Stress and alopecia areata: a psychodermatologic study.

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.