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One of the most extensive epidemiological investigations in the last five decades regarding alopecia areata prevalence and incidence in the United States shows that the burden of the condition is rising, disproportionately affecting females and people living in the Northeast.

To overcome health disparities and fight diseases effectively, it is vital to understand the prevalence and incidence of any health disorder. Alopecia areata (AA) is an autoimmune disorder causing patchy hair loss, complete scalp hair loss, i.e., alopecia totalis (AT), or even complete body and facial hair loss, i.e., alopecia universalis (AU). The conditions start at a young age, with most cases first diagnosed by age 40. Fortunately, most recover within the first year of diagnosis, but the disease progresses to AT or AU in a small number of cases. 

In the United States, overall AA prevalence is estimated at 0.1% to 0.2%. However, these estimates are based on studies done in the 1970s. Hence, it is vital to know more about the latest trends. A new study, published in JAMA Dermatology, investigated the latest trend in the prevalence and incidence of AA in the United States.

Prevalence and Incidence of AA Have Increased Over the Years

For the purpose of the study, researchers used IBM MarketScan Commercial and Medicare Supplemental databases from January 1, 2015, to December 31, 2019. This data contains information from 130 different insurance providers and includes more than 25 million cases annually. The present study analyzed the data for the years 2016 to 2019. 

The study found that AA was much more likely to be diagnosed in women. In the year 2016, out of 18,368 patients, 12,295 (66.9%) were women. Although there has been variation over the years, women still constitute more than 60% of AA cases. Another interesting finding of the study was the upward trend, with AA prevalence increasing from 0.199% in 2016 to 0.222% in 2019. Further, the study found that 5% to 10% of cases of AA were AT/AU. It also found that the prevalence of AA was highest in the Northeast.

The Bottom Line

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Though this study was able to show an increasing disease burden and shed light on gender and regional disparities, there were some limitations. These include a lack of data about the severity or degree of scalp hair loss. Additionally, this study used data from patients covered by commercial insurance; thus, the results may not be generalizable to the whole population. There was also a lack of information about the racial or ethnic identity of the patients; therefore, the data could not shed light on racial disparities. 

Source:

Mostaghimi, A., Gao, W., Ray, M., Bartolome, L., Wang, T., Carley, C., Done, N., & Swallow, E. (2023). Trends in prevalence and incidence of alopecia areata, alopecia totalis, and alopecia universalis among adults and children in a US Employer-Sponsored insured population. JAMA Dermatology, 159(4), 411. https://doi.org/10.1001/jamadermatol.2023.0002