New research has found varying levels of correlation between alopecia areata (AA) and anxiety and depression across China, Japan, India, Brazil and the United States, highlighting the need for more attention on AA’s effect on mental health.¹

“Hair loss due to alopecia areata can be an extremely anxiety-provoking experience for those affected by the condition and their families.² This disorder affects approximately 2% of the global population, with women typically twice as likely to have alopecia areata. This hair loss disorder is known to be associated with other comorbid conditions, and while many studies have investigated the rates of comorbid disorders in alopecia areata, few have specifically examined the relationship between mental health disorders and alopecia areata,” lead investigator Aditya K. Gupta, MD, PhD, MBA, Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Mediprobe Research, London, Ontario, Canada, and colleagues wrote.¹

Gupta and colleagues gathered data on AA, anxiety and depressive disorders within the Global Burden of Disease Study 2021, from China, Japan, India, Brazil and the United States for males and females stratified age by less than 20, 20 to 54 and 55 years of age and older. They also collected data on prevalence and years lived with disability (YLDs) measures as surrogate markers for extent and severity of disease respectively. They also calculated Pearson’s correlation coefficient for both prevalence and YLDs for AA versus anxiety as well as for AA versus depression.

The investigators found significant positive correlations of AA with anxiety and depression in females: primarily in China, Japan, India, and Brazil for anxiety, and China, India, and Brazil for depression. Specifically, females less than 20 years of age had a significant positive correlation between AA and depression in China (Pearson’s R, .8421), Japan (Pearson’s R, .5673), and India (Pearson’s R, .6682), while both females between the ages of 20 and 54 years (Pearson’s R , .8652) and over 55 years (Pearson’s R , .3807) had a significant positive correlation in China only. For depression, females less than 20 years of age had a significant positive correlation in China (Pearson’s R, .8535), India (Pearson’s R, .8461), and Brazil (Pearson’s R , .4648) while females aged 20–54 years had a significant correlation in China (Pearson’s R, .3202), India (Pearson’s R, .7748), and Brazil (Pearson’s R, .5362).The investigators did not find any significant correlations for male participants.¹

“We have demonstrated that there is a complex relationship between alopecia areata and anxiety and depressive disorders, with correlations varying by country. There is an interplay between mental health and alopecia areata, where some patients may experience distress due to hair loss, while others may have pre-existing anxiety or depression which could potentially be worsened by hair loss,” Gupta and colleagues concluded.¹ “The impact of hair loss disorders such as alopecia areata on the mental health of patients should not be discounted, but rather addressed as part of a patient’s ongoing care.”

REFERENCE

1. Gupta AK, Economopoulos V, Talukder M. Examining the Relationship Between Alopecia Areata and Mental Health: An Investigation of the Global Burden of Disease Study 2021. J Cosmetic Derm. 2025;24(7). doi:https://doi.org/10.1111/jocd.70325

2. ‌Gupta AK, Polla Ravi S, Wang T. Alopecia areata and pattern hair loss (androgenetic alopecia) on social media – Current public interest trends and cross‐sectional analysis of YouTube and TikTok contents. J Cosmetic Derm. Published online January 6, 2023. doi:https://doi.org/10.1111/jocd.15605