This global analysis of alopecia areata (AA) from 1990 to 2021 provides the most comprehensive evaluation to date, showing that while the absolute number of cases has increased, the age-standardized incidence rate (ASIR) has remained relatively stable or slightly declined. Using data from the Global Burden of Disease (GBD) 2021 study, researchers found that AA incidence is highest in developed regions like North America, Southeast Asia, and Australia. The most rapid increases are occurring in low-SDI regions such as Africa and parts of South Asia. AA is nearly twice as prevalent in females and peaks in individuals aged 30–34. Although developed countries have higher ASIRs, the rate of increase is slower, suggesting improved disease management and awareness. In contrast, rising rates in developing regions likely reflect better healthcare access and diagnostic capabilities.
The study highlights strong associations between AA and comorbidities such as atopic dermatitis, iron deficiency, and depression—especially in high-SDI regions. Women showed stronger links to anxiety disorders, while men had a higher correlation with acne vulgaris. Age-specific trends revealed different comorbidity profiles: younger individuals were more likely to have atopic dermatitis, while older adults showed associations with rheumatoid arthritis and psychological conditions. These findings emphasize the need for a multidisciplinary, patient-specific approach to AA management that considers both physical and mental health.
Reference: Zhou J, Liang L, Zhang H, et al. Global Burden of Alopecia Areata and Associated Diseases: A Trend Analysis From 1990 to 2021. J Cosmet Dermatol. 2025 Mar;24(3):e70076. doi: 10.1111/jocd.70076. PMID: 40013610; PMCID: PMC11866473.
