Abstract
Alopecia areata is a representative inflammatory skin disease that is associated with various environmental stimuli. While psychological stress is believed to be a major pathogenetic trigger in alopecia areata, infants and newborns also suffer from the disease, suggesting the possible presence of other environmental factors. Daily lifestyle is well known to be involved in various inflammatory diseases and influences the severity of inflammatory skin diseases. However, only a limited number of studies have summarized these influences on alopecia areata. In this review article, we summarize lifestyle factor-related influences on the pathogenesis of alopecia areata and focus on environmental factors, such as smoking, alcohol consumption, sleep, obesity, fatty acids, and gluten consumption.
Highlights
The skin is the outermost layer of the body that is exposed to various environments [1,2]
CD4+ IL-17+ cells infiltrate around hair follicles in the acute phase [27] and are significantly higher in patients less than 30 years old [28], while Th17 is downregulated in the late phase [29]
These findings indicate that Th1, Th2, and Th17 activation is involved in the development of alopecia areata
Summary
The skin is the outermost layer of the body that is exposed to various environments [1,2] Because of this characteristic, the skin plays various vital roles, such as protection against external stimuli and the exertion of inflammatory cytokines [3,4]. Recent studies have identified that daily lifestyle factors, such as smoking, alcohol intake, and sleep, play a vital role in the development of inflammatory skin diseases [5]. Alopecia areata is a representative hair follicle disease, and environmental factors are known to influence disease development [8]. Environmental factors influence immunological actions in various inflammatory diseases; daily lifestyle factors are associated with the development of alopecia areata. We summarize the influence of daily lifestyle-related environmental factors on the development of alopecia areata. We discuss the possible pathogenetic role of these environmental factors in alopecia areata based on the immunological pathology of the disease
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