Effect of Social Stress on Gut Health May Trigger Alopecia Areata

It has long been established that stress is one of the key non-genetic influences on hair loss of various kinds.

The autoimmune disorder Alopecia Areata, which causes rounded bald spots, or patchy hairloss to the scalp, to appear suddenly, can often be triggered by a sudden shock or trauma.

Now, scientists investigating the relationship between 'social stress' - defined as that caused by particularly stressful life events - and autoimmune diseases have found that gut health may be the missing link.

This work expands on previous studies also suggesting associations between the gut and Alopecia Areata.

Social stress-reactive gut microbiota

The study was written and carried out by researchers at the Azrieli Faculty of Medicine, Bar Ilan University in Safed, Israel, and was published in early May 2019 by the American Society for Microbiology.

Through a number of mice trials, where a group of mice were subjected to other aggressive mice (providing 'social stress') for 10 days, and a control group of mice was not, they demonstrated that "chronic social stress induces virulence-associated transcriptional patterns in the murine gut microbiota".

Essentially, this means that when we encounter intense stress in our lives, the reaction this causes in our gut may then affect our immune system, leading to some individuals having an increased risk of developing autoimmune disorders, including the various forms of Alopecia Areata, including Alopecia Totalis and Alopecia Universalis.

You can find out more about the methodology and in-depth report of the team's finding in their paper, entitled Social-Stress-Responsive Microbiota Induces Stimulation of Self-Reactive Effector T Helper Cells.

These findings may show that the type of stress that can trigger autoimmune disorders does not need to be sudden, for instance following an accident or a bereavement, and may also be due to prolonged periods of high stress levels.

Furthermore, they are food for thought for researchers developing potential treatments for these conditions; in the future it may be that we see drugs that target the gut in order to treat Alopecia Areata.

Current treatment options

Current Alopecia Areata treatment options tend to only be of significant potential benefit for people with the scalp-only form.

Those with the more extensive forms - Alopecia Totalis and Universalis - which cause baldness of the entire head, including facial hair, or from head to toe, respectively - have limited options at present.

However, over the past few years previously unseen levels of research and development have been on-going and it is hoped that - whilst a cure for Alopecia Areata remains elusive, new treatment options for all forms of the disorder will soon be ready for prescription.

The most promising area of development at present is that of JAK inhibition, with various large pharmaceutical companies, including Pfizer and Aclaris Therapeutics, racing to be the first to bring their Alopecia Areata medication to market. It is estimated that the earliest these treatments - topical and/or oral - would be made available by is 2021.

For now, adults with the scalp only phenotype can get hair loss advice and treatment recommendations from a specialist hair loss clinic, whilst children under 16 with any form and adults with more extensive iterations should consult their GP or dermatologist.