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PTSD, Trauma or Intense Stress Increases Alopecia Areata Risk

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A new study has backed the long-standing theory that trauma or intense stress may trigger certain autoimmune disorders, including Alopecia Areata.

The University of Iceland in Reykjavik published a report in the summer of 2018 investigating links between autoimmune disease and stress. This concluded that stress-related disorders, such as post-traumatic stress disorder (PTSD) were “significantly associated” with a risk of those affected developing subsequent autoimmune disorders.

what is an autoimmune disorder information alopecia areataThese conditions included type 1 diabetes, psoriasis, rheumatoid arthritis, coeliac disease and Alopecia Areata.

Up to 40 per cent extra risk

Using 1981-2013 data from a Swedish register, the Icelandic team conducted a study exploring 106,464 patients with stress-related disorders, each population-matched to individuals without any such diagnosis, and 121,652 full siblings. Siblings were used to assess any potential genetic, familial associations.

The stress diagnoses the exposed group registered included PTSD, acute stress reaction, and adjustment disorder. It was noted that the median age at which these diagnoses were received was 41 years of age, with women making up the majority of these patients (60 per cent female versus 40 per cent male). It was noted that previous research into PTSD and autoimmune disorders tended to revolve around military-based, men-only studies.

The reason for the study was to try and establish firm links between forms of stress and autoimmune disease. The study author writes:

“Individuals with such stress-related disorders experience an array of physiologic alterations, including disruption of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, which in turn may influence multiple bodily systems, eg, immune function, and thereby susceptibility to disease.

Manifested as abnormal immune reaction in specific organs or bodily systems, autoimmune disease may be influenced by psychiatric reactions to life stressors. Although animal data lend support to a potential link, epidemiological evidence underpinning the association between stress-related disorders and autoimmune diseases in humans is limited.”

Researchers found the risk of people with PTSD or another stress diagnosis developing one of 41 autoimmune disorders was 30-40 per cent greater than those without. The full study findings were published on the JAMA Network website.

Stress-related alopecia

Whilst stress is a well-known factor in a number of different hair loss conditions, these generally present as thinning hair from all over the scalp around three months after being sparked. Alopecia Areata, on the other hand, can affect various hair-bearing areas of the head and body, all of which come on suddenly.

Mild to moderate Alopecia Areata involves patchy hair loss developing on the scalp only; these bald spots can be singular or multiple and as small as a £2 coin to far larger rounded areas. Alopecia Totalis and Alopecia Universalis are more extensive, causing total baldness of the head and from head-to-toe, respectively.

The shedding starts when a trigger – which could range from shock or trauma, to allergies or skin injuries – causes the body to start attacking its own hair follicles. This disrupts the hair growth cycle for follicles in the affected areas, prematurely shunting actively growing hairs into the dormant Telogen phase during which hair is shed. These follicles remain stuck in this stage with no way of knowing whether or not they will resume normal hair growth of their own accord, and – if so – when this may happen.

In cases of the mildest, scalp-only form, hair regrowth will usually begin again spontaneously within 12 months, though treatment is also possible to help accelerate this process. This outcome is less likely, and effective treatment options far more limited at present, for the more severe phenotypes.


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The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.


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