Does alopecia areata (AA) affect all races and ethnic groups equally? If yes, why is this important? Knowing AA prevalence among different groups can help improve diagnosis, management, and research into this common autoimmune disease. AA touches nearly 6.7 million people in the United States alone. Currently, about 700,000 people are actively living with the disease, and others have either had it or will develop it at some point. Asian Americans seem to have highest prevalence This past March, the online issue of JAMA Dermatology published an article reviewing the prevalence — the proportion of a population affected — of alopecia areata (AA), alopecia totalis (AT), and alopecia universalis (AU) among patients of Asian, Black, Hispanic/Latino, and white descent. The researchers found that AA was more common among women (67% of cases) and that most adults with AA were between the ages of 30 and 49. But they also found a difference in racial and ethnic groups. They found while AT and AU were pretty even across all groups: – 414 of every 100,000 patients with AA were Asian American – 314 of every 100,000 were of multiple races – 226 of every 100,000 were Black Americans – 122 of every 100,000 were Hispanic – 168 of every 100,000 were white An earlier study, from 2022, published in the British Journal of Dermatology and looking at patients with AA prevalence in the United Kingdom, reported similar findings. The authors wrote, “People of nonwhite ethnicity were more likely to present with AA, especially those of Asian ethnicity.” There are some limitations to studies like this because the information depends on people self-reporting their racial or ethnic background and many people may have AA but be undiagnosed. Because of this, there still may be some confusion about actual numbers. For example, a 2020 study found that Black people had a higher prevalence than Asians, but both groups still had higher rates compared with white people. The importance of the findings Gone are the days when it’s assumed that one medical condition affects all people the same way. Knowing that certain diseases, like AA, affect groups differently can help researchers identify possible causes that may not have been considered before. For example, are there genetic, social, or environmental issues that haven’t been found yet? If researchers could zero in on these, the information could lead to a better understanding of the disease, which could possibly lead to prevention measures or better treatments. Recognition and diagnosis of AA may also be improved if doctors know to consider the disease in certain populations. Skin conditions look different according to skin color. For example, a rash may look red or pink on someone with white skin, but it may only appear darker on a Black person’s skin. This can lead to healthcare professionals not recognizing dermatologic problems in people with different skin colors. Earlier recognition and diagnosis of AA could lead to more aggressive – and hopefully effective — treatment options for patients. And finally, knowing who may be at higher risk of developing AA can help healthcare professionals provide awareness and support within those communities. They could address health inequities or disparities, helping those who are affected get the help they need in a timely manner.
