Psychological Distress Greater in Patients With Androgenetic Alopecia

A new study reported that participants with androgenetic alopecia demonstrated significantly greater levels of generalized anxiety, social anxiety, depression, and perceived stress compared with those without the condition.1

“…due to the limited number of studies focusing on single symptoms, a meta-analysis could not be conducted across these dimensions,” wrote investigator Yuan Kong, from the Beijing Changping Hospital of Integrated Chinese and Western Medicine, and colleagues.1

Not only does hair perform essential biological and psychosocial functions, including scalp protection, sensory perception, and sebum regulation, but it has a meaningful impact on body image. People with this type of hair loss may experience lowered self-esteem, anxiety, and depression, which ultimately can hinder quality of life and social functioning.1

Androgenetic alopecia carries a substantial health burden, affecting up to 50% of the male population by age 50 and up to 80% by age 80. Female hair loss occurs in approximately 12% of women by age 30, 25% by age 49, and 30% to 40% of women aged 60 to 69 years.2

Hair loss in women, although generally less severe than in men, is discussed less often and is a source of shame for many individuals living with the condition. Many women believe they are alone in their experience with androgenetic alopecia and may feel a loss of femininity and youth.2

Studies dating back to the 1990s reported the links between advanced hair loss and stress related to socioemotional functioning, self-esteem, positive life events, and coping behaviors.1 A 2023 study found that among 1230 male patients diagnosed with androgenetic alopecia, 95% experienced stress and 78% felt embarrassed by their hair loss. Another study showed that patients with androgenetic alopecia demonstrated greater somatization, depression, and hostility.

While numerous studies have shown greater rates of depression in patients with androgenetic alopecia, other studies have reported no significant association between depression and this type of hair loss. These conflicting findings emphasize the need for further research on depression in this patient population.

Moreover, research on psychological well-being in individuals with androgenetic alopecia remains limited by a narrow focus on physiological outcomes, small and inconsistent samples, and incomplete assessment of psychological domains, often without appropriate non-androgenetic alopecia comparison groups or representation from Asian populations. To address these gaps, investigators compared the psychological well-being between androgenetic alopecia and non-androgenetic alopecia populations using broader, multinational data that include both sexes, multiple assessment scales, and studies from China, to inform prevention and intervention strategies.

The team conducted a systematic search of CNKI, Wanfang, PubMed, Web of Science, Cochrane, EMBASE, and EBSCO from inception to June 30, 2025. In total, 13 studies were included, comprising 2737 patients with androgenetic alopecia and 17,382 controls.

Compared with controls, patients with androgenetic alopecia demonstrated significantly greater levels of generalized anxiety symptoms (pooled SMD, -0.50; 95% confidence interval [CI], -0.99 to 0.00; P =.05), social anxiety symptoms (pooled SMD, -0.50; 95% CI, -0.84 to -0.16; P =.004), depression symptoms (pooled SMD, -0.38; 95% CI, -0.65 to -0.12; P =.004), and perceived stress (pooled SMD, -1.09; 95% CI, -1.43 to -0.74; P <.001). Investigators observed no significant difference in general distress between patients with and without androgenetic alopecia (pooled SMD, -0.01; 95% CI, -0.39 to 0.37; P =.97).1

Consistent with previous studies, Kong and colleagues observed reduced self-esteem, life satisfaction, and emotional intelligence dimensions, along with greater body image dissatisfaction, somatization, interpersonal sensitivity, and psychoticism, in patients with androgenetic alopecia.1

“Future research and clinical practice should focus on the psychological health of AGA patients,” investigators concluded.1 “First, psychological assessment should be incorporated into the routine clinical process. Standardized psychological scales should be used to comprehensively evaluate patients’ anxiety, depression, stress, and other psychological states, to detect…potential problems in time. Second…dermatologists should work together with psychologists to provide comprehensive treatment plans for patients. For example, patients with significant anxiety and depression symptoms should be referred to psychologists for cognitive-behavioral therapy or pharmacotherapy.”

References

1. Kong Y, Shang Y, Zhang L. Association between androgenetic alopecia and psychological well-being: a systematic review and meta-analysis. Front Psychiatry. 2025;16:1705957. Published 2025 Nov 26. doi:10.3389/fpsyt.2025.1705957

2. Androgenetic alopecia: A Guide to Pattern Hair Loss. Ishrs. Accessed December 23, 2025. https://ishrs.org/androgenetic-alopecia/