Stress and Alopecia Areata
Wednesday, May 20th, 2009
Single balding spot of alopecia areata
Alopecia areata (AA) is an autoimmune hair loss condition that presents itself in the form of patchy hair loss in scalp and other hair bearing areas. The role of emotional stress in alopecia areata has been discussed before in medical literature, however, the exact mechanism of it has never been explored. I just found a new article on the relationship of the stress response to the pathogenesis of alopecia areata that was investigated by subjecting normal and skin graft-induced AA-affected mice to light ether anesthesia or stress due to restraining the animal.
Plasma corticosterone, adrenocorticotropic hormone, and estradiol levels were determined in this study as indicator or stress level, whereas gene expression in brains, lymphoid organs, and skin was measured by quantitative RT-PCR for corticotropin-releasing hormone, arginine vasopressin, proopiomelanocortin, glucocorticoid receptor, mineralocorticoid receptor, corticotropin-releasing hormone receptor types 1 and 2, interleukin-12, tumor necrosis factor-alpha, and estrogen receptors type-1 and type-2. The mice with alopecia areata had a marked increase in hypothalamic-pituitary-adrenal tone and activity centrally and peripherally in the skin and lymph nodes.
There was also altered interaction between the adrenal and gonadal axis compared with that in normal mice which proved that the stress level has been higher in those animals. Stress further exacerbated changes in the activity of hypothalamus pituitary axis in mice with alopecia areata.
Alopecia areata animals had significantly blunted corticosteroid and ACTH responses to acute ether stress (physiological stressor) and a deficit in habituation to repeated restraint stress (psychological stressor). All the findings in the study suggests that altered brain responses during stress may be associated with the occurrence of alopecia areata, which prove the hypothesis that the stress is an important factor in occurrence of alopecia areata.
As we said before, treatment of alopecia areata is through observation of the patient and in some cases injections of steroid could be useful. More experimental studies have shown some improvements in extensive types of alopecia areata such as alopecia totalis. Hair transplant should not be done in patients with active alopecia areata since patients may lose transplanted hair through the same mechanism.
