Prevalence of alopecia and its contributing factors among primary healthcare attendees in the Jazan region, Saudi Arabia

The psychosocial burden of androgenetic alopecia in Saudi Arabia: A cross-sectional study

Background

The most prevalent cause of hair loss is androgenetic alopecia. Improved therapeutic modalities may result from knowing how stress affects hair growth, incorporating stress-coping methods into the treatment of hair loss disorders, and developing new pharmacotherapeutic approaches. This study aimed to examine the psychosocial burden of androgenetic alopecia in Saudi Arabia.

Materials and Methods

A cross-sectional online survey study was conducted among patients with androgenetic alopecia in Saudi Arabia in February 2023. A previously developed questionnaire was adapted from a previously published tool and used in this study. This association between patients' characteristics and the level of psychosocial disease was identified using binary logistic regression analysis.

Results

This study included 1230 patients. The majority of the patients (78.0%) reported that they felt embarrassed by their androgenetic alopecia. The median score of the psychosocial impact of androgenetic alopecia on the patients was 1.00 (0.00-2.00), which is equal to 10.0%, reflecting a low level of psychosocial burden on the patients by their condition. Binary logistic regression analysis identified that patients without a family history of androgenetic alopecia were 36.0% less likely to be affected psychosocially by their condition (P < 0.01).

Conclusions

A low-level psychosocial effect was seen in our study among individuals with androgenetic alopecia. Further research should be done to determine how the type of alopecia affects patients' psychological results, as well as the influence of the disease's duration on those outcomes. Dermatologists are recommended to raise patients' knowledge of their disease and lessen stigmatization in the meantime.

Assessing the Impact of Alopecia on Quality of Life, Depression, and Self-Esteem in Saudi Arabia

Objectives The objective of this study is to assess the effects of alopecia on quality of life, depression, and self-esteem in the Eastern Province of Saudi Arabia. Methods We made a questionnaire that included sociodemographic data, type of alopecia, medical aid sought, and whether they benefited from it or not. The study uses the Dermatology Life Quality Index, Patient Health Questionnaire-9, and a single-item self-esteem scale to assess the quality of life, depression, and self-esteem, respectively. Results The questionnaire was completed by 403 individuals in total, and after applying the exclusion criteria (only Saudis, from the Eastern Province), 231 participants were included in this study. Of the participants, 49.4% had hereditary baldness and only 9.5% benefited from treatment. Of the patients, 52.4% had higher levels of depression, and 18.2% had an effect on their life. Patients with a moderate or greater effect on their lives had a significant relationship with hereditary baldness. Younger age, being female, being married, having lower income, and having hereditary baldness were significantly associated with higher depression levels (p = <0.05). The study found that as age increased, depression levels decreased and self-esteem scores increased. Depression was linked to lower quality of life, while self-esteem was linked to both lower quality of life and higher depression levels. These factors are interrelated, with age influencing their relationship. Conclusions The results of the study highlight the significant occurrence of depression and decreased quality of life among patients who have alopecia, particularly those with hereditary baldness. It is crucial to provide psychological assistance and counseling to enhance their mental health and overall wellness.

The Impact of Androgenic Alopecia on the Quality of Life of Male Individuals: A Cross-Sectional Study

Background Hair plays a significant role in physical appearance and hair loss can profoundly affect self-esteem and mental health. Studies show that people with clinically obvious and undetectable hair loss may have dramatically decreased quality of life (QoL). This study investigated the impact of androgenic alopecia on the quality of life of male individuals in the Eastern Province of Saudi Arabia and their willingness to seek treatment. Methods In the eastern province of Saudi Arabia, a cross-sectional study was carried out among men identified with androgenic alopecia (AGA). A self-administered survey was disseminated among the patients through social media sites. The questionnaire includes fundamental demographic factors including age, place of residence, level of education, the severity of androgenic alopecia, treatment method, and Skindex-29 to assess the patient's quality of life. Results Four hundred-two male patients out of 717 participants were selected, and 158 (39.3%) were aged between 20 to 29 years old. Satisfaction with treatment medication was reported by 24 (19.5%) out of those who underwent treatment (n=123). Less effectiveness was the most common reason for treatment dissatisfaction (81, 81.8%). The overall mean Skindex-29 score was 23.2 (SD 19.6) out of 100 points. Younger age, suffering hair loss for a shorter duration, undergoing alopecia treatment, being diagnosed with alopecia by a medical doctor, and having a moderate level of AGA were the factors that greatly affected the patient's QoL. Conclusion Consistent with the literature, this study showed that AGA significantly impaired patients' QoL. Among QoL domains, the symptoms domain had a greater effect on patients than the emotions or functional domains. Younger males who were suffering recently from hair loss and were diagnosed with AGA by the medical doctor demonstrated greater QoL impairment than the rest of the patients. A multicenter study may result in a better representation of the impact of QoL in patients with AGA.

Stress-Related Hair Loss Among the General Population in Al Majma'ah, Saudi Arabia: A Cross-Sectional Study

Background Hair loss is a prevalent concern affecting individuals worldwide, often attributed to various factors including genetics, hormonal changes, and stress. This study aims to investigate the prevalence of stress-related hair loss among the general population in Al Majma'ah, Saudi Arabia, and hair loss association with sociodemographic characteristics and risk factors. Methods A cross-sectional study was conducted involving 1080 participants. Data were collected through a structured questionnaire that encompassed sociodemographic factors, stress levels, psychosocial factors, and habits related to hair care and lifestyle. The data were analyzed using descriptive statistics, chi-square tests, and logistic regression analysis. Results The study revealed that 770 (71.3%) of participants reported experiencing hair loss, with females showing a higher prevalence compared to males 622 vs. 148 (78.2% vs. 51.9%). A significant relationship between age and hair loss was observed (Chi-x2 = 8.264, p-value = 0.016), with individuals aged 31 to 40 years experiencing hair loss more frequently 108 (80.6%). Stress was found to be a significant contributing factor to hair loss (χ^2 = 37.533, p < 0.001), with 674 (73.8%) of participants reporting stress. Moreover, stress levels exhibited a dose-response relationship with the severity of hair loss. Psychosocial factors, including personal relationship problems and financial difficulties, also demonstrated significant associations with hair loss (p-value = 0.005, 0.003, respectively). Conclusion The study underscores the considerable prevalence of stress-related hair loss among the general population in Al Majma'ah, Saudi Arabia. Stress, along with various sociodemographic and psychosocial factors, emerged as significant contributors to hair loss. These findings emphasize the need for holistic approaches that address both physiological and psychological aspects to mitigate the burden of hair loss in the community. Further research is warranted to explore the underlying mechanisms and develop targeted interventions for individuals at risk of stress-induced hair loss.

Histopathologic Spectrum of Alopecias Seen in a Jamaican Setting

ABSTRACT

Alopecia is common in Jamaican, primarily Afro-Caribbean patients. We performed a retrospective review examining the histopathologic alopecia diagnoses over ∼5 years. Requisition forms and pathology reports were assessed. Demographic/clinical/technical/diagnostic and pathologic findings of chronicity/severity data were recorded. Three hundred thirty-eight biopsies were included. The majority were 4 mm punches, grossed horizontally. The F:M ratio was 4.8:1, mean age = 42.7 years, and mean duration of alopecia = 5.1 years. Cicatricial alopecias (CAs) predominated over non-CAs (NCAs). The top 10 diagnoses were central centrifugal CA (21.9%), folliculitis decalvans (10.9%), multifactorial alopecias (10.1%), pattern hair loss (8%), lichen planopilaris (7.1%), alopecia areata (6.2%), discoid lupus erythematosus (6.2%), nonclassifiable lymphocytic scarring alopecias (5.6%), frontal fibrosing alopecia (5.3%), and nonspecific NCAs (5%). This contrasted with other richly pigmented populations where discoid lupus erythematosus predominates. Other interesting findings included relatively frequent folliculitis decalvans and lichen planus pigmentosus in 40.9% of frontal fibrosing alopecia cases. Scarring/nonscarring clinicopathologic congruence occurred in 83.4%.Regarding histopathologic features of severity/chronicity, CAs had markedly decreased hair counts. Perifollicular fibrosis affecting retained hairs occurred in 75% of CAs, moderate to severe in >50% of these. Approximately 50% of NCA samples demonstrated advanced miniaturization (T:V ratio <2:1). In our study, relatively young women with chronic hair loss and CA are most frequently biopsied. Central centrifugal CA is the most common diagnosis. Local features of chronic/severe disease are seen microscopically. Clinical impression of scarring/nonscarring correlates well with histopathology.

Treatment Patterns and Unmet Needs in the Management of Alopecia Areata: Results of a Physician's Survey in the Middle East

INTRODUCTION

Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss involving the scalp, face, and/or body. Literature on the prevalence, patient characteristics, management approaches, and challenges faced by patients with AA across the Middle East is limited. Therefore, a greater understanding of the current AA landscape within the region is needed. This cross-sectional study surveyed dermatologists from four countries to assess dermatologists' perspectives on the prevalence of AA within the Middle East, as well as patient characteristics, unmet needs, and management strategies.

METHODS

This blinded, quantitative, observational study surveyed practicing dermatologists in Egypt, Lebanon, Saudi Arabia, and the United Arab Emirates. The survey was conducted between September 2021 and January 2022 and comprised 47 closed-ended, multiple-choice questions as well as Likert scale responses. These questions assessed the characteristics of physicians and the patients in their practices, physicians' familiarity with treatment, and physicians' treatment approaches.

RESULTS

The estimated prevalence of AA varied across the region. Across all age groups treated for AA, the majority of patients had AA of mild severity (pediatric: 63%; adolescent: 60%; adult: 54%) and the scalp was reported as the most affected area (65%). Potent topical corticosteroids were the most frequently used treatment for mild to moderate and severe AA (92% and 78%, respectively). There was a lack of awareness of investigative treatments, with only 33% of dermatologists aware of these options. The greatest unmet needs in treating AA included long-term disease control, improved efficacy, faster onset of action, and better safety profiles (62%, 53%, 52%, and 51%, respectively).

CONCLUSIONS

This study provided insight into the diagnosis and management of AA in the Middle East. Treatment strategies were similar regardless of the severity of AA. Long-term disease control and improved efficacy and safety profiles were identified as key unmet needs in the treatment of AA.

Dermoscopic evaluation of the efficacy of combination of topical spironolactone 5% and minoxidil 5% solutions in the treatment of androgenetic alopecia: A cross sectional-comparative study

BACKGROUND

Androgenetic alopecia (AGA) is a common chronic dermatological illness that affects both men and women.

AIM

To assess and compare dermoscopically the impact of a combination of topical minoxidil solution (5%) and topical spironolactone solution (5%) in treating AGA in both sexes.

PATIENTS AND METHODS

One hundred and twenty patients diagnosed with AGA were divided into three groups; each group is composed of 40 patients. Group A (n = 40) were treated with a 5% topical minoxidil solution, group B (n = 40) were treated with a 5% topical spironolactone solution, and group C (n = 40) were treated with a 5% topical minoxidil and spironolactone combination.

RESULTS

Following the initiation of treatment and at 6 weeks (midterm), reduction in all dermoscopic features was observed in all groups; however, it was not statistically significant except for vellus hair reduction (p = 0.033). On the contrary, upright regrowing hairs were insignificantly increased in all groups (p = 1.088). The pattern of dermoscopic features remained to insignificantly decrease toward the end of 12 weeks treatment (full term) in all studied groups except for vellus hair that showed further significant reduction toward the end of the study (p = 0.011).

CONCLUSION

Both spironolactone as a 5% topical solution and minoxidil as a 5% topical solution might be used safely in a twice-daily dosage to treat AGA in both genders. Furthermore, combining them in a single topical dose form can boost efficacy and yield greater advantages.

Quality of Life and the Presence of Depression Among Adults with Hair Loss in the South of Saudi Arabia

Purpose

This study aims to measure quality of life and the presence of depression among adults suffering from perceived hair loss.

Methods

This study used a cross-sectional design that targeted adult subjects with perceived hair loss in the Jazan region of Saudi Arabia. Data were collected during interviews in selected primary healthcare centers. Data pertaining to the demography, quality of life, and presence of depression in participants were collected. Quality of life was assessed via a modified Arabic version of the Dermatology Life Quality Index (DLQI). The presence of depression was assessed via Patient Health Questionnaire-9 (PHQ-9). A chi-squared test was used to detect statistically significant differences between the levels of quality of life and depression and the measured demographic characteristics.

Results

A total of 483 subjects reported having hair loss. The median age of the sample was 30 years. The majority of the respondents were female (74.5%) and had university-level education (71.4%). Only 169 (35%) reported seeking medical advice concerning their hair loss. The effect of hair loss on quality of life score varied between 2 and 29, with a median score of 6. The median depression level was 6, and the level varied between 0 and 27. Gender, education level, seeking medical care due to hair loss, and worsening of hair loss seem to have an impact on quality of life and depression levels (p values < 0.05).

Conclusion

Nearly half of the sample experienced a more than moderate impact on their quality of life induced by their perceived hair loss. Additionally, more than half of the sample exhibited moderate or stronger levels of depression. Encouraging subjects with perceived hair loss to seek medical advice concerning their hair loss may result in early identification, appropriate diagnosis, and the use of curative measures, may consequently improving patients’ quality of life and preventing depression.