An occupational perspective of the lived experience of individuals with Alopecia Areata: A scoping review.
Lexi Lindley, Daniel Cezar da Cruz, Angela Murphy
PMID 42186606WHAT IT FOUND
A scoping review of 11 qualitative studies maps how alopecia areata disrupts daily life (school, work, self-care, relationships) across the lifespan.
It identifies unmet occupational needs and calls for OT involvement, but tests no treatment and offers no evidence that any intervention works.
Key findings
01Ten of the eleven included studies reported that AA affected valued and meaningful daily occupations, including shopping, childcare, work, and leisure, with disruptions ranging from temporary avoidance to long-term withdrawal from activities like swimming, running, and attending the gym.
02Nine of the eleven studies described self-care routines becoming dominated by concealment — wigs, shaving, makeup, regular mirror checks — and that this shift produced feelings of shame, inauthenticity, frustration, and in some cases active avoidance of mirrors because the person no longer recognised themselves.
03The authors frame the collective experience as occupational injustice — disruption, deprivation, and alienation — and call for occupational therapists to advocate at micro, meso, and macro levels, but the review does not test any intervention or measure whether OT involvement changes outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only English-language, open-access publications were included, which the authors acknowledge may have excluded relevant studies and limits global applicability. The included studies are predominantly from Western countries (5 North America, 3 UK, 1 each Australia, Lithuania, Pakistan), with under-representation of ethnic minority groups in a third of the studies. Only 11 studies met inclusion criteria, and the search was limited to a 20-year window (2003–2023). No protocol was registered before the review was conducted. The review synthesises qualitative and mixed-methods studies; it does not pool data or test any intervention, so it cannot support claims about treatment effectiveness. The first author has lived experience of AA, which the authors address through reflexive discussion but which may shape interpretation.
Declared interests
The authors declared no conflicts of interest and no financial support for the research, authorship, or publication.
The easy way to misread this
Do not read this review as evidence that occupational therapy or any other intervention improves outcomes for people with alopecia areata. It is a descriptive synthesis of lived experiences that identifies unmet needs and argues for OT involvement; it contains no intervention arm, no outcome measure, and no comparison group. The statistics it cites (82% increased unemployment probability, 56% higher work absences, 30–38% increased mental-health risk) come from individual included studies, not from this review's own analysis, and should not be attributed to the scoping review itself.