Many people have a deep connection with their hair, as it is often seen as part of their identity and self-expression. That being said, people who have a strong attachment to their hair might be fearful of going bald. Given the prevalence of androgenetic alopecia —a type of hair loss—it’s natural to feel worried about losing your hair.
However, there’s a stark difference between a “normal” level of fear about losing your hair and severe, recurring anxiety that affects your day-to-day life. If you’re experiencing significant distress surrounding a fear of baldness, it could be a sign of a phobia, obsessive-compulsive disorder (OCD), or other mental health disorders.
Why am I afraid of going bald?
According to a 2020 survey of 32,000 Americans, most men (59%) and women (57%) between 18 and 24 said the thought of going bald terrified them. But where exactly does a fear of baldness come from? Well, there are a few factors that can lead to fear of hair loss:
- The connection between length of hair and attractiveness. A study found that women with longer hair are considered more attractive than women with short hair.
- Genetics. Androgenetic alopecia (also known as male-pattern and female-pattern baldness) may develop due to your family genes. So, if you have someone in your family who is balding, you might fear that the condition will be passed on to you.
- Traumatic experiences. You may develop a fear of balding if you’ve been bullied or teased for thinning hair or a receding hairline.
How would I know if my fear of balding is a serious problem?
For the most part, it’s pretty common to have a fear of baldness. However, according to Tracie Ibrahim, LMFT, CST, Chief Compliance Officer at NOCD, if you’re constantly ruminating on this fear to the point where it’s causing significant distress, it could be a sign of an underlying mental health disorder.
“It’s normal to not want to go bald or to fear that because you see other bald people in your family,” she says. “When it causes a lot of distress or impairment in your functioning, that’s when it becomes unhealthy.”
It’s normal to not want to go bald or to fear that because you see other bald people in your family. When it causes a lot of distress or impairment in your functioning, that’s when it becomes unhealthy.
Tracie Ibrahim, LMFT, CST
Could my fears be related to a mental health condition?
In some instances, a fear of hair loss or balding could be a sign of several mental health conditions. Here’s a look at mental disorders that could be the underlying causes of a fear of baldness.
Peladophobia
Peladophobia, or phalacrophobia, is a specific phobia that revolves around the fear of balding. Specific phobias are anxiety disorders that cause an intense fear of situations or things that pose no actual threat.
If you have peladophobia, you may experience physical symptoms, such as panic or anxiety attacks at the thought of balding or actually experiencing hair loss.
Some potential symptoms of peladophobia include:
- Having obsessive thoughts about balding.
- Repeatedly checking hairline or scalp.
- Avoiding social situations.
- Camouflaging your perceived hair loss with hats or wigs—even if there’s no hair loss present.
- Spending excessive amounts of money on hair treatments that prevent balding.
Trichotillomania
Trichotillomania, or simply trich, is another mental health disorder that might cause a fear of balding. Trich is part of body-focused repetitive behaviors (BFRBs), which are a group of mental health conditions that cause people to engage in repetitive behaviors that fixate on their bodies. Trich, in particular, causes an irresistible urge to pull out your hair, which can cause hair loss.
“With trichotillomania, a lot of times, people will start to get bald spots, which can be distressing,” says Ibrahim.
Some of the symptoms of trichotillomania can include the following:
- Repeatedly pulling out your hair, typically from your scalp, eyebrows, or eyelashes, but can also occur from other areas of your body.
- An increasing sense of tension before pulling out your hair or when you try to resist pulling.
- Repeatedly trying to stop or decrease the hair-pulling behavior without success.
- Feeling a sense of relief or pleasure after pulling the hair out.
- Chewing, biting, or eating the pulled-out hair.
- Experiencing significant distress or impairment at work, school, and social situations.
Body dysmorphic disorder (BDD)
Body dysmorphic disorder (BDD), also known as body dysmorphia or dysmorphophobia, is a mental health disorder characterized by excessive worry about “flaws” in your appearance—despite the fact that others often don’t notice them.
“People who have BDD and a fear of balding are constantly comparing themselves to others and spending a lot of time looking in mirrors to make sure [their perceived baldness] is not showing,” says Ibrahim.
Fears about body image can also cause the following symptoms of BDD:
- Excessive grooming or exercising
- Skin picking
- Repeatedly camouflaging yourself (trying to cover up your “flaws” with a wig, hat, hoodie, etc.)
Obsessive-compulsive disorder (OCD)
Obsessive-compulsive disorder (OCD) is a highly treatable mental health disorder that causes a cycle of obsessions and compulsions. Obsessions are intrusive thoughts, images, urges, feelings, and/or sensations that cause intense fear and anxiety. Compulsions are the mental or physical behaviors done to temporarily relieve distress from obsessions and/or to prevent something bad from happening.
A subtype of OCD that can align with an intense fear of balding is perfectionism OCD, also known as “just right” OCD. Perfectionism OCD can cause frequent intrusive thoughts and compulsions about organization, perfection, and making things feel “just right.” If you have this OCD subtype, you may experience re-occurring anxiety about losing your hair and experience distress if your hair doesn’t look “perfect” in your eyes.
How do I stop worrying about balding?
The idea or experience of losing your hair can be daunting. If your fear of balding is tied to an underlying mental health condition, consider seeking help from a therapist to address your fears. If they determine that you’re experiencing a phobia, trich, BDD, or OCD, here’s what treatment might look like:
Treating BDD
According to Ibrahim, a specially designed cognitive behavioral therapy (CBT) can treat BDD. CBT is a type of talk therapy that helps you manage your anxiety and identify the core beliefs driving your decision. A CBT therapist with expertise in body dysmorphia can teach you alternative ways to manage your obsessive thoughts without engaging in behaviors like camouflaging or mirror-checking.
Ibrahim also adds that family therapy and medications, such as antidepressants, may be part of the treatment plan for managing BDD symptoms.
Habit reversal training (HRT) for trichotillomania
Habit reversal training (HRT) is the preferred treatment for trich. “HRT trains you to be aware of what happens that makes you pull your hair in the first place and teaches you a competing response,” explains Ibrahim. “So, instead of pulling, you’d learn to do something else instead.”
Exposure and response prevention (ERP) for phobias and OCD
The best treatment for peladophobia (or any specific phobia) and OCD is exposure and response prevention (ERP) therapy. This evidence-based therapy helps you break the cycle of obsessions and compulsions by teaching you strategies that help you face your fear of balding head-on without responding with compulsive behaviors. Decades of scientific research support ERP’s effectiveness, with 80% of people with OCD and 80-90% of people with phobias seeing a significant change in their symptoms when they do this therapy.
You’ll work with a therapist specializing in ERP to develop a customized treatment plan to address your fears. They’ll start by exposing you to your smallest fears and gradually work up to more anxiety-inducing ones.
In addition to exposure, your ERP therapist will teach you response prevention techniques, which are strategies that help you resist responding to your fears with compulsions. For example, Ibrahim says your therapist may have you say response prevention messages like “I may or may not go bald if I don’t put mayonnaise in my hair every Thursday.”
While ERP is super effective in helping you get control of your symptoms, don’t expect to see any significant changes overnight. This specialized therapy requires patience and consistency to make long-lasting changes.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Bottom line
It’s natural to fear losing your hair. What makes a “normal” fear of balding become a more concerning issue is if you’re having obsessive thoughts, avoiding your daily activities, and/or engaging in unhealthy behaviors such as hair-pulling.
If you’re experiencing symptoms of a phobia, trichotillomania, BDD, or OCD, please seek help from a therapist. They can diagnose your condition and start you on a treatment journey to reduce your symptoms.
Key takeaways:
- Given how common balding is, it’s normal to have a fear of hair loss to a certain extent. However, if you’re experiencing intrusive thoughts or compulsions about balding, it could be a sign of a mental health disorder.
- Peladophobia, trichotillomania, body dysmorphic disorder (BDD), and OCD are mental health conditions linked to an intense fear of balding.
- Specialized cognitive behavioral therapy (CBT), habit reversal training (HRT), and exposure and response prevention (ERP) therapy are the most effective treatments for addressing severe balding anxiety.
