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Despite numerous qualitative studies examining the experience of people with alopecia, a comprehensive synthesis is lacking. This can obscure progress in research and minimize the impact of psychosocial support people with alopecia can receive. This systematic meta\u2010synthesis aimed to critically integrate the existing literature to enhance psychological understanding of how people with alopecia manage issues about identity and appearance changes, and provide some evidence\u2010based recommendations for clinicians working in the area of psychodermatology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of six databases: APA PsycInfo (OVID), Medline (OVID), Embase (OVID), CINAHL (EBSCO) and Scopus identified 22 eligible studies on the lived experience of alopecia among adults, adolescents and parents. The Critical Appraisal Skills Programme Qualitative Checklist was used to appraise the quality of the studies. Extracted data underwent inductive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The synthesis, representing 990 people living with alopecia, identified five main themes, focusing on managing identity and appearance changes: (1) coming to terms with a changed identity; (2) the journey to acceptance; (3) complexities of concealing hair loss; (4) social influences in both facilitating and hindering adaptation; and (5) treatment experiences highlighting unmet needs. Findings reveal substantial variation in managing identity and appearance changes, with some individuals achieving acceptance swiftly while others struggle. Social reactions and personal interpretations significantly shape adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Alopecia profoundly impacts identity, coping, and social interactions, often accompanied by dissatisfaction with health care and treatment options. The reactions of other people and interpretations of these experiences appear to play a key role in adjustment. The review underscores the need for personalized, non\u2010pharmacological interventions that address personal and social challenges. Greater co\u2010production in health care training and intervention development is necessary to improve support for individuals with appearance\u2010altering conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjhp.70048","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T12:36:42Z","timestamp":1768826202000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A systematic review and meta\u2010synthesis of qualitative studies of alopecia: Managing identity and appearance changes"],"prefix":"10.1111","volume":"31","author":[{"given":"Zoe","family":"Hurrell","sequence":"first","affiliation":[{"name":"South Wales Doctoral Programme in Clinical Psychology, School of Psychology, Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3501-4093","authenticated-orcid":false,"given":"Vasilis S.","family":"Vasiliou","sequence":"additional","affiliation":[{"name":"Department of Psychology Royal Holloway, University of London  London UK"},{"name":"Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0927-277X","authenticated-orcid":false,"given":"Fuschia M.","family":"Sirois","sequence":"additional","affiliation":[{"name":"Department of Psychology Durham University  Durham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6788-7222","authenticated-orcid":false,"given":"Andrew R.","family":"Thompson","sequence":"additional","affiliation":[{"name":"South Wales Doctoral Programme in Clinical Psychology, School of Psychology, Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745691613506909"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41687\u2010020\u201000240\u20107"},{"key":"e_1_2_9_4_1","unstructured":"All Party Parliamentary Group on Skin. 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