Do I have alopecia? How do I know if I have alopecia? Expand The word ‘alopecia’ simply means hair loss. If you are experiencing any more hair loss than what is normal for you, you are experiencing some type of alopecia. The next step is identifying which type of alopecia you have. We recommend you first speak to a GP. If your GP is unable to make a diagnosis, they may refer you to a dermatologist. You can read more about the different types of alopecia here. Please note, ‘alopecia’ is often used by doctors as an abbreviated way to discuss ‘alopecia areata’. This can be confusing when there are different types of alopecia too! If in any doubt as to what type of alopecia your GP is referring to, ask them to clarify.
Should I see a dermatologist? What can I expect from a dermatology appointment? Expand A dermatologist is a specialist in skin conditions, including conditions affecting hair and nails. A dermatologist should have more extensive knowledge about types of alopecia than a GP. They should be able to provide you with a diagnosis (if there is any doubt) and explain more about the condition and explain any treatment options available to you. It is likely the dermatologist will examine your scalp (and/or other areas of hair loss) and ask you questions about your hair loss to make a diagnosis. A biopsy (a medical procedure that involves taking a small sample of body tissue from the affected area) is occasionally needed to make a diagnosis. Your dermatologist will tell you if this is required. In the majority of cases of hair loss, a diagnosis is possible without the need for a biopsy. Top Tip: Take a pen and paper to any appointment so you can make notes. It is easy to forget what is discussed. Or consider taking a friend or family member with you if you are struggling emotionally; it can be hard to take information in when we’re feeling upset.Please note, not all dermatologists have a good understanding of hair loss conditions. Dermatology covers a huge number of skin conditions and some dermatologists specialise on particular conditions e.g. psoriasis or skin cancer. It can be helpful to find a dermatologist who specialises in hair loss.
Where can I find a dermatologist specialising in hair loss? Expand There is an organisation called the British Hair and Nail Society (BHNS), made up of members who are dermatologists specialising in hair and nail conditions. They have a ‘Find a Specialist’ page on their website. BHNS members are made up of both private and NHS doctors. Please note that this is not an exhaustive list as not all dermatologists specialising in hair loss have chosen to be members of BHNS.
Can you recommend a hairdresser who is sensitive to those with hair loss? Expand Firstly, it is worth remembering that hairdressers come into contact with alopecia on a very regular basis. They are often the first person to recognise hair loss. Most hairdressers will treat their clients sensitively regarding their hair loss. MyNewHair is a charity founded by and inspired by Trevor Sorbie MBE. They provide public advice and support a national network of independent salons and professionals who provide a wig styling service for people suffering from cancer and medical hair loss. Each professional who signs up to MyNewHair’s network pledges their commitment to responsible training and providing a caring and sensitive service for their clients. Many MyNewHair stylists are trained to cut and style wigs and they have a 'salon finder' on their website. You can find more information here.
Is it normal to experience itchiness/soreness with alopecia? Expand Hair loss often occurs without any discomfort however some of us can experience different sensations when we lose hair. As such it is hard to define what is ‘normal’. If you experience discomfort at the point of losing hair, such as feelings of itchiness, soreness, burning or aching, you are certainly not alone. When hair loss occurs, there is inflammation around the hair follicles. It is this inflammation that can cause discomfort. Some people with alopecia report similar sensations when their hair is growing back. Taking anti-inflammatories (such as Aspirin and Ibuprofen) or antihistamines (such as Piriton) might help to ease symptoms. Applying a cold or warm compress to the affected areas can also provide some relief. Discuss your symptoms with your GP and/or dermatologist as some physical symptoms are more typical of particular types of alopecia so it is helpful for your doctor to fully understand what symptoms you are experiencing.
Can special shampoos or supplements help regrow hair? Expand There are many products marketed as helping with hair loss but rarely is there any clinical evidence to back up the claims made. We would always recommend checking the product’s website and searching for appropriate evidence prior to making a purchase. We recommend seeking advice from your GP before taking any supplement. Please note, there is limited evidence about the use of supplements. This paper from 2017 provides a review of the role of vitamins and minerals in hair loss. If you wish to try a shampoo or supplement, we recommend being mindful of the following: A product that one person insists has worked miracles for them, will not work for everyone. It is also worth remembering that, with alopecia areata, spontaneous regrowth can occur at any time and may be coincidental with the time of trying a new product. The financial cost of some hair loss products can be considerable, and most products will suggest that the effects will only be seen following months of use. A financial and emotional investment in a product that then has no effect can lead to feelings of disappointment. It can be challenging to manage expectations when trying new products and this should be a point to consider before trying any new shampoo or supplement.
Can I dye my hair when I have alopecia? Expand The short answer is yes. The part of the hair that is coloured in the dyeing process is the hair shaft. Dye doesn’t reach the hair follicles which is the part of the hair we are most concerned with when looking at alopecia. However, dyeing hair can cause hair loss if the hair shaft is weakened with prolonged treatments (most commonly damage occurs when taking hair from a very dark colour to a very light colour). Some people with alopecia choose to colour their hair and find a change in hair colour can help boost confidence and even help to make the hair loss less noticeable. If choosing to colour your hair, always carry out the sensitivity patch tests when using home dye products even if you have used the product before (skin sensitivity can change with alopecia). For best results, consider a salon treatment.
When should I shave my head? Expand There is no right or wrong time to decide to shave your head. It all comes down to personal choice. Some people who are losing their hair never shave their heads. It is not an essential part of the journey. Some might decide to shave their head once their hair loss has become impossible to conceal. Others, particularly those who are not experiencing alopecia for the first time, may decide to shave their head after the appearance of just one or two patches as they do not wish to watch any further hair fall out. It is about deciding what you will be most comfortable and happy with and not been influenced by what others think is best for you. Only you know how you feel. This question comes up a lot in our private Facebook group and this can be a good place to learn about the experiences of others.
Can I get a wig on prescription through the NHS? Expand Possibly. Local NHS organisations decide which services they spend their budget on. In some local areas, this means funding wig provision, commonly two synthetic wigs per year. In other local areas, wig provision is not funded by the NHS meaning you will not be able to access a wig. If you can access wig provision via the NHS, prescription charges may be applicable in England whilst in Scotland, Wales and Northern Ireland a prescription charge will not be payable. Human hair wigs are not routinely offered via the NHS although some people with alopecia are able to access human hair wigs via NHS provision. To find out if you can access wigs via the NHS and what your local provision looks like, you will need to ask your dermatologist.
When should I tell people I am losing my hair? Expand It is a very personal choice when to tell others about your hair loss. Some people choose to tell people about their hair loss early on in their experience of alopecia whilst others choose to be further along in their journey before they inform others. Some may decide never to tell others about their alopecia. Something to consider is that by being open with others about your alopecia, it can help to reduce any fear or worry of your alopecia being revealed. Secrecy about alopecia can, for some, be an additional burden. When we decide to tell someone may be different depending on who we are telling. For instance, we may tell close family and friends earlier than we tell colleagues or potential romantic partners. Our private Facebook group can be a good place to find out the experiences of others.
I no longer look like my passport/driving licence photo; do I need to get a new passport/driving licence? Expand UK passports and driving licence photocards are valid for ten years. It is common for someone’s appearance to change during that time. Naturally, having alopecia can change our appearance more significantly than others. However, you are not required to get a new passport or driving licence before it expires. You are still able to travel with a passport if you do not bear a close resemblance to your photo. Customs staff will look at your features such as your eyes, nose and mouth. If questioned, you can simply explain you have alopecia. If you are nervous or anxious about such interactions, you may wish to consider applying for a new passport with an updated photo. You can apply for a new passport before your current one expires. If renewing a passport or driving licence and your appearance has changed significantly between passport photos, you may need to get someone else to sign (a countersignatory) to confirm your identity. The application form will explain this.
Can I wear a head covering in my passport/driving licence photo? Expand Yes. Head coverings are accepted in passport/driving licence photos for both religious reasons and medical reasons. Alopecia is considered a medical reason. It is important that the head covering, such as hat, headscarf or bandana, does not cover or obscure the face in any way. It is recommended that a covering note is included with the application to simply state ‘I am wearing a head covering in my photo for medical reasons. I have <insert name of condition>.’ Including a short note explaining the reason for the head covering reduces the chance of the application being rejected by an examiner. This note does not need to be written by a doctor.
I have a job interview, but I normally don’t wear a wig. Should I wear a wig to the interview or present myself as I look day to day? Expand If you do not normally wear a wig, you should not feel as though you should wear a wig for a job interview. If you normally have your alopecia visible to others, you should not feel the need to conceal your hair loss for a job interview. If you are nervous that your interviewer may misunderstand your hair loss, possibly assuming you are unwell and/or undergoing medical treatment, you could consider a brief mention about your alopecia either in the interview (or before the interview). Perhaps something along the lines of: “Just in case you were wondering about my appearance, I have no hair/I am missing some patches of hair because I have alopecia. It doesn’t affect my general health or ability to do the job”. If it would be helpful to speak to others with alopecia and how they have navigated nerves about job interviews, consider joining our private Facebook group and asking for the experiences of others.
What can I do to help my child with alopecia? What advice is available for parents of children with alopecia? Expand We understand that having a child who is experiencing alopecia can be challenging, not just for the child but also parents (and the wider family). Parents are often able to resolve issues encountered by their child. Unfortunately, alopecia is not something that parents can ‘fix’. One of the main difficulties of experiencing alopecia can be the many, many questions you and your child will have and the few answers that exist. That is why Alopecia UK is here to help and looking through our website is a great place to start. We have created resources for parents to help guide you and your child. You can find these here. We also recommend taking a good look through all of the webpages in the ‘Children and Young People’ section of our website. We have lots of resources that can be helpful, including story booklets, animation videos and a Schools Pack that can help with any challenges your child may encounter in their school.