Hearing impairment in patients with alopecia areata

Background Alopecia areata is an autoimmune disease that damages hair follicles and follicular melanocytes can be involved in the autoimmune process. Therefore, similar to vitiligo, there may be a relationship between sensorineural hearing loss and alopecia areata. Aims/objectives This study aimed to investigate potential hearing impairments in patients with alopecia areata. Methods A total of 42 subjects with alopecia areata and 42 healthy individuals enrolled in this cross-sectional study. The hearing was evaluated by vestibular evoked myogenic potential, otoacoustic emission and pure tone audiometry tests in the patients and control subjects. Results A normal otoacoustic emission was reported in 59.5% and 100% of subjects with alopecia areata and the controls, respectively (P = 0.02). Higher speech recognition thresholds (P = 0.02) and speech discrimination scores were reported more in subjects with alopecia areata than in controls (P < 0.001); however, the most comfortable level of speech was not significantly different between the groups (P = 0.06). The greatest increase in the hearing threshold was recorded at a frequency of 8000 Hz, while at frequencies of 500 and 1000 Hz, the patients and controls did not significantly differ (P > 0.05). About 6 (14.3%) and 2 (4.8%) of patients with unilateral and bilateral involvement, respectively, demonstrated no vestibular evoked myogenic potential response in the alopecia areata group. The patients and controls did not significantly differ in terms of amplitudes of the vestibular evoked myogenic potential test (P = 0.097). Limitation Small sample size and qualitative measurement of otoacoustic emission were limitations of our study. Conclusion Hearing loss was more common in alopecia areata patients than in healthy individuals. Follicular melanocytes may be involved in the alopecia areata inflammatory process, and destroying melanocytes may impact hearing function in the inner ear. However, there was no significant relationship between the duration and severity of alopecia areata and hearing loss.