Stress and alopecia areata: a psychodermatologic study.

Gupta MA, Gupta AK, Watteel GN.

Department of Psychiatry, University of Western Ontario, London, Canada.

Psychosocial stress has been reported to play a role in the onset and/or exacerbation of alopecia areata.

Little is known about the clinical characteristics of alopecia areata patients whose alopecia is stress-reactive.

We examined the relation between the stress reactivity of alopecia areata and a wide range of psychosocial measures among 16 patients with alopecia areata/totalis and 28 patients with alopecia universalis.

The degree to which the alopecia was exacerbated by stress was measured by patient ratings on a 10-point scale.

A wide range of psychologic measures correlated (p<0.05) with the stress reactivity score. Stepwise logistic regression analysis revealed that patients with higher depression scores were more likely to be in the high-stress reactor group.

Patients whose alopecia is stress-reactive may suffer from depressive illness, a potentially important consideration in the overall management of such patients.