Significant impact of telogen effluvium on quality of life, depression, anxiety and stress: a prospective case-control study

Abstract

Background: Although stress and hair loss are often interrelated, there are few publications that have focused on the association between hair loss and stress. Telogen effluvium (TE) is a common form of generalized hair loss. Objectives: To evaluate the perceived stress, depression, anxiety, and quality of life (QoL) in patients with TE. Materials & Methods: A total of 205 patients diagnosed with TE and 105 healthy age-and sex-matched controls participated in the study. The questionnaires used in the study were the Dermatology Life Quality Index (DLQI), the Perceived Stress Scale (PSS) (including the Perceived Self-Efficacy Subscale [PSES] and the Perceived Helplessness Subscale [PHS]), the Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Results: The mean scores for the DLQI, PSS, BAI, and BDI of the TE group were significantly higher than those of the controls (p<0.001, p=0.012, p=0.011, respectively). No statistically significant correlation was found between duration of disease (months) and DLQI, PSS, PHS, PSES, BAI, or BDI levels (p>0.05). DLQI scores significantly correlated with PSS, PHS, PSES, BAI, and BDI in the TE group (p<0.001 for each). Conclusion: The decrease in QoL of TE patients correlates with an increase in symptoms of stress, depression and anxiety. More comprehensive multi-centre studies are needed to further understand the association between TE and stress, depression, and anxiety status. © 2025 Elsevier B.V., All rights reserved.