Serum Zinc Concentration in Patients with Alopecia Areata

Alopecia areata is an autoimmune non-scarring disease in which the exact mechanism that induces loss of immune privilege is unknown. Zinc is important for DNA stability and repair mechanisms that are essential in maintaining normal hair growth. Zinc deficiency has been investigated as an important factor in many autoimmune diseases, and may have a possible role in the aetiopathogenesis of alopecia areata. This study included 32 patients with severe forms of alopecia areata, and 32 age- and sex-matched healthy controls. When comparing serum zinc levels in these 2 groups, statistically significantly lower zinc concentrations were found in the alopecia areata group (p = 0.017). Detected zinc deficiency was statistically more prevalent in patients with alopecia areata (p = 0.011). Evaluating patients with alopecia areata, a statistically significant negative correlation between serum zinc levels and severity of the disease was found (ρ = 0.006). The results indicate that zinc serum assessment is necessary in patients with alopecia areata. Low serum zinc levels were found to correlate with severity of alopecia areata. Given that most severe forms of alopecia areata are frequently most treatment-resistant, additional randomized control trials examining zinc supplementation are necessary to investigate its potential role in the restoration of hair follicles. SIGNIFICANCE Alopecia areata is an autoimmune disease in which T-cells attack and damage hair follicles. The mechanism of this process is not fully understood. Zinc is known to be important for DNA stability, for normal hair growth, and in control of T-cells. This study found significantly lower levels of serum zinc in patients with alopecia areata than in healthy controls. Low levels of zinc are more pronounced in patients with long-lasting and more severe alopecia areata. The results of this study emphasize the importance of measurement of serum zinc levels in patients with alopecia areata, and provide a basis for further research into the importance of zinc supplementation in the treatment of alopecia areata with other modalities.