Does Severity of Hair Loss Matter? Factors Associated with Mental Health Outcomes in Women Irradiated for Tinea Capitis in Childhood

Abstract

Hair loss resulting from childhood irradiation for tinea capitis has been linked to mental health effects in women. However, the association of hair loss severity with mental health in this population is unknown. To address this gap, this study examined the association between hair loss severity and mental health outcomes in women irradiated for tinea capitis in childhood as well as the factors that contribute to these outcomes. Medical records, held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims, were retrospectively reviewed for 2509 women who received compensation for full or partial alopecia resulting from irradiation for tinea capitis. Mental health outcomes were determined by the number of mental health conditions reported. The results show that among women with more hair loss, risk was increased for a range of mental health problems, especially social anxiety (RR 2.44, 95% CI 2.09–2.87). Hair loss severity emerged as a significant predictor of mental health, adding to the effects of other predictors such as family, social and physical health problems (β = 0.13, 95% CI 0.27, 0.56). The effects of hair loss severity on mental health outcomes were mediated by women’s negative social experiences (indirect = 0.72, 95% bias-corrected confidence interval, 0.53–1.08). Healthcare professionals supporting women with hair loss after irradiation for childhood tinea capitis should be alert to a history of severe levels of hair loss.

Gender Differences in Psychosocial Outcomes of Hair Loss Resulting from Childhood Irradiation for Tinea Capitis

“…These results clearly suggest that the gender difference in depression risk is not due to the higher prevalence of other risk factors among women, such as low self-esteem, social anxiety, and social avoidance, but rather due to the effect of gender per se. By shedding light on the role of gender in the development of depression among women with alopecia resulting from childhood irradiation for tinea capitis, our results add to earlier reports documenting depression among women with different types of alopecia [32,35,[46][47][48] and higher rates of depression among women with androgenetic alopecia compared to men [24]. A plausible explanation for the important role that gender plays in the development of depression among women with alopecia is that hair symbolizes women's fertility, femininity, sexuality, and attractiveness in society [7,9,10].…”

“…The first study [32] found that hair loss due to childhood irradiation for tinea capitis in women is linked to psychosocial impacts, including depression, anti-depressant and/or anti-anxiety drug use, psychiatric hospitalization, suicide attempts, social anxiety, and divorce, as well as health impacts, such as migraines, which have been found to be associated with childhood trauma and stressful life events in adulthood [33,34]. The second study [35] extended these findings, linking hair loss severity in women to an increased risk of mental health problems and showing an indirect effect of hair loss severity on mental health via an impact on women's social life. To date, no study has investigated the effects of hair loss in men irradiated for tinea capitis during childhood or examined gender differences in the outcomes of hair loss resulting from childhood irradiation for tinea capitis.…”

Understanding and addressing populations whose prior experience has led to mistrust in healthcare

“…The ringworm claimants’ mistrust in Israeli healthcare organizations might, in addition to the lack of a clear notification process, also be partly explained by the emotional influences of such treatments [ 47 ], legal claims against the Israeli government based on the duty to inform patients at risk [ 43 ], and a reluctance of the Israeli Authorities to publish a formal apology for implementing the treatment regime [ 48 ].…”

β-Nicotinamide Mononucleotide Promotes Cell Proliferation and Hair Growth by Reducing Oxidative Stress

“…Hair is an important part of human body, but hair loss has been a global public health problem that is mainly related to the aging process. Various factors can cause hair loss, including mental stress, disease, autoimmune diseases, and drug treatments [1,2]. The main cause of hair loss, especially in men, is attributed to a decrease in male hormones.…”