Patients with Androgenetic Alopecia Have a Higher Risk of Depression

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A bidirectional genetic analysis revealed a possible correlation between androgenetic alopecia and depression.¹ It was found that patients with depression do not have a higher risk of developing androgenetic alopecia. Conversely, patients with androgenetic alopecia are more likely to be clinically depressed.

Mendelian randomization with genome-wide association studies (GWAS) datasets occurred. The two-sample analysis used data from the Neale Lab Consortium. The alopecia dataset included 154,988 European male and female patients with 35,563 cases and 119,435 controls. The depression dataset of 484,598 was split into 27,568 cases and 457,030 controls.

To assess genetic correlation, investigators utilized the inverse variance weighted, MR-Egger regression, weighted median, and simple and weighted mode methods. Eligible single nucleotide polymorphisms associated with androgenetic alopecia were selected as instrumental variables. Thus, the significance threshold was p < 1.0 × 10–5. Instrumental variables were assumed to be independent of confounding factors and were "hypothesized to influence the outcome solely through exposure risk factors," according to the authors.

It was found that patients with depression do not have a higher risk of developing androgenetic alopecia (odds ratio = 1.101, 95% confidence interval =0.890–1.362, p = 0.374). The Cochrane’s Q test showed that there was no significant heterogeneity in the data (p = 0.420) and the MR-Egger intercept showed no evidence of directional pleiotropy (p = 0.569).

“We hypothesize that this may be partly due to depression potentially increasing the risk of other types of hair loss, such as telogen effluvium, or due to patients’ heightened concern about pre-existing hair loss and the influence of antidepressants,” the researchers concluded.

However, having androgenetic alopecia may exacerbate the risk of developing depression (odds ratio = 1.015, 95% confidence interval = 1.002–1.029, p = 0.020). Conversely, non-significant results in data heterogeneity and horizontal pleiotropy were found via Cochrane’s Q test (p = 0.884) and the MR-Egger intercept (p = 0.389).

The research does have some limitations such as the selection bias of a European population and no specific sub-analysis based on gender, age, or disease duration. Future literature should explore the underlying biological mechanisms that can further define the relationship between these two conditions.

Both depression and androgenetic alopecia have similar pathogenesis factors including genetics, hormones, stress, and immune dysregulation.² Alopecia can affect a person’s self-esteem and self-consciousness, thus reducing their mental health and quality of life. 

About 65% of men with androgenetic alopecia experience mild to moderate emotional distress.³ Other questionnaire-based studies have confirmed these findings, with female patients demonstrating more pronounced effects.

Clinical interventions, such as hair transplantation, have been proven to have positive psychological benefits on patients. Even minor improvements experienced with topical minoxidil treatment can enhance quality of life. But even with these dermatological therapies, the investigators recommend evaluating patient perceptions of their hair loss via psychological questionnaires and follow-up assessments to provide psychosocial support and intervention when needed.

“This will help patients to establish effective psychological coping mechanisms,” the authors wrote. “Furthermore, early intervention can also lead to the optimized allocation of medical resources, thereby elevating the overall standard of healthcare.”

References

1. Li, H., Cai, H., Li, P., Zeng, Y., & Zhang, Y. (2025). Assessing Causality Between Androgenetic Alopecia with Depression: A Bidirectional Mendelian Randomization Study. Clin Cosmet Investig Dermatol, 18, 445–451. https://doi.org/10.2147/CCID.S501182

2. Sadick NS, Callender VD, Kircik LH, Kogan S. New Insight Into the Pathophysiology of Hair Loss Trigger a Paradigm Shift in the Treatment Approach. J Drugs Dermatol. 2017;16(11):s135-s140.

3. Cash TF. The psychological effects of androgenetic alopecia in men. J Am Acad Dermatol. 1992;26(6):926-931. doi:10.1016/0190-9622(92)70134-2