Triggering role of stressful life events in patients with alopecia areata.

Recent clinical studies examined the role of stress as a potential trigger for alopecia areata. However, it is still questioned whether and to what extent stress plays a role in its pathogenesis. We determined whether stressful life events are risk factors in the onset and course of alopecia areata among our population. The study included 61 consecutive patients with alopecia areata who were all outpatients at dermatology clinics of Semnan city. Sixty age- and sex-matched individuals selected among healthy subjects with respect to the diagnosis of alopecia areata served as controls. Stressful events were assessed using Traumatic Events Questionnaire (TEQ). No differences were found in the number as well as mean scores of physical and sexual stressful life time events across the two groups, while patients experienced a greater number of emotional stressing events with higher mean scores than the healthy group. Among different TEQ items, alopecia patients tended to have higher scores on the items indicating history of loss of a family member during childhood and a history of emotional neglect by relatives. In conclusion, loss of family members and emotional neglect by relatives might have major roles in triggering the onset and exacerbation of alopecia areata.