AA and Androgens
Alopecia areata is an autoimmune disease. It occurs in about 2 % of the population and in all age groups and races. To date the role of hormones in alopecia areata is unknown – although the area is poorly studied in general.
In 2017, Conic and colleagues set out to retrospectively review the clinical features of patients with alopecia areata that were seen at the Cleveland Clinic over the period 2005 to 2014. In total, data from 504 patients was tabulated and as a comparison group 172 patients with seborrheic dermatitis were also reviewed.
Elevated androgens were far more common in those with alopecia areata compared to controls (13 % vs 1 %). Ovarian cysts were also more frequent in those with AA being present in 8.6 % of patients vs just 3.2 % of controls.
This study was interesting and certainly caught my attention. Very little is known about how hormones affect AA. The increase incidence of androgens warrants further study. If consistently found in a proportion of patients, one needs to explore whether use of anti-androgens could benefit some patients with AA as well. In the same light, one needs to consider whether androgenic progestins in oral contraceptives could act as a trigger for AA in some patients
Conic et al. Comorbidities in patients with alopecia areata. Journal American Academy Dermatology; 754-756.
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887