ALOPECIA areata (AA) is an autoimmune condition marked by sudden and often distressing hair loss. It is widely understood to have a genetic component, but until now, the extent of familial risk and related health conditions in affected families had not been comprehensively quantified. A recent systematic review and meta-analysis has brought together findings from 67 studies worldwide to assess the prevalence of familial AA and associated comorbidities. Notably, the study confirms that a significant proportion of patients with AA have close family members who are also affected, underlining the importance of family-based awareness and clinical vigilance.
The researchers conducted the systematic review and meta-analysis in line with PRISMA guidelines, screening literature from databases including EMBASE, Cochrane Library, PubMed, and Web of Science up to mid-October 2023. Studies were included if they reported a confirmed diagnosis of AA and data on family history or comorbid autoimmune conditions. Two independent reviewers handled data extraction and assessed study quality, with disagreements resolved by a third party. Pooled prevalence estimates were calculated using a random effects model to account for inter-study variability.
From the 67 studies comprising 24,226 individuals with AA, the pooled prevalence of a family history of AA was 17.6% (95% CI: 14.9–20.6%; I²=96%). Among relatives, the overall prevalence was 0.90% (CI: 0.55–1.47%; I²=98%), rising to 3.22% (CI: 2.31–4.48%; I²=94%) in first-degree relatives. Comorbid conditions were found in 9.61% of relatives, including atopic dermatitis (18.9%), diabetes (10.1%), thyroid disease (4.7%), vitiligo (5.5%), and other autoimmune diseases (12.1%). These findings provide robust evidence of both hereditary susceptibility and an elevated autoimmune disease burden within affected families.
This study reinforces the importance of taking a detailed family history in clinical settings when assessing patients with alopecia areata. Routine screening of first-degree relatives for autoimmune conditions, combined with genetic counselling, may support earlier diagnosis and intervention. However, the high heterogeneity among included studies is a limitation and calls for more uniform research methods. In future, population-based studies focusing on more distant relatives will be essential to further clarify familial risk patterns. These findings strengthen the case for integrated, family-centred approaches to AA care and monitoring.
Reference
Huang Y et al. Familial patterns of alopecia areata: A systematic review and meta-analysis. J Autoimmunol. 2025;151:103378.
