Alopecia Areata Flares More common after Second Dose of Vaccines — Donovan Hair Clinic

Nguyen and Tosti recently set out to evaluate how alopecia areata is influenced by COVID infection and COVID vaccines. The authors sent a survey to members of “Alopecia Areata, find a cure” on social media. Individuals were eligible to participate in completion of a survey if they had been diagnosed with AA and tested positive for  COVID-19  or  received  at  least  one  COVID-19  vaccination.  In total, 131 of 214 members (61.2%)  completed the questionnaire.


Respondents with Prior COVID Positive Results.

Of  59  respondents  who  tested  positive  for  COVID-19,  25  (42.4%)  reported  AA  symptoms  after  infection:  60.0%  (15/25)  had  a  new diagnosis of AA, and 36.0% (9/25) experienced relapse of pre-existing  AA. 


Respondents with Prior COVID Vaccination.

Of  113  respondents  who  received  at  least  one  COVID-19  vaccination,  77  (68.1%)  reported  AA  symptoms  after  vaccination:  50.6%  (39/77)  had  a  new  diagnosis  of  AA,  and  49.4%  (38/77)  experienced  relapse  of  pre-existing AA.  Vaccines included Pfizer, Moderna and Oxford-AstraZeneca 


It was noted that more  patients  developed  symptoms  of  AA  after  the  second  COVID-19  vaccination  (25/47,  53.2%)  than  the first vaccination (12/47, 25.5%) or third vaccination (10/47, 21.3%). On average, symptoms of AA occurred 50.6 days (7 weeks) after COVID-19 infection and 61.5 days (8 weeks) after COVID-19 vaccination.




 All in all, this study supports the notion that both vaccination and COVID infection can precipitate and flare alopecia areata. It’s not possible to calculate true incidence from this study but it is interesting that such a large proportion of patients had flares or new onset disease with vaccination or infection. More studies are needed to better understand the true incidence.  


Nguyen B and Tosti A. Alopecia areata after COVID-19 . J Eur Acad Dermatol Venereol. 2022 Aug 11;10.1111/jdv.18491.

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