was. Yet it was only at that point that I learned something that’s been central to the way I’ve worked ever since: hair loss isn’t about how you look – it’s about how you feel. I’ve got amazingly thick hair, so even though half of it fell out, people said they couldn’t tell. But I knew, and I was shocked by how much it affected my confidence and how I felt about myself. It made me feel like I had lost my identity.
I had just started my formal training as a clinical trichologist, so I also understood what was happening. I had telogen effluvium – where the growth and shedding cycle of hair is disrupted, so more of it than normal is in the resting, shedding and regrowing phase – caused by the hugely restricted diet I was on following major bariatric (weight loss) surgery eight weeks earlier. But even though I knew the science – that this hair wasn’t lost but was regrowing – what your eyes see and your brain tells you are very different from what you know logically. You think: “I’ve got to be losing my hair permanently. I’m going to need a wig.” I had a phase of collecting the hairs and counting them to see if they were reducing. And I had a phase of just putting them in the bin and not looking at them.
Often when I diagnose a patient, I’ll tell them what they’re seeing and feeling. I’ll describe how their hair feels a lot thinner in the mid-lengths to ends, this halo of little spiky hairs, the textural feel like candy floss. I always say: “You feel really hair aware, you notice every little negative thing about your own hair, you notice everybody else’s. You will touch it last thing at night before you go to sleep, and the first thing you’ll do in the morning is feel for your hair. You’ll be selective where you sit, you won’t want to sit under a light, you probably won’t want to color it. You were a daily washer – and now you wash once a week if you’re lucky.” And they sit nodding, and they go: “Yeah, all of those things. How did you know?
I’ve never talked publicly about my own experience of hair loss before now. I’m not sure why – I think it’s because I don’t see why people would want to know about me. But I do tell my patients I’ve been there myself. I feel that, because I’ve experienced it, I know what a big decision it is to see someone like me. And that really gives them validation that there’s a problem, because very often hair loss is dismissed. People are told that it’s cosmetic, it’s their age, it’s the menopause, that everybody’s hair thins. And it takes courage to admit you’ve got a problem. To then be dismissed makes you feel as if it’s not valid or you’re making it up.
The NHS is a fantastic organisation, but it sees hair loss as cosmetic. So there is no real signposting to the people who can help; no real empathy. Yet there’s so much we can do to treat something like telogen effluvium, which is one of the most common conditions we see.
Lots of people will say: “It’s only my hair. I feel a bit of a fraud.” They worry that they seem vain. And I always tell them it’s nothing to do with vanity, that it’s about their identity – their hair is a massive statement about them. And if it’s not behaving and it’s causing anxiety, let’s have a look at why, and let’s fix it. That’s what we do with anything else. So why should it be different for hair? Hair loss isn’t life-threatening. But it’s quality-of-life threatening.
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