Hyposecretion of the Adrenal Androgen Dehydroepiandrosterone Sulfate (DHEA-S) in the Majority of Alopecia Areata Patients: Is It a Primitive and Pathogenic Perturbation of the Hypothalamic-Pituitary-Adrenal Axis?

The study investigated the basal serum levels of four hormones in 142 alopecia areata patients and found that while prolactin, ACTH, and cortisol levels were normal, dehydroepiandrosterone sulfate (DHEA-S) levels were significantly reduced in the majority of patients compared to controls. This reduction was observed in 69.1% of males and 74.7% of females, suggesting a potential primitive deficit in DHEA-S production. The findings indicated that low DHEA-S secretion might be linked to the pathogenesis of alopecia areata and could be indicative of chronic stress response. Preliminary therapeutic data suggested that normalizing DHEA-S levels might be beneficial for some patients, warranting further investigation into DHEA supplementation as a treatment for severe chronic/relapsing alopecia areata.