<p>A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States</p>

Abstract

Purpose: Alopecia areata (AA) is an autoimmune disease characterized by the development of non-scarring alopecia. The prevalence is not well known, and estimates vary considerably with no recent estimates in the United States (US). The objective of this study was to define the current AA point prevalence estimate among the general population in the US overall and by severity. Patients and Methods: We administered an online, cross-sectional survey to a representative sample of the US population. Participants self-screening as positive for AA using the Alopecia Assessment Tool (ALTO) also completed the Severity of Alopecia Tool (SALT) to measure the severity of disease as a percent of scalp hair loss. Self-reported AA participants were invited to upload photographs for adjudication of AA by 3 clinicians. Results: The average age of participants was 43 years. Approximately half of the participants (49.2%) were male, and the majority were white (77.1%) and not of Hispanic origin (93.2%). Among the 511 self-reported AA participants, 104 (20.4%) uploaded photographs for clinician evaluation. Clinician-adjudicated point prevalence of AA was 0.21% (95% CI: 0.17%, 0.25%) overall, 0.12% (95% CI: 0.09%, 0.15%) for "mild" disease (≤50% SALT score), and 0.09% (95% CI: 0.06%, 0.11%) for "moderate to severe" disease (>50% SALT score) with 0.04% (95% CI: 0.02%, 0.06%) for the alopecia totalis/alopecia universalis (100% SALT score) "moderate to severe" subgroup. The average SALT score was 44.4% overall, 8.8% for "mild", and 93.4% for "moderate to severe". Conclusion: This study suggests that the current AA prevalence in the US is similar to the upper estimates from the 1970s at approximately 0.21% (700,000 persons) with the current prevalence of "moderate to severe" disease at approximately 0.09% (300,000 persons). Given this prevalence and the substantial impact of AA on quality of life, the burden of AA within the US is considerable.

Autoimmune Diseases Are Linked to Type IIb Autoimmune Chronic Spontaneous Urticaria

“… CSU, chronic spontaneous urticaria; AID, autoimmune diseases; F: female; M: male; ITP, idiopathic thrombocytopenic purpura; SLE, systemic lupus erythematosus. * References 25 53 ; † Some patients had more than one autoimmune disease; ‡ HT in 20.7% (248/1,199) of patients, Graves' disease in 1.2% (15/1,199) of patients, and diagnosis of autoimmune thyroid disease is not specified in 3.5% (42/1,199) of patients; § Pernicious anemia in 0.4% (3/751) of patients. …”

“…* References 25 53 ; † Some patients had more than one autoimmune disease; ‡ HT in 20.7% (248/1,199) of patients, Graves' disease in 1.2% (15/1,199) of patients, and diagnosis of autoimmune thyroid disease is not specified in 3.5% (42/1,199) of patients; § Pernicious anemia in 0.4% (3/751) of patients.…”

Alopecia Areata Treatment Patterns, Healthcare Resource Utilization, and Comorbidities in the US Population Using Insurance Claims

“…Alopecia areata (AA) is a chronic autoimmune disorder causing sudden, non-scarring hair loss. Prevalent in about 0.21% of the US population [ 1 ], the disorder is heterogenous in severity and distribution and can affect any hair-bearing region of the body [ 2 ]. Patients may progress from patchy AA to complete scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis) [ 2 , 3 ].…”

“‘You lose your hair, what’s the big deal?’ I was so embarrassed, I was so self-conscious, I was so depressed:” a qualitative interview study to understand the psychosocial burden of alopecia areata

“…eyebrows and eyelashes) and body [1]. A recent (2017) national US population survey estimated lifetime prevalence of AA at approximately 2.5% [2], slightly higher than previous regional estimates of 1.7% (1970-1989) [3] and 2.1% (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009) [4]; although current prevalence was found to be similar to upper estimates from the 1970s at around 0.2% (0.09% moderate-severe disease) [2]. AA can occur at any age and affects both children and adults; median age at diagnosis is 33 years [4], and diagnosis is more likely during childhood for males and during adolescence for females [5].…”