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Clinical severity does not reliably predict quality of life in women with alopecia areata, telogen effluvium, or androgenic alopecia

Presented as: Reid E, Haley AC, Borovicka J, West DP, Wickless H. Quality of life correlates more closely with patient-rated versus physician-rated hair loss severity in women with nonscarring alopecia. JID 2010.
https://doi.org/10.1016/j.jaad.2010.11.042Get rights and content

Background

Hair loss may significantly impact an individual’s self-image, and studies indicate that patients with both clinically apparent and clinically imperceptible hair loss may have significantly decreased quality of life (QoL). Moreover, clinical severity of hair loss does not necessarily predict impact on QoL.

Objective

The aim of this study was to assess QoL in patients (n = 104) with alopecia areata, telogen effluvium, and androgenic alopecia, and to compare QoL with hair loss severity (HLS) as independently rated by both patient and dermatologist.

Methods

Questionnaires and clinical assessment tools were used to assess HLS, and QoL was measured by completion of Skindex-16.

Results

Overall, patients rated their hair loss as more severe than the dermatologist, and the patient’s HLS rating more strongly correlated with QoL than the dermatologist’s rating. Clinical assessment of HLS did not reliably predict the patient’s QoL, nor did it predict the patient’s perception of HLS.

Limitations

A convenience sample was recruited from a referral clinic and Skindex-16 has not been validated for use in women’s alopecia disorders.

Conclusion

These findings indicate dermatologists should address these psychosocial and QoL issues when treating patients with alopecia.

Section snippets

Methods

Participants in this study had been given the diagnosis of AA, TE, or AGA and were receiving treatment at Northwestern University’s Hair Loss Disorders Clinic between March and November 2009. A total of 104 female patients participated in the study that was approved by the Northwestern University Institutional Review Board, and all participants provided written informed consent before participation.

Severity of hair loss was assessed by a board-certified dermatologist using Severity of Alopecia

Results

In all, 104 patients were enrolled (n = 23 AA, n = 33 TE, n = 41 AGA, n = 7 unknown). Some measures had missing data so that samples sizes are smaller than 104 depending on the measure being analyzed.

Discussion

Alopecia in women significantly affects self-image, and psychosocial factors often negatively impact patient QoL.4, 5, 9, 11 In seeking to investigate QoL in patients with AA, TE, or AGA, and to compare QoL with HLS as rated by both patient and dermatologist, patient ratings of HLS were determined to be strongly correlated with QoL. The more severe the patient’s hair loss rating, the more bothered the patient is in all 3 Skindex-16 QoL domains (symptoms, emotions, and function).

Furthermore,

References (19)

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Funding sources: None.

Conflicts of interest: None declared.

Reprints not available from the authors.

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