Immune Privilege Collapse And Alopecia Development: Is Stress A Factor

The review examined the collapse of immune privilege in hair follicles as a factor in autoimmune hair loss disorders such as alopecia areata (AA) and lichen planopilaris (LPP). It noted that the hair follicle is an immune privileged site, and its collapse could contribute to these conditions. AA affects about 2% of the global population and involves T-cell-mediated inflammation, while LPP results in permanent hair loss due to T lymphocyte activity. Emotional stress was identified as a potential trigger for immune privilege collapse, with over 65% of AA patients reporting stress as a trigger. The review emphasized the need for further research into the mechanisms of immune privilege and its collapse in hair loss disorders, highlighting the role of stress in activating a local neuroendocrine axis that leads to neurogenic inflammation and hair follicle destruction.