Alopecia epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD

Overview

The epidemiology and demographics of alopecia varies by the type of alopecia as well as the age, race, sex, and health status of an individual. For example, in androgenetic alopecia, which has the highest prevalence of all the types of alopecia with about 50,000 per 100,000 men and 15,000 per 100,000 women worldwide, age and sex playing a role shown by the fact that men are more affected than women and post-menopausal women represent the highest proportion among females. In the case of alopecia areata, sex plays no role but fair skinned races are more commonly affected and the prevalence is about 100-200 per 100,000 individuals .

Epidemiology and Demographics

• In alopecia areata, the prevalence is 0.2% and has no age or sexual predilection. However, it affects white races more than dark races.
• In telogen effluvium, women are at higher predisposition than men.
• Tinea capitis has a higher incidence among the pediatric age group and in darker races.
• Anagen effluvium is more common in cancer patients receiving treatment with chemotherapeutic agents.
• Traction alopecia is more commonly seen among black populations with females being affected more often than males (31.7% vs 2.3). Traction alopecia was seen in 18% of girls between the ages of 5.4 to 14.3 years based on a study of African-American girls. An 8-month old girl was the youngest reported case in the study.
• Out of every 20 cases of chronic cutaneous lupus erythematosus, 10–17 cases are due to discoid lupus erythematosus. As in systemic lupus erythematosus in general, women are more often afflicted with the condition than men, and it is usually between the ages of 20 to 45.

Prevalence

• Androgenetic alopecia is believed to have a worldwide prevalence of about 50,000 per 100,000 men and 15,000 per 100,000 women. Postmenopausal women make up the large majority of this number.
• Alopecia areata has a prevalence of about 1 in 1000 people, and risk of about 2% over an individual's life . Alopecia areata can occur in adults and children and distribution is about equal between the sexes . The mean age for diagnosis of alopecia areata is 32 years in males and 36 years in females based on a study of the population of Olmsted County, Minnesota which was done between 1990 to 2009 .
• Only limited studies on the prevalence of trichotillomania have been performed and these were done among U.S. university students, Israeli adolescents and older adults within the same community. The prevalence were between 1 in 200 to 1 in 50.
• When using numbers with decimal points, avoid reporting more than 1 number after the decimal point. For example, report a prevalence as 10.1 instead of 10.09322. Many numbers after the decimal point may suggest a false sense of accuracy.
• You can use one or more of these template sentences.
  • Worldwide, the prevalence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average prevalence of _____ per 100,000 persons.
  • Worldwide, the prevalence of (insert disease state here) is _____ per 100,000 persons.
  • In developed countries, the prevalence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average prevalence of _____ per 100,000 persons.
  • In developed countries, the prevalence of (insert disease state here) is _____ per 100,000 persons.
  • In developing countries/ Africa, the prevalence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average prevalence of _____ per 100,000 persons.
  • In developing countries/ Africa, the prevalence of (insert disease state here) is _____ per 100,000 persons.
  • In ____ (insert year), the prevalence of _______ (insert disease name) was estimated to be _______ (insert number) cases per 100,000 individuals worldwide.

Incidence

• The overall incidence of alopecia areata is approximately 20.2 per 100,000 person-years.
• The standard format to report the incidence is ___ per 100,000 individuals.
• When using numbers with decimal points, avoid reporting more than 1 number after the decimal point. For example, report a incidence as 10.1 instead of 10.09322. Many numbers after the decimal point may suggest a false sense of accuracy.
• You can pick one or more of the template sentences below for this section:
  • Worldwide, the incidence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average incidence of _____ per 100,000 persons.
  • Worldwide, the incidence of (insert disease state here) is _____ per 100,000 persons.
  • In developed countries, the incidence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average incidence of _____ per 100,000 persons.
  • In developed countries, the incidence of (insert disease state here) is _____ per 100,000 persons.
  • In developing countries/ Africa, the incidence of (insert disease state here) ranges from a low of _____ per 100,000 persons to a high of _____ per 100,000 persons with an average incidence of _____ per 100,000 persons.
  • In developing countries/ Africa, the incidence of (insert disease state here) is _____ per 100,000 persons.
  • In ____ (insert year), the incidence of _______ (insert disease name) was estimated to be _______ (insert number) cases per 100,000 individuals worldwide.

Case Fatality Rate

• The case fatality rate is defined the number of deaths (fatality) among patients with the disease (case). Case fatality rate should be distinguished from "Mortality Rate" (defined as the number of deaths among the at-risk population).
• The case fatality rate is usually described as a function of time (e.g. In 2015 / annually etc...).
• When using numbers with decimal points, avoid reporting more than 1 number after the decimal point. For example, report the case fatality rate as 10.1% instead of 10.09322%. Many numbers after the decimal point may suggest a false sense of accuracy.
• You can pick the template sentence below for this section:
  • In ____ (year), the case fatality rate of ____ (disease name) is ____ (case fatality rate in %).
  • The annual case fatality rate of ____ (disease name) is approximately ____ (case fatality rate in %).

Age

• This section can describe the impact of the disease depending on the persons age, and the age-specific prevalence and incidence.
• The prevalence of ____ (insert disease state here) increases/decreases with age.
• _____ (insert acute disease) commonly affects _____ (insert age group).
• _____ (insert chronic disease) is usually first diagnosed among _____ (insert age group).

Gender

This section describe how prevalence of the disease varies by gender. When describing male to female ratios with decimal points, avoid reporting more than 1 number after the decimal point. For example, report a ratio as as 1.5 to 1 instead of 1.48294 to 1. Many numbers after the decimal point may suggest a false sense of accuracy. You can use either of the following template sentences:

• ______ (insert gender 1) are more commonly affected with ______ (insert disease name) than _____ (insert gender 2). The _____ (insert gender ratio e.g. male to female) ratio is approximately _____ (insert number > 1) to 1.
• The prevalence and incidence of (insert disease state here) does not vary by gender.
• Men and women are affected equally by (insert disease name here).
• (Insert disease state here) is more prevalent in men women.
• The prevalence of (insert disease state here) among men is ____ per 100,000, while it is _____ per 100,000 among women.
• The incidence of (insert disease state here) among men is ____ per 100,000, while it is _____ per 100,000 among women.

Race

This section describes how the disease differs based upon race. You can use the following template sentence for this section:

• The prevalence of _____ (insert disease) does not vary by race.
• (Insert disease state here) is more prevalent in the ____ (insert race) race and ____ (insert other race) races.
• There is no racial predilection for ____ (insert disease name)
• _____ (insert disease) usually affects individuals of the _____ (insert race) race. _____ (insert other race) individuals are less likely to develop ______ (disease name).