Background
Alopecia areata (AA) can have a significant impact on wellbeing. Consequently, individuals with AA often seek treatments or products to promote hair regrowth or camouflage their hair loss ...that incur a financial cost to the individual.
Objectives
The current study aimed to examine the direct financial burden of AA to understand the wider impact of the condition and the factors which influence spending on products and services.
Methods
A total of 829 United Kingdom based participants completed an online survey. Demographic and condition‐specific data were collected, alongside spending on AA‐related products and services. Participants were asked about their use of products and services, the associated costs, how they financed these costs, and their household income to determine what percentage of income they spent on products and services.
Results
Participants predominantly identified as female (85.9%), white (92.7%) with a mean age of 42.7 years and a median AA duration of 10.94 years. Female gender, Asian ethnicity, lower income, and worse AA symptoms predicted higher spend from income. Wigs were the most common product used and incurred the greatest cost (median £700). The highest cost for men was private dermatology services (median = £550). On average people spent 3% of their disposable income (prior to housing costs) on AA‐related products and services.
Conclusions
This study outlines the risk factors associated with higher financial burden from managing AA which require consideration by health providers, commissioners, and policy makers when designing services to support the wellbeing of people living with AA.
This study investigated the financial burden of alopecia areata (AA) and its influencing factors on spending among 829 participants in the UK. Female gender, Asian ethnicity, lower income, and more severe AA symptoms were associated with higher expenditure on AA‐related products and services. These findings underscore the importance of considering these risk factors when developing support services for individuals with AA.
Alopecia areata (AA) affects men at similar rates to women, yet comparatively little is known about men’s experience of the condition. We interviewed a demographically diverse group of 18 men with AA ...to explore this gap. From qualitative thematic analysis, participants’ accounts described a profound yet often-minimised impact of AA on their lives, in the context of poor public awareness and misguided assumptions about AA in men. Conversely, this adversity appeared to facilitate personal growth for many. These findings can help health professionals better understand men’s gendered experience of AA, which we discuss through the lens of masculinities theory.
Itch and worry about itch are predominant symptoms in atopic dermatitis (AD). Mindfulness refers to paying attention in a certain way, non-judgementally and on purpose. In patients with chronic pain, ...which shares several similarities with chronic itch, a significant relationship between pain intensity, mindfulness and pain catastrophizing has been found. The aim of this study was to investigate whether itch intensity and mindfulness are related to itch catastrophizing in AD patients. Participants receiving treatment for AD (
= 155; 58 male; mean age: 46.5 ± 12 years) completed measures of itch-related catastrophizing (Itch Cognitions Questionnaire; ICQ) and mindfulness (Comprehensive Inventory of Mindfulness; CHIME) during their stay at a rehabilitation center in Borkum, Germany. In addition to other variables, their average itch intensity during the last 2 weeks was assessed by means of a visual analog scale. A positive relationship between itch intensity and itch catastrophizing was found (
= 0.409;
< 0.01). Moreover, the mindfulness scales "acting with awareness," "accepting and non-judgemental orientation," and "non-reactive orientation" were negatively related to itch catastrophizing. A linear regression analysis revealed that itch intensity in combination with "acting with awareness" was able to explain more than 27 % (corrected
= 0.274;
< 0.001) of the variance of itch catastrophizing. Thus, itch intensity and certain facets of mindfulness were associated with itch catastrophizing in AD patients. Psychological interventions aiming to increase acting with awareness might have a buffering effect on itch catastrophizing, which in turn could lead to lower itch intensity in patients with AD. Future RCTs should test this hypothesis.
Abstract
Alopecia areata is an autoimmune disorder causing nonscarring hair loss that is associated with significant psychological comorbidity (Macbeth AE, Holmes S, Harries M et al. The associated ...burden of mental health conditions in alopecia areata: a population-based study in UK primary care. Br J Dermatol 2022; 187:73–81). In addition to seeking psychological support from medical professionals, patients will often turn to online resources. In this study, we evaluated the range and quality of the online psychological support material available for patients with alopecia areata. A Google search was undertaken using private browsing on 5 June 2022, with several search terms: ‘alopecia areata online support group UK’, ‘alopecia support’ and ‘alopecia areata psychology’. The National Centre for Complementary and Integrated Health (NCCIH) guidelines for the evaluation of online resources were used. These guidelines assess information source and accuracy, funding, peer review status, linking policies and contemporaneity. Our search generated a total of 154 000 results. Advertisements, scientific articles, educational resources and duplicates were excluded, with nine resources included in the final analysis. Of the nine resources reviewed, three were specific for patients with alopecia areata, with the remaining resources focused on other types of hair loss. Six were authored or reviewed by dermatologists and seven had a documented peer review process of their content. One resource had no clear authorship and three had no clear peer review process. Nine of the resources were charity funded and one was a National Health Service resource. Four had been updated in the last 3 years and a further two within 5 years. All resources had clearly documented security and linking policies. All resources acknowledged the psychological impact of hair loss and eight had links to support groups or discussion forums. Only five had psychological support and advice on their website, with others only referring to the psychological burden and then signposting patients on to other sources for support. Only three of the resources referred to therapies such as cognitive behavioural therapy. The prevalence of mental health comorbidity in alopecia areata is high compared to the general population (Macbeth et al.). Our preliminary study has shown that the online psychological support available is lacking. With patients increasingly turning to the Internet for support and health information, there is an opportunity and need for development in this area.
ObjectivesThis study aimed to examine levels of social anxiety, anxiety and depression reported by people with alopecia as a result of a dermatological condition and associations with wig use. The ...study also sought to report on experiences of wearing wigs in social situations and the relationship with social confidence.DesignA cross-sectional survey was sent by email to the Alopecia UK charity mailing list and advertised on social media.ParticipantsInclusion criteria were a diagnosis of alopecia, aged 13 or above and sufficient English to complete the survey. Exclusion criteria included experiencing hair loss as a result of chemotherapy treatment or psychological disorder. Participants (n=338) were predominantly female (97.3%), Caucasian (93.5%) and aged between 35 and 54 years (49.4%) with a diagnosis of alopecia areata (82.6%).Main outcome measuresThe Social Phobia Inventory measured symptoms of social anxiety, and the Hospital Anxiety and Depression Scale was used to measure symptoms of anxiety and depression. Survey questions were designed to measure the use of wigs. Open-ended questions enabled participants to comment on their experiences of wearing wigs.ResultsClinically significant levels of social anxiety (47.5%), anxiety (35.5%) and depression (29%) were reported. Participants who reported worries about not wearing a wig reported significantly higher levels of depression: t(103)=3.40, p≤0.001; anxiety: t(109)=4.80, p≤0.001; and social anxiety: t(294)=3.89, p≤0.001. Wearing wigs was reported as increasing social confidence; however, the concealment it afforded was also reported as both reducing fear of negative evaluation and maintaining anxiety.DiscussionOverall, 46% of participants reported that wearing a wig had a positive impact on their everyday life with negative experiences related to fears of the wig being noticed. Psychological interventions alongside wig provision would be beneficial for people living with alopecia.
BH07 The socioeconomic burden of alopecia areata Montgomery, Kerry; Zucchelli, Fabio; Clayton, Julie ...
British journal of dermatology (1951),
06/2023, Letnik:
188, Številka:
Supplement_4
Journal Article
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Odprti dostop
Abstract
It is widely acknowledged that alopecia areata (AA) can have a significant impact on psychosocial wellbeing and daily functioning. Individuals with AA often seek treatments or products to ...promote hair regrowth or use strategies to conceal their hair loss, which results in a financial cost to the individual. The current study aimed to examine the socioeconomic burden of AA, to understand the wider impact of the condition. A total of 829 UK-based participants completed an online survey. Demographic and condition-specific data were collected, alongside spending on AA-related products and services over the preceding year, and AA-associated work absenteeism and presenteeism. Participants predominantly identified as female (85.9%) and White (92.7%), with a mean age of 42.7 years and median duration of AA of 10.94 years. The median expense on AA-related products and services over the preceding year was £840. Wigs incurred the greatest cost to individuals (median £700). Although accessed by approximately 10% of participants, private dermatology and mental health services also incurred significant costs, when used. Over half of the sample also reported that the products and services they used made their quality of life a little or much better. Using hierarchical regression analysis, sex and AA symptoms uniquely predicted higher financial burden, with females and those with more severe AA spending a greater proportion of their disposable income on AA-related products and services. Lower disposable income also predicted greater financial burden from spending. Regarding work absenteeism, 21% of participants reported being signed off work due to AA since their diagnosis, and over the preceding 7 days, 10.5% of those in employment (n = 525) reported missing > 1 h of work due to AA. Of 154 participants claiming work-related benefits, 33 said their reason for claiming was connected to their AA. The presenteeism findings suggest, on average, a minimal effect of AA on participants’ work productivity in the preceding 7 days, with those more recently diagnosed reporting lower productivity. The findings suggest that products/services to manage the aesthetic consequences of hair loss from AA are costly yet broadly valued by individuals. It is concerning that those with lower disposable income spent proportionately more on AA products and services, implying these individuals consider this spending as essential. The other risk factors identified in the findings also require consideration by health providers, commissioners and policymakers when designing services to support the wellbeing of people living with AA.
Funding: this study was funded by Pfizer Inc.
Abstract Background The most common forms of hair loss in men, alopecia areata (AA) (an autoimmune condition) and androgenetic alopecia (AGA) (pattern baldness), alter individuals' appearance in ways ...that may impact psychological and social wellbeing. We currently have a limited understanding about this impact of alopecia in men, their support needs, and preferences. Objectives We sought to investigate and explore the psychosocial impact of alopecia on men, alongside their experiences of treatment and support. Methods The study used a mixed methods cross‐sectional online survey with 177 men aged 17–79: 83 with AGA and 94 with AA. Quantitative questions included purpose‐made rating scales of men's support experiences, and standardised measures of wellbeing and appearance‐focused anxiety. Qualitative data comprised participants' answers to an open‐ended question asking about their subjectively salient experiences related to their alopecia. Results The combined findings indicate that while participants in both subsamples had sought minimal support for psychosocial concerns, such concerns were in fact commonplace. Over half of participants (56%–57%) shared qualitative accounts of depleted confidence, while wellbeing scores were on average lower than matched norms. Participants identifying as sexual minority also reported greater appearance‐focused anxiety compared to those identifying as straight. Conclusions The apparent contrast between participants' minimal help‐seeking and accounts of affected wellbeing suggests an unmet support need for men with alopecia. Masculine norms may impede men from accessing psychosocial support, both by discouraging help‐seeking behaviours and by encouraging minimisation of appearance concerns. The findings also suggest sexual minority status may pose a greater risk of distress in affected men.
The psychological and social impact of hair loss and its ongoing treatment can be considerable. Medical treatments are not always successful, and alternative treatments, such as medical tattooing, ...are growing in popularity. The aims of this study were to explore adults' motivations, experiences, and self-perceived outcomes in relation to medical tattooing. Individual telephone interviews were conducted with 22 women from the United Kingdom aged 26-67 years who had undergone medical tattooing in the past 5 years related to hair loss. Interviews were transcribed and inductive thematic analysis was performed. Appearance concerns, loss of self-confidence/identity, and the practicalities of daily upkeep were cited as reasons for seeking a semi-permanent solution. Trust in the practitioner and the ongoing costs of tattoo maintenance were important considerations in participants' decision-making process and their overall satisfaction with treatment outcomes. Participants felt the emotional impact of hair loss and the subsequent need for appearance-restoring treatment remains unrecognised. This study provides insight into participants' perceptions of an under-researched and unregulated but widely accessible treatment. Implications for the decision-making process are discussed, and suggestions for health professionals are offered.
The research reported in this thesis examined social anxiety in people with visible skin conditions to identify potential targets for intervention. Mindfulness refers to the tendency to pay attention ...to the present and cultivates a non-judgmental attitude towards experiences. Disengaging from negative patterns of thinking by paying attention to the present, could target rumination which maintains social anxiety. The findings of Study 1, an interpretative phenomenological analysis (N=10) indicated that social anxiety in people living with visible skin conditions arises as a result of an interaction between negative self-appraisals, fear of negative evaluation and previous reactions of others. Targeting this evaluative process using mindfulness techniques could be beneficial in reducing social anxiety; therefore, Study 2 examined the relationship between mindfulness and psychosocial distress in people with visible skin conditions (N=120). Mindfulness explained 41% of the variance in social anxiety, after controlling for subjective severity. These findings suggest that increasing mindfulness, particularly awareness, and non-judgment of inner experience could reduce social anxiety. To examine the potential of mindfulness interventions to reduce social anxiety, a systematic review was conducted. Findings highlighted that mindfulness is effective in reducing social anxiety. Potential mechanisms for the effects of mindfulness include reduced reactivity to negative self-referential information and increased attentional control. Study 3 tested the effectiveness of Mindfulness Based Cognitive Therapy (MBCT) for social anxiety in people with visible skin conditions. A multiple baseline single case series was used to examine individual change profiles over time. Reliable and/or clinically significant reductions in social anxiety and at least one other area of psychosocial distress were reported by treatment completers (N = 7). The findings suggest that MBCT is a promising intervention for social anxiety in dermatology patients, and further research is warranted. Feasibility studies may provide important information regarding recruitment and attrition when considering randomised control trials.
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