Androgenetic Alopecia Tied to Impaired HRQoL

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The link between androgenetic alopecia (AGA) and health-related quality of life (HRQOL) and psychiatric disorders was examined.

Androgenetic alopecia (AGA) is associated with moderate impairment of health-related quality of life (HRQoL) and emotional health, suggesting patients with AGA may require appropriate referral to psychological support, according to study findings published in JAMA Dermatology.

The study was a systematic review and meta-analysis of 41 studies comprising 7995 patients with AGA. The studies included case series, case-control studies, cross-sectional studies, cohort studies, and randomized clinical trials that reported either HRQoL or psychiatric outcomes in the AGA population.

In the pooled cohort, the Dermatology Life Quality Index (DLQI) score of patients was 8.16 (95% CI, 5.62-10.71), indicating the disorder had a moderate effect on quality of life. Subgroup analyses found no differences between men and women (7.94 [95% CI, 4.46-11.42] vs 10.10 [95% CI, 7.40-12.79], respectively; P =.34) or European and Asian countries (5.93 [95% CI, 4.79- 7.07] vs 8.36 [95% CI, 5.66-11.06], respectively; P =.10) with respect to DLQI scores.

In addition, the meta-analysis showed a pooled Hair-Specific Skindex-29 score of 29.22 (95% CI, 24.17-34.28) in the emotion dimension, indicating AGA also had a moderate impairment on emotions. In contrast, the pooled Center for Epidemiologic Studies Depression Scale score of 14.98 (95% CI, 14.28-15.68) did not indicate symptoms of depression.

The researchers identified factors directly associated with HRQoL in the meta-analysis, including married or coupled status and receipt of oral or topical medical treatments. Greater self-rated hair loss severity, lower visual analog scale score, and higher educational level held inverse associations with HRQoL in the pooled AGA cohort.

The researchers noted that several of the studies in the meta-analysis did not exclude participants with psychiatric disorders or chronic diseases, factors which the researchers suggest may confound quality of life.

Given these findings, the researchers concluded that “patients with AGA deserve attention and appropriate psychological and psychosocial support.”


Huang CH, Fu Y, Chi CC. Health-related quality of life, depression, and self-esteem in patients with androgenetic alopecia: A systematic review and meta-analysis. JAMA Dermatol. 2021;157(8):963-970. doi:10.1001/jamadermatol.2021.2196