Most people we talked to had alopecia areata, which is an autoimmune condition (see also about causes). They had lots of different experiences and ideas about what might have triggered it to start or become more severe. As Rosie said, “No one’s trigger is exactly the same and some people never even find out what theirs is.”
Some of the tiggers mentioned were:
This might be ‘general’ stress but could also be from particular things such as bullying, exams and studies, family breakdown, worries about family members (e.g. who are ill), moving home, bereavements, being a victim of a crime (such as a burglary), money worries, difficult times at work, pressures on childcare and household tasks. Meghan finds there’s often a lag of about a month between when she goes through a stressful time, such as with her studies, and when her hair falls out.
Others disagreed that stress had triggered their alopecia areata. Arti finds it frustrating that her doctors keep saying she has alopecia because of stress as she feels that alopecia is the source of stress in her life rather than a result of it. Emma thinks it can be patronising for doctors to insist stress is the reason for alopecia even when the person with it says it’s not. Many people said that even if stress had been a trigger initially, it isn’t the reason why they have continued to have alopecia. Grace does yoga to relieve stress but adds that it isn’t the “root of the problem.”
Emily and Krista both think changing or occasionally missing contraceptive pills may have been a factor in their hair loss. Krista also stopped taking antidepressants because of side effects and she thinks coming off a high dose could have upset the balance of her hormones. Beth’s dad thinks her hair might regrow with the hormonal changes if she becomes pregnant in the future.
- illness or another condition;
Doctors sometimes ran tests to check if the hair loss was being caused by another condition. Emily and Emma were both prescribed iron tablets when their blood results showed they had low iron levels, but their alopecia continued. Hannah has seizures which are also triggered by stress and finds her alopecia tends to be more severe when she has more fits. Some people thought medications they took for other conditions might have been triggers for their alopecia.
There were some other possible factors mentioned by some, such as:
A few people wondered if this could have played a role in triggering their alopecia. Others were sceptical and thought “blaming” diet was unfair. Emily eats mostly vegetarian food and although she took iron tablets when her blood tests showed low iron levels, her alopecia continued. Lots of people thought that an unhealthy diet wasn’t necessarily a trigger for alopecia, but that “eating well” could help regrowth. Ben stopped eating gluten after a test showed he was intolerant and although his alopecia continued, he says he looks and feels healthier than before.
Annie X says her hair tends to fall out in February but quickly regrows between March and June. Emilie found her scalp grew “peach fuzz” in the summer months. Emma’s noticed a pattern in which her hair falls out in October.
- hair styling and products;
Some people thought things like hair dye, perming or putting weaves into the hair had played a role for them, but others disagreed. There is an alopecia subtype called traction alopecia caused by the hair being pulled tightly e.g. with hairstyling, but this wasn’t relevant for most of the people we talked to as they had alopecia areata (an autoimmune condition).
There was a lot of uncertainty about triggers and it was a very emotional topic. Sometimes people felt it was their ‘fault’ that they had alopecia, which was very difficult to cope with. Other people had sometimes made comments which implied blame that they had done something “wrong” or that there was something ‘wrong’ with them. Imogen’s heard nasty comments that she must be very ill and unhealthy because her hair has fallen out. Emilie finds it annoying when people tell her “don’t stress” because “there’s bound to be things that are gonna stress you.”