Stress: an important cofactor in patients with lichen planopilaris and frontal fibrosing alopecia

It has been shown that patients with hair loss may experience reduced confidence, increased self-consciousness, and low self-esteem. However, data concerning patients with lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) remain limited.

The aim of the study was to assess the quality of life and psychological status of patients with LPP and FFA.

In 83 patients with LPP and 79 patients with FFA, we assessed the health-related quality of life, disease perception, depression, anxiety and stress using dedicated questionnaires: DLQI, IPQ-B and DASS-21.

In 34% (28/83) of patients with LPP and 19% (15/79) of patients with FFA, the disease had at least a moderate effect on the patient's quality of life. In patients with LPP and FFA, positive correlations were observed between the DLQI and LPPAI (r = 0.406, p < 0.001 and r = 0.317, p < 0.01, respectively). Moderate or high threat was experienced by 59% (49/83) of patients with LPP and 61% (48/79) of patients with FFA. A moderate or severe stress level was noted in 42% (35/83) and 31% (24/79) of patients with LPP and FFA, respectively. In 29% (25/83) of patients with LPP and 20% (17/79) of patients with FFA, at least a mild depression level was observed. Only 10% (8/83) of patients with LPP reported a mild or moderate anxiety level. Stress was considered as the most common cause of the disease by 42% (35/83) of patients with LPP and 42% (33/79) of patients with FFA.

Patients with LPP and FFA may experience a substantial impairment of the quality of life and stress, which, in their opinion, is a cause of their condition.