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

Introduction: 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. Aim: The aim of the study was to assess the quality of life and psychological status of patients with LPP and FFA. Material and methods: 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. Results: 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. Conclusions: 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.