A Link Between Psychiatric Disorders and Non-Scarring Alopecias: A Systematic Review

November 2022 in “ Skin health and disease ”

Ana L. Forneris Crego, Anastasia Therianou, Parastoo Hashemi, Claire A. Higgins

non-scarring alopecias Alopecia Areata AA Telogen Effluvium TE Androgenetic Alopecia AGA acute stress anxiety depression hair loss conditions

TLDR People with hair loss conditions often have more mental health issues like depression and anxiety compared to those without hair loss.

This systematic review analyzed 21 articles and found a significant correlation between non-scarring alopecias (hair loss conditions) and psychiatric disorders. The study included 20,779 controls and 9,221 patients, with the majority having Alopecia Areata (AA). Patients with hair loss were found to have significantly more mental health disorders (35.1% vs. 8%), depression (26% vs. 8%), and anxiety (42.2% vs. 3.3%) than the control group. Acute stress was more associated with AA, while anxiety was more correlated with Telogen Effluvium (TE). Androgenetic Alopecia (AGA) patients showed the most association with other psychiatric disorders. The review concluded that alopecia types are more associated with psychiatric disorders than the general population, with higher levels of psychiatric disorders observed in TE and AGA patients. The study suggests that more extensive studies and coordination between psychiatrists and dermatologists could help to improve the outcome of both mental health disorders and hair loss.

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research An Overview of Alopecias

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research The Difficult Hair Loss Patient: A Particular Challenge

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research Evaluation of Anxiety and Levels of Serum B12, Folate, TSH, Ferritin, and Zinc in Telogen Alopecia Patients with Trichodynia

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research Neuroimmunology of Stress: Skin Takes Center Stage

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research Hair Growth Inhibition by Psychoemotional Stress: A Mouse Model for Neural Mechanisms in Hair Growth Control

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research Stress Exposure Modulates Peptidergic Innervation and Degranulates Mast Cells in Murine Skin

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research Burden of Hair Loss: Stress and the Underestimated Psychosocial Impact of Telogen Effluvium and Androgenetic Alopecia

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research The Presence of Trichodynia in Patients With Telogen Effluvium and Androgenetic Alopecia

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research Stress Inhibits Hair Growth in Mice by Inducing Premature Catagen Development and Harmful Perifollicular Inflammatory Events via Neuropeptide Substance P-Dependent Pathways

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research Psychological Characteristics of Women with Androgenetic Alopecia: A Controlled Study

58 citations , September 1991 in “British Journal of Dermatology”

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research Successful Treatment of Severe Alopecia Areata With Oral or Topical Tofacitinib

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research Alopecia Areata of the Beard: A Review of the Literature

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research Phototherapy for Alopecia Areata

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research Alopecia Areata: Clinical Presentation, Diagnosis, and Unusual Cases

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research Diagnosis of Hair Loss: Clinical Features of Common Causes

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