An occupational perspective of the lived experience of individuals with Alopecia Areata: A scoping review.
Lexi Lindley, Daniel Cezar da Cruz, Angela Murphy
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
1Ten 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.
2Nine 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.
3The 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.
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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.
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