title: The psychosocial impact of hair loss among men: a multinational European study.
abstract: OBJECTIVE
  Hair plays an important role in determining self-image, social perceptions, and psychosocial functioning. The objectives of this survey were to identify the impact of hair loss on the self-image of men in five European countries and their level of concern about hair loss with regard to image and personal attractiveness. Moreover, we evaluated participants' use of treatments for hair loss and whether treatment success was associated with psychological benefit.
  
  
  METHODS
  A structured questionnaire of closed-ended questions was administered by telephone in major cities in Germany, France, Italy, Spain, and the United Kingdom. Random sampling was used, and eligible respondents were men from 18 to 45 years old.
  
  
  RESULTS
  Of the 1536 men responding to the telephone survey, 729 (47%) reported hair loss; these men are the subject of this report. Over 70% of these men reported hair to be an important feature of image, and 62% agreed that hair loss could affect self-esteem. The realization that they were losing hair was linked to concern about losing an important part of personal attractiveness (43% of men), fear of becoming bald (42%), concern about getting older (37%), negative effects on social life (22%), and feelings of depression (21%). Reduced self-confidence in personal attractiveness was also reported by 38% of men who were not in stable romantic relationships. Less than 10% of men were currently pursuing treatment for hair loss, and three out of four had never pursued treatment for hair loss, either at present or in the past. Those few men who pursued treatment and reported success (n = 73) also reported psychosocial benefits as a result: from 43% to 59% experienced improvements in parameters of self-esteem and perception of personal attractiveness. Reliance on self-reporting of hair loss and use of nonvalidated instruments to measure psychological outcomes are important study limitations.
  
  
  CONCLUSIONS
  The results of this survey indicate a gap between the need for treatment of hair loss and initiation of such treatment among men in five European countries. Further research is needed into the factors affecting men's willingness to seek treatment for hair loss.
authors.affiliation: Gallup Spain, Madrid, Spain.
authors.forename: Mariola
authors.initials: M
authors.lastname: Alfonso
authors.forename: Hertha
authors.initials: H
authors.lastname: Richter-Appelt
authors.forename: Antonella
authors.initials: A
authors.lastname: Tosti
authors.forename: Miguel Sanchez
authors.initials: MS
authors.lastname: Viera
authors.forename: Marcos
authors.initials: M
authors.lastname: García
mesh_terms: D000293:Adolescent; D000328:Adult; D000505:Alopecia / Q000503:physiopathology / Q000523:psychology*; D003625:Data Collection; D005060:Europe; D006801:Humans; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011897:Random Allocation; D012649:Self Concept; D011795:Surveys and Questionnaires