People can have one or more diseases related to alopecia areata at the same time. For example, someone can have diabetes and alopecia areata, or lupus, hypertension, and alopecia areata. But one does not cause the other. These are called comorbid conditions. The most common diseases related to alopecia areata include autoimmune diseases, such as thyroid disease and type 1 diabetes, and atopic conditions (related to allergies), such as asthma, allergic rhinitis (hay fever), atopic dermatitis, and other forms of eczema. Mental health conditions, such as depression or anxiety, can also occur among people with alopecia areata. It’s possible that they are comorbid or they occur because of hair loss and many of the issues that can surround it. Interestingly, researchers have found that if one person has alopecia areata, chances are some of their close family members have autoimmune diseases. Given that atopic disorders and autoimmune diseases also run in families, it’s important to know if you are at elevated risk for any possible comorbid conditions. Speak with your doctor about your risks and what you should watch for. Autoimmune diseases related to alopecia areata Normally, your immune system protects you from becoming sick. It detects viruses and other microbes and helps fight them off. Autoimmune diseases are illnesses that cause your immune system to go into overdrive and attack your healthy tissues instead of just microbes. If you have an autoimmune disease, like alopecia areata, you have a higher risk of getting another. Here are a few of the more common ones. Thyroid disease The most common disease related to alopecia areata is thyroid disease. The thyroid is a small butterfly-shaped gland at the front of your neck, just below the larynx (voice box). Its role is to control your body’s metabolism, from your body temperature to your cholesterol levels. It even helps control a woman’s menstrual cycle. Experts recommend that people with alopecia areata be screened for thyroid disease, even if they aren’t showing symptoms. There are several diseases associated with the thyroid. The most common one among people with alopecia areata is hypothyroidism, an underactive thyroid. This is most often caused by Hashimoto’s thyroiditis. If you have Hashimoto’s thyroiditis, your immune system attacks your thyroid cells, preventing the gland from producing thyroid hormones. Learn more about thyroid disease at the American Thyroid Association. Type 1 diabetes Type 1 diabetes, what used to be called juvenile diabetes or insulin-dependent diabetes, is another common disease related to alopecia areata. If you have type 1 diabetes, your pancreas cannot produce insulin. Insulin is a hormone that your body needs to get glucose (sugar) into the blood cells for fuel. Without insulin, your body can’t get the energy it needs. Learn more about type 1 diabetes at JDRF. Celiac disease Celiac disease is a hereditary autoimmune disorder that is triggered when people consume even the tiniest amount of gluten. Gluten is a protein found in barley, rye, and wheat. Whenever someone with celiac disease consumes gluten, their body’s immune response attacks the small intestine and, eventually, the intestinal wall becomes too damaged to properly absorb nutrients. Individuals with alopecia areata have a higher chance of also having celiac disease, so researchers recommend that children with alopecia areata be tested for celiac disease. Learn more about celiac disease at the Celiac Disease Foundation. Rheumatoid arthritis Rheumatoid arthritis can occur with alopecia areata, but it’s not as common as other autoimmune diseases. However, while not many people with alopecia areata have this type of arthritis, it seems that people with rheumatoid arthritis have a higher risk of having alopecia areata, especially if their disease begins between the ages of 20 and 40 years. Learn more about rheumatoid arthritis at the Arthritis Foundation. Vitiligo Vitiligo is another disease that can occur alongside alopecia areata. People with vitiligo lose patches of color (pigment) from their skin, leaving a milky-white color instead of their usual skin tone. The patches are usually symmetrical on both sides of the body, although there is a rare form that only affects one side of the body. Learn more about vitiligo at the National Institutes of Health and the Vitiligo Clinic & Research Center Atopic Conditions Atopic conditions are related to allergies or a too-sensitive immune system. These diseases can also be related to alopecia areata because it isn’t uncommon for someone with alopecia areata to have at least one atopic condition too. In fact, as many as 38% of people with the disease also have atopic conditions. Asthma Asthma is a chronic respiratory disease that can range from mild to severe. During an asthma “attack,” the airway becomes inflamed and narrow, making it hard for you to exhale (breathe out). The more inflammation, the harder it is to push air out of your lungs. Up to 90% of children and half of adults with asthma have atopic asthma, triggered by allergies. People with alopecia areata and asthma usually have the atopic type. Learn more about asthma at the American Lung Association. Allergic rhinitis Allergic rhinitis, or hay fever, is a common allergic response to something in the environment. It could be pollen, grass, even dust mites or pet hair. The condition can be seasonal, only in the spring or fall, for example, or it can be perennial, all year round. If you have allergic rhinitis, you may have itchy eyes, a stuffy or runny nose, and feel miserable. Learn more about allergic rhinitis at the American College of Allergy, Asthma & Immunology website. Atopic dermatitis (eczema) Atopic dermatitis is a type of eczema, a skin condition that causes rashes, and dry and itchy skin. For some people, it has no rhyme or reason when their atopic dermatitis flares up, while for others, their rashes and flare-ups are caused by exposure to something they are allergic to. Learn more about atopic dermatitis and eczema at the National Eczema Association. Mental Health Conditions Mental health conditions could be considered the hidden comorbid conditions associated with alopecia areata. Given the importance of hair in our society – it’s usually one of the first things we use to describe someone – it shouldn’t be a surprise that alopecia areata affects emotions or psychological well-being for many. Depression and anxiety Mental health conditions like depression and anxiety can happen alone or together. Depression, in the medical sense, is more than feeling sad because of an event or issue. Usually, a doctor will diagnose depression if you have had at least five symptoms every day for a minimum of two weeks. As for anxiety, everyone is anxious from time to time, but an anxiety diagnosis means you have experienced anxiety symptoms most days for the previous six months. Several studies have found that people with alopecia areata are more likely to have anxiety or depression (or both) than people without the condition. One study, published in 2022, added that people with alopecia areata have up to 38% higher risk of new-onset depression or anxiety. Learn more about depression and anxiety at the Mental Health Foundation.
