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The Association Between Alopecia Areata and Iron Deficiency Anemia: A Large-Scale Population-Based Case-Control

Batya Davidovici^1,2, Yarden Drutin³, Amir Ben-Tov^1,4,5

¹Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

Journal of Personalized Medicine

|June 25, 2026

Summary

Alopecia areata (AA) is linked to iron deficiency anemia (IDA). This study found a higher prevalence of IDA in AA patients, suggesting IDA may be a treatable comorbidity for hair loss.

Keywords:

alopecia areata autoimmune disease case–control study comorbidity iron deficiency anemia

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Area of Science:

Dermatology
Immunology
Hematology

Background:

Alopecia areata (AA) is an autoimmune disorder causing non-scarring hair loss, often linked to other autoimmune conditions.
Previous research on the association between AA and iron deficiency anemia (IDA) has produced inconsistent findings.
Systemic immune dysregulation is implicated in AA, prompting investigation into associated conditions like IDA.

Purpose of the Study:

To investigate the association between alopecia areata and iron deficiency anemia.
To analyze a large population-based cohort for a potential link between AA and IDA.
To determine the prevalence and temporal relationship of IDA in patients with AA.

Main Methods:

Retrospective case-control study utilizing health maintenance organization data (2.35 million individuals).
Included 33,401 AA patients (2005-2019) matched 1:2 with 66,802 controls.
Confirmed diagnoses via clinical coding; statistical analyses included Kruskal-Wallis, Pearson's χ², and Fisher's exact tests.

Main Results:

IDA prevalence was significantly higher in AA patients (15%) compared to controls (10%).
The odds ratio for IDA in AA patients was 1.61 (95% CI: 1.55-1.67; p < 0.01).
IDA preceded AA in 40% of cases, followed AA in 58%, and was concurrent in 2%.

Conclusions:

This study confirms a significant association between alopecia areata and iron deficiency anemia.
Iron deficiency anemia should be assessed and managed as a potential treatable comorbidity in patients with AA.
The findings underscore the importance of considering systemic factors in the management of autoimmune hair loss disorders.