34301 The relationship between the degree of scalp hair loss and health-related quality of life among patients with alopecia areata

Abstract

Background: Previous research suggests that alopecia areata (AA) negatively impacts patients’ health-related quality of life (HRQL) including considerable psychosocial impacts. Purpose of the current study was to examine relationship between AA scalp hair loss and HRQL impacts. Methods: This cross-sectional, web-based survey included patients recruited through a patient foundation who self-reported a physician diagnosis of AA. Survey included questions on disease characteristics, patient burden and impact (assessed through Skindex-16 for AA and questions on work and sexual relationships), healthcare utilization, and treatment experience. Results: Patients with AA (N = 1327) completed the survey, mean age 39.7 years (SD = 12.3), 58.4% female. Patients were diagnosed on average 10.5 years ago (SD = 12.2). The degree of current hair loss included: 0% (2.6%), 1-20% (39.8%), 21-49% (26.2%), 50-94% (10.2%), and 95-100% (21.3%) of scalp hair missing. There was a non-linear relationship between HRQL and current patient-reported AA scalp hair loss. Patients with 1-94% of current scalp hair missing reported higher symptom, functioning, and emotional impacts due to AA than patients with 0% or 95-100% missing scalp hair (all P < .0001). Patients with moderate and large areas of hair loss reported greater impact on work (P < .0001) and sexual relationships (P < .001). Females reported higher impact on emotions due to AA (P = .014), while males reported higher impact in all other areas (P < .05). Conclusion: There is a nonlinear relationship between AA scalp hair loss and impacts on HRQL. Future research may help elucidate why those with the greatest amount of hair loss appear to cope better than those with moderate hair loss.