What is the Relationship Between Migraines and Alopecia Areata?

New Study Supports a Complex “BIDIRECTIONAL” Relationship Between Alopecia Areata and Migraine Headaches

A new population based cohort study suggests that patients with alopecia areata are more likely to develop migraine headaches. Surprisingly, the data from the study also suggest that patients with migraines are more likely to develop alopecia areata.

Authors from Taiwan evaluated extensive data contained in the National Health Insurance Research Database in Taiwan. 5608 patients with alopecia areata were matched 1 to 4 with controls (who did not have alopecia areata).

Patients were followed between January 1, 1998, and December 31, 2011. Participants were then followed up until the development of migraine or the end of the study.

In addition to evaluating whether patients with alopecia areata were more likely to develop migraine the authors also examined whether patients with migraine were more likely to develop alopecia. The authors studied 16,650 patients with migraine and 66,600 matched control individuals. Patients were followed until the development of alopeciai areata or the end of the study.

Results

Patients with alopecia areata had a nearly three fold increased risk of developing migraines compared to control patients adjusted hazard ratio [aHR], 3.26; 95% confidence interval [CI], 2.12-5.01). This included an increased risk of several types of migraine headaches including migraine with aura, migraine without aura, and unspecified migraine. In addition, patients who had a history of migraine also had about a two fold increased risk of developing alopecia areata (aHR, 1.96; 95% CI, 1.15-3.32).

Conclusion

This data is very interesting and suggests a ‘bidirectional’ relationship between migraine and alopecia areata. Patients with alopecia areata are at increased risk to develop migraines and patients with migraines are at increased risk to develop alopecia areata.

There is certainly more and more evidence accumulating that suggests that there is some sort of immune dysfunction taking place in the pathways leading to migraine headaches. It will be interesting to determine in the future if migraine medications themselves have a positive impact on reducing the risk of developing alopecia areata or the severity of alopecia areata in those patients with migraine who have alopecia areata.

REFERENCE

Ying-Xiu Dai et al. Bidirectional association between alopecia areata and migraine: A nationwide population-based cohort study. J Am Acad Dermatol. 2021 Jul;85(1):254-256.