Assessing the Role of Stressful Life Events in the Induction and Recurrence of Alopecia Areata: A Case-Control Study

March 2022 in “ Journal of the American Academy of Dermatology ”

Panagiotis Ferentinos, Eugenia Kalogeropoulou, Georgia Pappa, Anastasia Antoniou, Evangelia Bozi, Miltiades Kyprianou, Dimitrios Rigopoulos, Alexander Katoulis

alopecia areata stressful life events genetic factors immunological factors environmental factors psychological stress hypothalamic-pituitary-adrenal axis hair growth inhibition psychiatric comorbidities psychosocial impact AA SLEs HPA axis

TLDR Stress can trigger or worsen alopecia areata.

This study investigated the association between stressful life events (SLEs) and the onset or recurrence of alopecia areata (AA) in 52 patients compared to 51 healthy controls. The findings revealed that patients with AA experienced significantly more SLEs in the year preceding the onset or recurrence of the condition. Changes in sleeping, personal, and eating habits were particularly associated with recent onset and mild/moderate severity of AA. SLEs were also strong predictors of the psychosocial impact of AA, as measured by various psychometric scales. Despite limitations such as small sample size and recall bias, the study suggests a pathogenetic role of psychological factors in AA and highlights the need for a holistic approach to treatment.

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