Alopecia-Related Stigma Linked to Greater Mental Health Burden Than Disease Itself

The impact on quality of life among patients living with alopecia is determined largely by the negative perceptions and stigma linked to one’s illness, recent findings suggest.¹

These findings were the result of an analysis led by King’s College London, known to be the largest of its kind. It was published in the British Journal of Dermatology. The analysis was backed by an academic research grant from Pfizer and involved a survey of 596 adults known to be living with alopecia areata.

“Alopecia can significantly affect an individual’s quality of life, affecting not only their physical appearance but also their self-esteem and overall mental well-being,” Christos Tziotzios, MD, lead investigator and adjunct Senior Lecturer at the St. John’s Institute of Dermatology, said in a statement.¹ “Despite this, it is a condition that is often overlooked by healthcare professionals.”

Recent findings highlighted by HCPLive demonstrated varying levels of correlation between alopecia areata and anxiety and depression throughout countries such as the US, China, India, Japan, and Brazil.² These prior data reinforce the need for more attention on alopecia’s mental health impacts that was demonstrated in the new King’s College study.

“By identifying the underlying causes of poor mental health in individuals with alopecia, we can provide earlier and more targeted support,” Tziotzios said in his statement.¹ “We are now hoping to research the impact of alopecia on adolescent patients and their families via the global collaborative Alopecia+us study and very much hope for as many participants to come forward and contribute.”

Alopecia areata is an autoimmune condition in which the body’s immune system mistakenly attacks hair follicles. The skin disease typically begins with small, round or oval bald patches which are found on the scalp or elsewhere around the body. More advanced cases may result in total loss of scalp hair, also known as alopecia totalis, or complete body hair loss, known as alopecia universalis.

Despite the widespread impact of the hair loss condition among populations around the world, alopecia is still often dismissed. Those who dismiss the condition often believe it is simply a cosmetic concern rather than a legitimate medical one, Tziotzios and coauthors noted.¹ In fact, within their analysis, over half of respondents in this new analysis reported feeling ashamed or self-conscious about their condition. More than 1 in 3 reported that their everyday activities—such as academics, work, housework, family activities, or leisure—were negatively impacted.

Overall, the data suggest a strong link between positive perceptions of the condition and reduced levels of anxiety among patients. In other words, those who maintained a more constructive outlook on their illness tended to experience fewer symptoms of anxiety.

The investigative team highlighted that incorporating evaluations of stigma and illness perception into regular clinical assessments could allow for greater insights among healthcare professionals into the lived experiences of individuals living with alopecia. The help provided by earlier psychological interventions could help counteract negative beliefs and diminish stigma felt by such patients, thereby leading to coping mechanism improvements.

The team has also announced the launch of the global ‘Alopecia+us’ study, an analysis funded by the Pediatric Dermatology Research Alliance (PeDRA) and supported by King’s Health Partners. This study is set to examine the ways in which alopecia affects younger patients during adolescence, as well as their families, in real-life settings.

In their description, the investigators highlighted participant, Lorna Pender, 41, from York, an ex-National Health Services (NHS) physician, who was first diagnosed with alopecia areata at age 8. Pender had noted that this early diagnosis left her feeling deeply insecure as well as socially isolated.

“I spent four years trying to navigate to an alopecia expert in the NHS who would entertain having a high-level scientific consultation with me, and two dermatologists in Yorkshire whose response was indifference and indignance that there was nothing they could offer me,” Pender said in a statement.¹ “Importantly there was no focus on my mental health.”

Pender described this experience as traumatizing, noting the challenges of further self-advocacy. Pender added that where it not for the aid of a national alopecia expert located in London responding to emails, the situation could have deteriorated further.

“This is exactly why Alopecia + me research is vital for driving this paradigm shift in the way dermatology and alopecia care incorporates the person living with the psychological impact of alopecia,” Pender said in her statement.¹ “As we see in this research, this is not linked to alopecia severity, demonstrating how psychological support is vital for all people with alopecia.”

References

1. King’s College London. Stigma driving depression in alopecia patients, rather than illness severity. EurekAlert! July 15 5, 2025. https://www.eurekalert.org/news-releases/1091126?.

2. Johnson V. Research Highlights High Rates of Anxiety and Depression With Alopecia Areata. HCPLive. July 8, 2025. Accessed July 15, 2025. https://www.hcplive.com/view/research-highlights-high-rates-of-anxiety-and-depression-with-alopecia-areata.