P136 Psychological impact of hair loss in women: a qualitative systematic review

Abstract Hair loss in women is associated with profound psychological distress, affecting mental health, self-esteem and social functioning. This systematic review consolidates findings from qualitative studies to explore the psychological burden of hair loss and evaluate the efficacy of supportive interventions. The aim is to inform best practices for holistic, patient-centred management in dermatology clinics, aligning with National Institute for Health and Care Excellence guidelines and international protocols. This review adhered to the PRISMA guidelines, with a comprehensive search of the PubMed, MEDLINE, PsycINFO and Embase databases for qualitative studies published between 2010 and 2023. Keywords included ‘psychological impact’, ‘hair loss’, ‘women’, ‘qualitative studies’ and ‘supportive interventions’. Inclusion criteria encompassed studies on the emotional and psychological burden of hair loss in women, with or without supportive interventions. Mixed-methods studies were included if qualitative data could be extracted. Single-case studies and those without a psychological focus were excluded. Data were thematically synthesized to identify psychological impacts and assess the effectiveness of interventions such as counselling, peer support and cosmetic solutions. Twenty-six studies involving 1450 participants met the inclusion criteria. The key findings are reported here. (i) Emotional distress: hair loss caused significant emotional distress, with 78% of women reporting feelings of shame, anxiety or depression. Younger women and those with more extensive hair loss experienced greater psychological burdens. (ii) Impact on self-image: self-esteem was negatively affected in 85% of participants, with themes of loss of femininity and perceived diminished attractiveness. (iii) Social withdrawal: over 60% of women avoided social interactions due to embarrassment, compounding isolation and low self-worth. (iv) Supportive interventions: psychosocial therapies such as cognitive behavioural therapy (CBT) and peer support groups reduced anxiety and improved coping in 68%, while cosmetic solutions such as wigs, scalp micropigmentation and hairpieces enhanced confidence and social reintegration for 72%. Emerging themes underscored the importance of empathic clinician–patient communication, with patients emphasizing the need for guidance and emotional support alongside clinical care. Hair loss in women exerts a profound psychological impact on mental health, self-esteem and social functioning. Supportive interventions, including CBT, peer support and cosmetic solutions, effectively alleviate distress and enhance quality of life. A multidisciplinary approach integrating psychological support into routine care pathways is essential. Recommendations for practice are (i) to implement psychological assessments to identify at-risk patients; (ii) to develop integrated care models combining dermatological and psychological support; (iii) to create age-specific, culturally sensitive interventions and (iv) to educate patients on supportive therapies, fostering proactive engagement. This review highlights the critical need for dermatologists to address both the physical and psychological dimensions of hair loss, offering practical insights for patient-centred care. By incorporating psychological screening, empathetic communication and evidence-based supportive interventions, dermatology clinics can significantly improve patient outcomes.