Table 1.

Intrapersonal components of the cumulative life course impairment model applied to alopecia areata

Stigma	Psychological comorbidities	Social/financial impact	Negative coping	Positive coping
Illness/cancer patient (perception)	Depression	Avoidance of activities/socializing	Wigs/make-up	Wigs/make-up
Not “life threatening” (perception)	Anxiety	Worry about wig being “found out”	Evolution of poor coping mechanisms	Support groups
Loss of self-identity	Suicidal ideation	Altered career course	Not worthy of support or treatment	Family/friends
Victim of bullying	Social avoidance	Inauthenticity of relationships	Lack of empathy from providers	Sense of part of larger AA community
Loss of femininity	Stress as a trigger for AA onset or recurrence	Restrictions on romantic/sexual relationships	Delayed referral to counseling	Self-acceptance
Pressure to conceal hair loss	Persistent worry about future loss	Cost of concealment and treatment	Minimization/expected to “come to terms with it”	Hope for future

AA – Alopecia areata