Hidden beneath Elline Surianello's beautiful hair is a woman few ever see.
Since she was 14, Surianello has suffered from a condition called alopecia, commonly known as hair loss. She wears a wig to hide the bald spots.
"To be like this all the time and think that this is how you have to be all the time, every day a little part of you dies," she said.
Surianello is among 30 million American women, about 1 in 5, living with female hair loss.
"Very few men are shocked that they are losing their hair," said Dr. Mark Kaufmann, a dermatologist. "With women, there's a complete shock and disbelief."
Surianello agreed to walk outside without her hairpiece with "Good Morning America" cameras following her.
"How do I function in the world knowing that everyone's paying attention to this," Surianello said, pointing to her hair. "Now they're not going to say anything to me because this is not a conversation, but they're going to ignore me. I become a nonentity. I become not a person that makes a statement. And I don't want to live my life that way."
About 70 percent of female hair loss is genetic. Other causes include stress, illness, medication and diet. Crash diets, tight ponytails/braids/weaves/extension, thyroid disorders, pregnancy, going off birth control and general anesthesia can all result in hair loss.
Dermatologist Susan Taylor had the following advice for preventing female hair loss.
• Don't ignore the problem. Get help soon.
• Hair care should be gentle, not painful. If it hurts, it's going to harm your hair.
• Avoid tight pony tails.
• Use gentle shampoos, nothing that itches.
• Don't skip conditioner.
• Don't over brush.
For those who have already lost a significant amount of hair, Taylor said Rogaine and cortisone injections or creams may help stabilize growth and in some cases regrow it. Rogaine costs about $25 per month. Cortisone requires a doctor's prescription and may be covered by insurance. Without insurance, the treatments cost approximately $50 to $150, Taylor said.
Hair transplants are the most expensive and time consuming treatment for female hair loss, at about $5,000 to $10,000 for a series of transplants over several months.
"There's a lot of research being done on stem cells," Taylor said. "The cells that grow hair have been identified, and hopefully we'll be able to use them one day to regrow hair in people who have lost it."