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Alopecia areata patients reported significantly increased daily activity impairment and work productivity loss, which correlated to worsening emotional symptoms.

Individuals suffering from alopecia areata (AA) tend to experience significant psychological and emotional distress that affects their work productivity and quality of life. This study demonstrated that emotional symptoms related to AA correlate with increased activity impairment and reduced work productivity. The study findings are published in the journal Dermatology and Therapy.

Alopecia Areata-Related Emotional Symptoms Hinder Daily Activities

This study demonstrated that the worsening of AA-related emotional symptoms significantly influenced daily activity impairment and work productivity loss (WPL). The average decline in these parameters was 25% for every 1 point increase on the Alopecia Areata Patient Priority Outcomes Emotional Symptoms (ES) score. WPL was associated with a decline in work performance, though absenteeism was not affected.

Alopecia Areata Had a Greater Impact than Psoriasis on Daily Activity and Work 

This study recorded mean daily activity impairment and WPL to be 13.3% and 12.2%, respectively, for psoriasis patients.

Cross-Sectional Study Design Limits Generation of Temporal Causality Statements

The cross-sectional nature of the data acquired in this study may limit the establishment of a causality argument on the effect of emotional symptoms on work productivity and activity impairment outcomes. However, it is likely that emotional symptoms associated with hair loss in AA, including embarrassment, frustration, and self-consciousness, may affect activity impairment and WPL.

The Causality Debate of Hair Loss and Stress in Alopecia Areata Patients

There is a dispute in establishing the causal relationship between hair loss and stress in AA patients, as these variables have a bidirectional relationship. Emotional symptoms related to hair loss with negative productivity outcomes can lead to certain personality attributes and premorbid stress.

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Bias Potential in Participating and Non-Participating Groups

There can be a potential bias between the two study groups owing to the under-representation of AA patients who are more severely emotionally affected since participating patients were less impaired from AA, as perceived by their dermatologists.

This study demonstrated that AA patients experience significantly increased WPL and daily activity impairment, which are associated with the emotional symptoms of AA.


Gandhi, K., Shy, M. E., Ray, M., Fridman, M., Vaghela, S., & Mostaghimi, A. (2023). The Association of Alopecia Areata-Related Emotional Symptoms with Work Productivity and Daily Activity Among Patients with Alopecia Areata. Dermatol Ther (Heidelb), 13(1), 285-298. https://doi.org/10.1007/s13555-022-00864-1