Risk factors for distress associated with alopecia:
(1) young age (under 30 years of age)
(2) female gender
(3) not being involved in a romantic relationship (possibly related to insecurity about attractiveness)
(4) self-esteem strongly dependent on physical appearance
(5) pre-existing poor self-esteem or psychological distress
(6) livelihood depends on appearance or the need to make a good first impression (salesperson, actor, other)
(7) ridicule from others
(8) belief that alopecia reflects ill health or physical deterioration
A man who is willing to shave his head is less likely to feel much distress.
A person with hair loss and one or more risk factors should be questioned more carefully to determine the person's level of concern and desire for change.