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People with alopecia areata have gender-specific comorbidities, including anxiety, dermatitis, hypothyroidism, and hyperlipidemia. According to a recent study, interactions between gender, age, and the severity of the disease influence the onset of these associated diseases.

Alopecia areata (AA) is a chronic inflammatory condition considered the second most common hair loss disorder after androgenetic alopecia. The estimated lifetime risk of AA worldwide is roughly 2%. Although the usual onset of this syndrome frequently happens in the third and fourth decades of life, it can manifest at any age, coinciding with an increased vulnerability to various conditions during an individual’s lifetime.

The etiology of AA is based on a systemic autoimmune malfunction in which the body initiates an immunological reaction against anagen hair follicles, resulting in their suppression. Many factors, such as genetics, oxidative stress, atopic inclinations, and gut microbiota, are potential influences on AA development. AA is also linked to various comorbidities, including cardiovascular disease, atopic dermatitis, thyroid disorders, lupus erythematosus, vitiligo, psoriasis, inflammatory bowel disease, and rheumatoid arthritis. 

This study, published in the journal Health Science Reports, examined the possible association between age, gender, and the occurrence of different comorbidities in patients with AA.

Study Population

The study was cross-sectional and included 402 AA patients. The mean age of the patients was 27.2 ± 13.4 years, and 52.2% (n=210) were male. The most common AA types were patchy, universalis, totalis, and ophiasis. The mean disease duration was 1.93 ± 2.15 years.

Influence of Alopecia Type and Gender on Associations

A significant association was seen between the type of alopecia and sex (p = 0.016). Interestingly, no significant association was found between the severity of AA, as measured by the Severity of Alopecia Tool (SALT) score, and the age of the patients, in relation to their sex (p = 0.193 and 0.118, respectively).

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Age-Dependent Recurrence Patterns in Alopecia Areata

Moreover, the study revealed that relapses in AA were not significantly linked to the type of alopecia (p = 0.111) or the severity of the disease (p = 0.125). However, a significant association emerged between recurrences and age above 18 years (p = 0.024).

Prevalence of Comorbidities and Gender Associations in Alopecia Areata

Anxiety and dermatitis were the most common comorbidities among participants. Additionally, sex was associated with hypothyroidism and hyperlipidemia (p = 0.002 and 0.024, respectively). No correlation was noted between the severity of AA and the onset of the disease or hypothyroidism (p = 0.97 and 0.66, respectively).

Age-Related Correlations and Comorbidities in Alopecia Areata

Age was also a factor in the occurrence of certain comorbidities. Age was significantly associated with hypothyroidism, hypertension, hyperlipidemia, and diabetes. Moreover, a significant association was found between AA severity and hyperlipidemia and vitiligo.

Correlations With Allergic Rhinitis and Asthma in Alopecia Areata

No association between the type of alopecia and the prevalence of dermatitis, anxiety, or allergic rhinitis was observed. However, a significant correlation was found between the prevalence of allergic rhinitis and individuals older than 18. No significant associations were found between asthma and age, type of disorder, or SALT score in AA patients with asthma.


Hamidpour, E., Shakoei, S., Nasimi, M., & Ghandi, N. (2023). Effects of age and sex on the co-morbidities of alopecia areata: A crosssectional hospitalbased study. Health Science Reports, 6(7), e1444. https://doi.org/10.1002/hsr2.1444