2025, Vol. 8, Issue 2, Part B

Author(s)
Neveen Emad Sorour, Sarah El-Sayed Abdel Rahman, Naglaa Fathy Al Husseini and Ghada Mohamed Shams

Abstract
Alopecia areata (AA) is a chronic, immune-mediated condition characterized by nonscarring hair loss (HL) due to targeting of anagen hair follicles. It typically manifests as smooth, well-defined bald patches on scalp but can also affect other hair-bearing regions, including eyelashes, extremities, eyebrows, and beard. Severe cases may result in complete loss of all body hair (alopecia universalis) or scalp hair (alopecia totalis). Relationship between psychosocial stress and AA remains debated. Some studies suggest a higher prevalence of psychiatric comorbidities, like depression and, anxiety among individuals with AA. Research indicates that substance P and nerve growth factor play an essential role in stress-related hair growth inhibition in mice and may contribute to AA pathogenesis. Furthermore, AA patients may demonstrate increased hypothalamic-pituitary-adrenal axis activity, which controls stress response, potentially affecting their capacity to manage stressors. Cortisol, a glucocorticoid hormone secreted by adrenal glands, rises in response to stress. Studies commonly assess stress using cortisol levels and Perceived Stress Scale, However, cortisol measurements from blood, saliva, or urine reflect acute stress responses and may not accurately indicate chronic stress. Cortisol in the hair can be utilized as a valid biomarker for chronic stress, as human hair grows at an average about rate 1 centimeter every month. This review article aimed to examine scalp hair cortisol concentration in cases had AA and correlate its level with the disease variables.

DOI: https://doi.org/10.33545/26649411.2025.v8.i2b.249

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