Atopic Diseases Common in Black Patients With Alopecia Areata

Man worried for alopecia checking hair for loss
A study examines the epidemiology of alopecia areata in a population of exclusively Black patients.

Black patients with alopecia areata (AA) are more likely to be women, younger, and have an increased prevalence of atopic disorders, according to study findings published in the Journal of the American Academy of Dermatology.

Investigators retrospectively enrolled Black patients who were diagnosed with AA at a dermatology clinic from January 1, 2015, to December 31, 2020.

A total of 198 Black patients with AA (mean age, 32.2 ± 17.78 years [range, 3-72]; 72.7% women) were included. The participants had a mean age at diagnosis of 27 ± 17.63 years (men, 22.1 ± 14.73 years; women, 28.8 ± 18.32 years), and 76.3% were diagnosed with AA before age 40 years.

Among the cohort, 22.2% had 1 or more autoimmune comorbidities, with thyroid disease the most common (6.6%). A majority of patients (59.1%) had 1 or more medical comorbidities, and about half of the group (49.5%) had dermatologic disease. Atopy was common, as 44.4% had 1 or more atopic conditions, including allergic rhinitis (28.8%), atopic dermatitis (20.7%), asthma (20.2%), and the complete atopic triad (3.0%).

Other comorbidities included hypertension (19.2%), seborrheic dermatitis (14.6%), obesity (13.1%), type 2 diabetes mellitus (8.1%), anemia (5.1%), and traction alopecia (6.6%). In addition, 19.7% of patients had psychiatric comorbidities including depression or anxiety.

Patchy disease was the most common clinical presentation, observed in 68.2% of patients. Other clinical types included ophiasis pattern (15.1%), facial involvement affecting the eyebrows, eyelashes, and/or facial hair (21.2%), and nail involvement (15.6%).

Study limitations include the retrospective design, limited sample size, and lack of a control group.

“While prior research demonstrates an association between history of atopy and risk for AA, atopic diseases (atopic dermatitis, allergic rhinitis, asthma) in our study were the most common comorbidity with a higher prevalence than reported in several previous studies,” stated the researchers. “Further evaluation of racial and ethnic differences in AA can shape physicians’ understanding of the disease, diagnostic approach, disease risk, and associated comorbidities.”

Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Feaster B, McMichael AJ. Epidemiology of alopecia areata in Black patients: a retrospective chart review.J Am Acad Dermatol. Published online January 29, 2022. doi:10.1016/j.jaad.2022.01.033