Illness perceptions, coping and quality of life in patients with alopecia

Br J Dermatol. 2009 May;160(5):1034-9. doi: 10.1111/j.1365-2133.2008.09014.x. Epub 2009 Jan 20.


Background: Alopecia can have substantial psychological consequences, but there has been no research looking at patients' beliefs about their condition nor how they relate to quality of life (QoL).

Objectives: To investigate the relationships between illness perceptions, coping and QoL in patients with alopecia.

Methods: The study employed a cross-sectional design. In total, 214 individuals with alopecia were recruited from four internet support groups. There were 171 women and 43 men (mean age 35 years). Participants completed an online questionnaire comprising the Revised Illness Perception Questionnaire, the Dermatology Life Quality Index and the brief COPE.

Results: The findings indicate several areas in which alopecia impacted on individuals' QoL, particularly in relation to symptoms and feelings. Women reported poorer QoL compared with men. Impaired QoL was associated with a strong illness identity, beliefs in the serious consequences of alopecia and strong emotional representations. Hierarchical multiple regressions indicated that illness perceptions accounted for 35% of the variance in QoL after controlling for demographic and disease factors, with coping adding a further 7% to the regression model.

Conclusions: Although alopecia is not a life-threatening condition, it can impair QoL by negatively impacting on self-awareness. The strong relationships found between patients' beliefs about their condition and QoL suggests that health professionals should recognize the psychological impact of alopecia and address negative beliefs and emotions surrounding the condition in treatment programmes.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Alopecia / psychology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Quality of Life / psychology*
  • Self Concept
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires