What lifestyle or psychological support options should I discuss with patients experiencing alopecia areata?

Lifestyle modifications to discuss with patients experiencing alopecia areata include advising on sun protection measures such as using sunblock and wearing hats to protect exposed scalp areas from sun damage, especially where hair loss patches are present. This helps prevent skin damage and potential complications from UV exposure ¹. Patients should also be informed about cosmetic options to camouflage hair loss, including hairstyling techniques (waving, dyeing, sprays, mousses), hair camouflage products like keratin microfibres, hair extensions (with caution due to potential follicle traction), dermatography (semi-permanent eyebrow tattooing), false eyelashes, headscarves, and hats ¹. The option of wigs or hairpieces should be discussed, noting that some patients may be eligible for NHS-funded wigs following dermatology referral, and resources such as Alopecia UK provide guidance on wig selection and care ¹.

Psychological support options are crucial given the unpredictable and often distressing nature of alopecia areata. Patients should be offered information about support groups such as Alopecia UK, which provide local support networks and educational resources for patients and families ¹. Consideration should be given to referral for additional psychological support, including counselling or cognitive behavioural therapy, especially if the patient experiences significant distress. For children, monitoring for behavioural changes such as withdrawal, mood alterations, or academic decline is important, with referral to child and adolescent mental health services if needed ¹.

Overall, the approach should be holistic, addressing both physical and psychological impacts of alopecia areata. Patients should be reassured that hair regrowth is often possible, though unpredictable, and that medical treatments may help but do not cure the condition ¹.

Recent literature emphasizes the importance of psychological well-being in alopecia areata management, supporting the guideline recommendations for psychological support and highlighting the need for individualized care plans that integrate lifestyle advice with mental health support (Abarca et al., 2025).