Awareness, knowledge, and perceptions of alopecia among UK postgraduate students: a cross-sectional study

Awareness, knowledge, and perceptions of alopecia among UK postgraduate students: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Awareness, knowledge, and perceptions of alopecia among UK postgraduate students: a cross-sectional study Pratigya Koju, Dev Acharya, Peter Collins, Narayan Poudel, Pujan Babu Dangi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9312281/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Alopecia is a medical disorder causing hair loss, affecting millions globally. Despite its prevalence, public awareness and understanding of the condition remain limited, potentially hindering early diagnosis, access to support, and well-being for individuals living with the condition. This research aimed to assess the current level of awareness of Alopecia among postgraduate health students. Methods A quantitative approach was administered to a representative sample of students at the School of Health and Society, gathering data on participants' knowledge of Alopecia symptoms, causes, treatment options, and psychosocial impact. 74 students took part in an online survey. Survey data were analysed using descriptive statistics and inferential tests to identify patterns and associations between awareness of alopecia and the gender of students. Results 17.3%(n = 13) of students had a high level of overall awareness of alopecia, 62.2% (n = 46) had a medium level of awareness, and 20.3% (n = 15) had a low level of awareness of alopecia, with no significant difference in awareness scores between male and female students. However, despite having a health background, only 20.3% of them felt confident that they knew the pathogenesis of the hair fall cycle. Female respondents were more aware of the prognosis and pathogenesis of alopecia and more likely to visit health care professionals than compared to male participants (p < 0.05) Conclusion The vast majority of respondents had moderate awareness of alopecia. This fact stresses the importance of awareness campaigns and interventions among both health students and general students Figures Figure 1 Figure 2 Background Hair plays a central role in human identity, culture, and psychosocial wellbeing, extending beyond its biological function. Consequently, hair loss can significantly affect quality of life [ 1 ]. Alopecia, defined as hair loss from the scalp or body, has become an increasing concern in contemporary society, with many individuals reporting emotional distress and willingness to pursue interventions [ 2 , 3 ]. The rising prevalence of alopecia, particularly among younger populations, highlights its importance as a public health and psychosocial issue [ 4 ]. Androgenic alopecia (AGA) is the most common form, affecting approximately 58% of men aged 18–50 and around 40% of women, with incidence increasing with age [ 5 , 6 ]. Alopecia areata (AA) has also shown a rise in global lifetime incidence, increasing from 2.1% during 1990–2009 to 2.5% in 2020 [ 7 ]. Although alopecia does not directly threaten physical health, its psychological and social consequences can be profound. Individuals frequently experience reduced self-esteem, anxiety, depression, and social withdrawal, with depression rates reported as high as 66.7% [ 8 , 9 ]. These impacts emphasise the importance of awareness for affected individuals and society [ 8 ]. Alopecia includes a diverse group of conditions broadly categorised into scarring and non-scarring types [ 10 ]. Scarring alopecia results from inflammatory destruction of hair follicles, leading to irreversible hair loss, whereas non-scarring forms, including AGA, AA, telogen effluvium, traction alopecia, and trichotillomania, are generally reversible [ 11 , 12 ]. These conditions arise from interactions between genetic predisposition, autoimmune mechanisms, hormonal factors, stress, nutrition, and infectious triggers [ 13 ]. Early diagnosis is essential, as it can prevent progression and reduce psychosocial and economic burden [ 14 ]. Current management options include FDA-approved treatments such as finasteride and minoxidil, alongside prostaglandin analogues, corticosteroids, immunotherapies, and surgical procedures including hair transplantation [ 15 , 16 ]. However, treatment effectiveness varies, long-term adherence is often required, and adverse effects may occur, including scalp irritation or sexual dysfunction [ 17 ]. Therefore, informed awareness is necessary to ensure realistic expectations and safe decision-making [ 18 ]. Alopecia also presents a financial burden. Global expenditure on alopecia-related products reached USD 8.2 million in 2022 and is projected to increase [ 19 ]. In the United Kingdom, average annual spending per patient is approximately £840, representing about 8.5% of disposable income [ 20 ]. Combined with stigma and psychological distress, this economic impact reinforces the need for public awareness. Despite its prevalence, significant gaps in research regarding alopecia awareness remain. Only 26% of individuals in Poland demonstrated basic knowledge of AGA [ 21 ]. Studies from Pakistan and the United States report low awareness of AA [ 22 , 23 ]. Although awareness seemed higher in Saudi Arabia, understanding of psychosocial consequences remained limited [ 24 ]. Knowledge deficits are evident among high-risk groups, such as African women vulnerable to traction alopecia and communities with religious grooming practices [ 25 , 26 ]. No studies have comprehensively assessed alopecia awareness among university students. This is a critical gap, as most students fall within the age group most susceptible to alopecia, namely 18–50 years [ 6 , 27 ]. University environments are key social spaces where stigma may occur [ 28 ]. As students are future professionals and policymakers, understanding their awareness is essential. Therefore, this study aims to assess awareness, knowledge, and perceptions of alopecia among postgraduate students at the University of Wolverhampton in the United Kingdom within a contemporary academic setting. Methods A cross-sectional primary research survey design was adopted to measure awareness levels at a single point in time [ 29 ]. Primary research enables the collection of original, context-specific data, offering flexibility and control over study variables [ 30 ] unlike secondary research which lacks customisation and may not be suitable when limited prior research exists [ 31 ]. As no previous studies examined awareness of alopecia among university students, primary research was deemed most appropriate. Cross-sectional surveys are also economical, effective for assessing prevalence and attitudes, and suitable for large student populations, though they cannot establish causality and rely on self-reported data [ 29 ]. Compared to cohort or experimental designs, they offer faster data collection despite reduced depth and causal insight [ 32 ]. The study utilised a quantitative case study research method grounded in positivism, which assumes an objective reality measurable through statistical analysis [ 33 ]. Quantitative methods allow generalisation, minimise researcher bias, and enable numerical comparison [ 34 ]. Since limited evidence exists on population-level alopecia awareness, a quantitative approach was justified to establish baseline understanding and trends before future qualitative exploration [ 35 ]. The quantitative case study allows focused investigation of a defined population and enable deep analysis of behaviours and characteristics within a real-world setting, making them suitable for this under-researched topic [ 36 ]. Practical constraints, including time, access, and resources, further justified focusing on this population. The study population consisted of postgraduate students enrolled in Master’s in Public Health (MPH) and MSc Health and Social Care programmes. Inclusion criteria required participants to be aged 18 or older, enrolled in the School of Health and Society, and willing to participate. A purposive sampling strategy was used because it intentionally selects participants with relevant knowledge or experience [ 37 ]. While purposive sampling risks researcher bias and reduced representativeness, it offers depth and relevance of the content. Seventy-four students participated, exceeding the required minimum sample size of 50 (20% of the population). Students were identified and contacted via Canvas, a student database used by the University to keep records of enrolled students. Data were collected using a self-administered online survey, chosen for affordability, consistency, accessibility, and replicability [ 38 ]. Although online surveys may involve self-selection bias or misinterpretation, they remain efficient for large student groups [ 39 ]. Questionnaire validity was supported through adaptation of previously validated surveys and extra items based on WHO and NHS resources [ 21 , 22 ]. Reliability was strengthened through a pilot study and use of instruments with Cronbach’s alpha values above 0.70. Data were entered into SPSS 29 for cleaning, coding, and analysis. Descriptive statistics summarised awareness levels, while inferential tests including Chi-square, Fisher’s exact test, and Mann-Whitney U assessed associations between awareness and demographic variables. Likert-scale items measured perceptions of alopecia consequences, stigma, treatment, and public health significance. Statistical significance was set at p < 0.05 [ 40 ]. Ethical approval was granted by the ethical board of university. Key ethical principles-confidentiality, anonymity, informed consent, voluntary participation, and avoidance of harm were upheld. No identifiable personal data were collected, participation was restricted to adults, and support contacts were provided. Results A total of 95 participants completed the survey, of which 74 valid responses remained after excluding missing data and non-health faculty students. Most of the respondents were found to be of age group (26–35) as represented in Table-1. Normality was assessed using the Kolmogorov–Smirnov test, with p < 0.05, leading to the use of non-parametric tests. Descriptive statistics were followed by appropriate inferential analyses, including chi-square tests, the Fisher exact test, and the Mann-Whitney test. Table-1 Age distribution of participants Age Males N(%) N Females (%) Total N(%) 18–25 5(6.75%) 10(13.5%) 15(20.3%) 26–35 15(20.27%) 32(43.24%) 47(63.5%) 36–45 3(4.05%) 7(9.45%) 10(13.5)% 46 or above 1(1.35%) 1(1.35%) 2(2.4%) Total 24(32.43%) 50(67.57%) 74(100%) Mode − 26–35 and std deviation- 0.672. 43.2% of participants correctly identified alopecia as hair loss from the scalp and other body areas, while 54.1% believed it referred only to scalp hair loss and 2.7% thought it was an infection with pus formation (p > 0.05). Less than half (44.6%) of participants knew that daily hair loss of more than 50–100 strands constitute a medical condition called alopecia. Only 20.3% of students were confident about the pathogenesis of the hair growth and loss cycle, while 55.4% were aware of hair fall but still lacked confidence in the details of its pathogenesis (p < 0.05). A total of 71.6% of participants reported that they would seek care from a general practitioner or dermatologist for early alopecia symptoms (p < 0.05), as represented in Fig. 1 . 83.8% of students were aware that if a person starts to develop symptoms and does not undergo any treatment for alopecia, the time interval to become completely bald depends on the type of alopecia, as some types progress slowly and others progress more rapidly (p = 0.036). Regarding awareness of the causes of alopecia, the majority of participants (71.6%) were aware of increasing age and heredity, as represented in Table 2. Table-2 Gender distribution on Awareness of cause of alopecia. Awareness of Causes of Alopecia Male N(%) Female N(%) Total N(%) Pearson chi square value significance (2 sided) Due to excess Androgen Hormone 15(20.27%) 26(35.13%) 41(55.4%) 0.724 0.395 increase in Age 17(22.97%) 36(48.64%) 53(71.6%) 0.011 0.917 Having hair tied tightly for long time 5(6.75%) 31(41.89%) 36(48.6%) 11.001 <0.01 Infections on scalp 13(17.57%) 30(40.5%) 43(58.1%) 0.227 0.634 Hereditary 14(18.91%) 39(52.7%) 53(71.6%) 3.086 0.079 Auto immune disorder 11(14.86%) 31(41.89%) 42(56.8%) 1.727 0.189 Cancer 12(16.2%) 25(33.78%) 37(50%) 0 1 When asked about causes and symptoms of various types of alopecia, most of them (60.8%) answered correctly for the AGA, the results for others are as represented in figure-2 below. 75.7% of respondents were aware of hair transplants and stem cell transplants as surgical treatments for alopecia, result for rest of the treatment options is as shown in Table 3. Table-3 Awareness of treatment options of Alopecia. Treatment options of Alopecia Male N(%) Female N(%) Total N(%) Pearson chi square value Asymptotic Significance (2-sided) Hair transplant and stem cell transplant 17(22.97%) 39(52.7%) 56 (75.7%) 0.452 0.501 Minoxidil and finasteride as treatment 9(12.16%) 17(22.97) 26(35.1%) 0.087 0.768 Corticosteroid and Immunotherapy 5(6.7%) 22(29.7%) 27(36.5%) 3.756 0.053 Laser therapy 6(8.1%) 19(25.67%) 25(33.8%) 1.225 0.268 Accupuncture and Holistic Medicine 4(5.4%) 12(16.2%) 16(21.6%) 0.515 0.473 Shampoos and conditioner 10(13.5%) 8(10.8%) 18(24.3%) 5.804 0.016 Likert scale was used to assess awareness of consequences of alopecia as represented in Table-4. Independent Samples test Mann Whitney U test was conducted to measure association between awareness of alopecia and gender which suggested significant difference in awareness between male and female regarding the statement that alopecia is just cosmetic issue, no further treatment needed only. Table-4 Percentage distribution of Likert scale for Awareness of consequences of Alopecia Statement Strongly disagree N (%) Somewhat disagree N (%) Neither disagree nor agree N (%) Somewhat agree N (%) Strongly agree N (%) Total N (%) The treatment course of Alopecia is quite expensive. 7(9.5%) 3(4.1%) 17(23%) 31(41.9%) 16(21.6%) 74(100%) Alopecia is just a Cosmetic Issue, no treatment needed. 43(58.1%) 12(16.2%) 13(17.6%) 2(2.7%) 4(5.1%) 74(100%) Alopecia is public health issue. 19(25.7%) 7(9.5%) 16(21.6%) 21(28.4%) 11(14.9%) 74(100%) Alopecia affects personal and marital associations. 4(5.4%) 11(14.9%) 20(27%) 27(36.5%) 12(16.2%) 74(100%) Alopecia has negative psychological impact. 3(4.1%) 6(8.1%) 14(18.9%) 21(28.4%) 30(40.5%) 74(100%) Alopecia patients often get victims of stigmatisation of being bald. 7(9.5%) 1(1.4%) 14(18.9%) 12(16.2%) 40(54.1%) 74(100%) Alopecia patients should be encouraged to accept their condition and should not be made fun of. Alopecia friendly and inclusive environment should be maintained by raising awareness about alopecia at every levels. 7(9.5%) 5(6.8%) 1(1.4%) 0(0%) 14(18.9%) 8(10.8%) 12(16.2%) 12(16.2%) 40(54.1%) 49(66.2%) 74(100%) 74(100%) Regarding overall awareness, only 17.3%(n = 13) of students had high level of awareness of alopecia, 62.2% (n = 46) had medium level of awareness and 20.3% (n = 15) had low level of awareness of alopecia with no significant difference in awareness scores in between male and female students. Discussion This study aimed to assess the level of awareness of alopecia among students at the School of Health and Society, a cohort presumed to have a solid foundation in health promotion and disease prevention. This research addressed a notable gap in the literature, as few studies have evaluated alopecia awareness in the general population. Overall, the results showed that most students possessed a moderate level of alopecia knowledge, with 62.2% (n = 46) categorized as medium level, 17.3% (n = 13) as high level, and 20.3% (n = 15) as low level of awareness. Less than half of respondents (43.2%) correctly identified alopecia as hair loss affecting the scalp or any part of the body, while 54.1% held misconceptions, such as believing alopecia was limited to scalp hair loss, was contagious, or was merely a cosmetic issue. These findings were lower than those reported by Alzubaidy et al. (2023), whose participants were patients with alopecia and therefore likely held more precise, personalized cognitive illness representations (CIRs) [ 24 , 41 ]. A total of 83.8% of students were aware that if one begins to develop symptoms and does not undergo any treatment for alopecia, the time interval to become completely bald depends on the type of alopecia, as some forms progress slowly while others progress more rapidly (χ² test, p < 0.05). In addition, 20.3% of students were confident about the pathogenesis of the hair fall cycle. While 55.4% of students were aware of hair fall, they still lacked confidence in the details of its pathogenesis (χ² test, p < 0.05; p = 0.04). Despite having a health-related background, the results suggest a very low level of awareness regarding the pathogenesis of the hair fall cycle. A majority of respondents (71.6%) reported that they would consult a general practitioner or dermatologist upon noticing early symptoms of alopecia, whereas fewer students opted for hair clinics, herbal or vitamin supplements, or cosmetic products. Female students were more likely to understand the prognosis of alopecia and to be more aware of the pathology of the hair fall cycle compared to male students (p < 0.05). They were also significantly more inclined to seek professional medical care. This difference may be attributed to the greater psychosocial impact of hair loss among females or their increased likelihood of discussing and researching cosmetic and dermatological concerns [ 42 , 47 ]. On average, 60.35% of students were aware of potential causes of hair loss, most commonly age, hereditary factors, autoimmune disorders, and excess androgens. This aligns with one previous study, which reported high awareness rates for hormones, stress, and aging in androgenetic alopecia (AGA) [ 21 ]. However, 50% of students erroneously selected cancer as a direct cause of alopecia, indicating misunderstanding; cancer itself does not cause alopecia, but its treatments (chemotherapy/radiotherapy) can damage hair follicles and lead to hair loss [ 43 ]. Knowledge of specific alopecia types varied. A total of 60.8% correctly answered questions on symptoms and causes of AGA, whereas 40.5% correctly identified symptoms and the autoimmune etiology of alopecia areata (AA), and 47.3% knew about trichotillomania. Lower awareness of other types of alopecia in compared to AGA may be due to their lower prevalence. Trichotillomania, which is more common in children and associated with stress responses, emphasizes the importance of parental awareness for early intervention [ 44 , 45 ]. Regarding treatment, 75.7% were more aware of surgical options like hair transplants than of topical/oral medications or corticosteroids. This trend may be influenced by increased global interest in hair transplantation [ 46 ]. In contrast, fewer students knew about drugs like minoxidil and finasteride, likely due to their prescription requirement and associated side effects, which reduce public visibility. Notably, 24.3% selected shampoos and conditioners as treatments, with male students more likely to do so, perhaps indicating a tendency to perceive alopecia as a less serious issue [ 47 ]. Students were generally aware of alopecia’s psychosocial impacts, acknowledging its potential to cause anxiety, depression, low self-esteem, and reduced quality of life-a concern supported by illness perception theory and previous research [ 48 , 49 ]. More than half recognized that alopecia treatment can be costly, which is quite similar to findings from a previous study [ 50 ]. While this study provides a strong initial insight, its cross-sectional design, self-reported data, and single-university sample limit causal interpretation and generalizability. The findings highlight the need for broader, longitudinal research to capture more diverse and evolving awareness levels. Conclusion The study highlights the need for enhanced education, public awareness campaigns, accessible support services, affordable treatments, and further research to improve alopecia understanding, reduce stigma, and strengthen prevention and early detection strategies in both academic and community settings. Declarations Conflicts of Interest The authors declare no conflicts of interest. Funding No funding was received for this study. Author Contribution PK designed the study, collected data and performed data analysis with the support of PC. PK drafted the manuscript with the support of DA. AP and PBD performed the statistical analysis and made comments on the first draft. 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Mesinkovska NA, Craiglow BG, Ball SG, et al. The Invisible Impact of a Visible Disease: Psychosocial Impact of Alopecia Areata. Dermatology therapy. 2023;13(7). https://doi.org/10.1007/s13555-023-00941-z . Weinman J, Petrie KJ, Moss-morris R, Horne R. The illness perception questionnaire: A new method for assessing the cognitive representation of illness. Psychol Health. 1996;11(3):431–45. https://doi.org/10.1080/08870449608400270 . García-Hernández MJ, Ruiz-Doblado S, Rodriguez-Pichardo A, Camacho F. Alopecia Areata, Stress and Psychiatric Disorders: A Review. J Dermatol. 1999;26(10):625–32. https://doi.org/10.1111/j.1346-8138.1999.tb02063.x . Ingrassia JP, Buontempo MG, Alhanshali L, et al. The financial burden of alopecia: a survey study. Int J women’s dermatology. 2023;9(4):e118–118. https://doi.org/10.1097/jw9.0000000000000118 . Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9312281","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":617112271,"identity":"c77c4e89-81c9-4840-87b4-8beaf6aaf287","order_by":0,"name":"Pratigya Koju","email":"","orcid":"","institution":"University of Wolverhampton","correspondingAuthor":false,"prefix":"","firstName":"Pratigya","middleName":"","lastName":"Koju","suffix":""},{"id":617112272,"identity":"af0109f9-75a9-49a9-9c65-a4a974524667","order_by":1,"name":"Dev Acharya","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4ElEQVRIiWNgGAWjYDCCAwwMzGAGewPjAYgQG7FaeA4wkKpFIoFILXwHmB9+Lqi5l9g/843BYR4GO3kGibQEvFokD7AZS884Vpw443YOSEuyYYNE2gG8WgwOMJgx87AlJDbczt1wcAYDcwKDRHoDAS3s35h5/iUkzr95FqSlnhgtPGbMvG0JiRtu8G448IHhMFALAYdJHuYplubtSzDeeCb/w4EPBscN23ieJeDVwne8feNnnm8JsvOOH0t8kFBRLc/PnmaAVws0UhgcIe43IByRcGBPrMJRMApGwSgYgQAACvJHfJ3f1HYAAAAASUVORK5CYII=","orcid":"","institution":"University of Wolverhampton","correspondingAuthor":true,"prefix":"","firstName":"Dev","middleName":"","lastName":"Acharya","suffix":""},{"id":617112273,"identity":"e2444a88-7a69-45f7-9c9c-07f254b1bec8","order_by":2,"name":"Peter Collins","email":"","orcid":"","institution":"University of Wolverhampton","correspondingAuthor":false,"prefix":"","firstName":"Peter","middleName":"","lastName":"Collins","suffix":""},{"id":617112274,"identity":"21772995-8a5e-41be-829e-f356b20fb00a","order_by":3,"name":"Narayan Poudel","email":"","orcid":"","institution":"University of Huddersfield","correspondingAuthor":false,"prefix":"","firstName":"Narayan","middleName":"","lastName":"Poudel","suffix":""},{"id":617112275,"identity":"c2ffc909-9961-4f35-a848-4223cba78133","order_by":4,"name":"Pujan Babu Dangi","email":"","orcid":"","institution":"University of Wolverhampton","correspondingAuthor":false,"prefix":"","firstName":"Pujan","middleName":"Babu","lastName":"Dangi","suffix":""}],"badges":[],"createdAt":"2026-04-03 11:10:31","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9312281/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9312281/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106214843,"identity":"2c278c80-48e9-4661-a3dd-ed8a0341f891","added_by":"auto","created_at":"2026-04-06 08:17:33","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":40777,"visible":true,"origin":"","legend":"\u003cp\u003ePercentage representation of response for action after developing hair loss.\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9312281/v1/65909329a25db6a726072b3d.jpg"},{"id":106214842,"identity":"2f5e58f1-8568-461b-9943-13c3eefbca32","added_by":"auto","created_at":"2026-04-06 08:17:33","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":32428,"visible":true,"origin":"","legend":"\u003cp\u003eAwareness of cause and symptoms of types of Alopecia.\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9312281/v1/aa4d0b6e0c9c8949cb6f5488.jpg"},{"id":107480270,"identity":"de9449a5-90b1-481b-86e2-dbfff9f24e4e","added_by":"auto","created_at":"2026-04-22 02:06:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":488881,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9312281/v1/e581b9e7-4bb4-4df5-bc34-4375cddfbef4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Awareness, knowledge, and perceptions of alopecia among UK postgraduate students: a cross-sectional study","fulltext":[{"header":"Background","content":"\u003cp\u003eHair plays a central role in human identity, culture, and psychosocial wellbeing, extending beyond its biological function. Consequently, hair loss can significantly affect quality of life [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Alopecia, defined as hair loss from the scalp or body, has become an increasing concern in contemporary society, with many individuals reporting emotional distress and willingness to pursue interventions [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The rising prevalence of alopecia, particularly among younger populations, highlights its importance as a public health and psychosocial issue [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAndrogenic alopecia (AGA) is the most common form, affecting approximately 58% of men aged 18\u0026ndash;50 and around 40% of women, with incidence increasing with age [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Alopecia areata (AA) has also shown a rise in global lifetime incidence, increasing from 2.1% during 1990\u0026ndash;2009 to 2.5% in 2020 [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Although alopecia does not directly threaten physical health, its psychological and social consequences can be profound. Individuals frequently experience reduced self-esteem, anxiety, depression, and social withdrawal, with depression rates reported as high as 66.7% [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. These impacts emphasise the importance of awareness for affected individuals and society [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlopecia includes a diverse group of conditions broadly categorised into scarring and non-scarring types [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Scarring alopecia results from inflammatory destruction of hair follicles, leading to irreversible hair loss, whereas non-scarring forms, including AGA, AA, telogen effluvium, traction alopecia, and trichotillomania, are generally reversible [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. These conditions arise from interactions between genetic predisposition, autoimmune mechanisms, hormonal factors, stress, nutrition, and infectious triggers [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Early diagnosis is essential, as it can prevent progression and reduce psychosocial and economic burden [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCurrent management options include FDA-approved treatments such as finasteride and minoxidil, alongside prostaglandin analogues, corticosteroids, immunotherapies, and surgical procedures including hair transplantation [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. However, treatment effectiveness varies, long-term adherence is often required, and adverse effects may occur, including scalp irritation or sexual dysfunction [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Therefore, informed awareness is necessary to ensure realistic expectations and safe decision-making [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlopecia also presents a financial burden. Global expenditure on alopecia-related products reached USD 8.2\u0026nbsp;million in 2022 and is projected to increase [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In the United Kingdom, average annual spending per patient is approximately \u0026pound;840, representing about 8.5% of disposable income [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Combined with stigma and psychological distress, this economic impact reinforces the need for public awareness.\u003c/p\u003e \u003cp\u003eDespite its prevalence, significant gaps in research regarding alopecia awareness remain. Only 26% of individuals in Poland demonstrated basic knowledge of AGA [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Studies from Pakistan and the United States report low awareness of AA [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Although awareness seemed higher in Saudi Arabia, understanding of psychosocial consequences remained limited [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Knowledge deficits are evident among high-risk groups, such as African women vulnerable to traction alopecia and communities with religious grooming practices [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNo studies have comprehensively assessed alopecia awareness among university students. This is a critical gap, as most students fall within the age group most susceptible to alopecia, namely 18\u0026ndash;50 years [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. University environments are key social spaces where stigma may occur [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. As students are future professionals and policymakers, understanding their awareness is essential. Therefore, this study aims to assess awareness, knowledge, and perceptions of alopecia among postgraduate students at the University of Wolverhampton in the United Kingdom within a contemporary academic setting.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA cross-sectional primary research survey design was adopted to measure awareness levels at a single point in time [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Primary research enables the collection of original, context-specific data, offering flexibility and control over study variables [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] unlike secondary research which lacks customisation and may not be suitable when limited prior research exists [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. As no previous studies examined awareness of alopecia among university students, primary research was deemed most appropriate. Cross-sectional surveys are also economical, effective for assessing prevalence and attitudes, and suitable for large student populations, though they cannot establish causality and rely on self-reported data [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Compared to cohort or experimental designs, they offer faster data collection despite reduced depth and causal insight [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study utilised a quantitative case study research method grounded in positivism, which assumes an objective reality measurable through statistical analysis [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Quantitative methods allow generalisation, minimise researcher bias, and enable numerical comparison [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Since limited evidence exists on population-level alopecia awareness, a quantitative approach was justified to establish baseline understanding and trends before future qualitative exploration [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. The quantitative case study allows focused investigation of a defined population and enable deep analysis of behaviours and characteristics within a real-world setting, making them suitable for this under-researched topic [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Practical constraints, including time, access, and resources, further justified focusing on this population.\u003c/p\u003e \u003cp\u003eThe study population consisted of postgraduate students enrolled in Master\u0026rsquo;s in Public Health (MPH) and MSc Health and Social Care programmes. Inclusion criteria required participants to be aged 18 or older, enrolled in the School of Health and Society, and willing to participate. A purposive sampling strategy was used because it intentionally selects participants with relevant knowledge or experience [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. While purposive sampling risks researcher bias and reduced representativeness, it offers depth and relevance of the content. Seventy-four students participated, exceeding the required minimum sample size of 50 (20% of the population). Students were identified and contacted via Canvas, a student database used by the University to keep records of enrolled students.\u003c/p\u003e \u003cp\u003eData were collected using a self-administered online survey, chosen for affordability, consistency, accessibility, and replicability [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Although online surveys may involve self-selection bias or misinterpretation, they remain efficient for large student groups [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Questionnaire validity was supported through adaptation of previously validated surveys and extra items based on WHO and NHS resources [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Reliability was strengthened through a pilot study and use of instruments with Cronbach\u0026rsquo;s alpha values above 0.70.\u003c/p\u003e \u003cp\u003eData were entered into SPSS 29 for cleaning, coding, and analysis. Descriptive statistics summarised awareness levels, while inferential tests including Chi-square, Fisher\u0026rsquo;s exact test, and Mann-Whitney U assessed associations between awareness and demographic variables. Likert-scale items measured perceptions of alopecia consequences, stigma, treatment, and public health significance. Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003ewas granted by the ethical board of university. Key ethical principles-confidentiality, anonymity, informed consent, voluntary participation, and avoidance of harm were upheld. No identifiable personal data were collected, participation was restricted to adults, and support contacts were provided.\u003c/p\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 95 participants completed the survey, of which 74 valid responses remained after excluding missing data and non-health faculty students. Most of the respondents were found to be of age group (26\u0026ndash;35) as represented in Table-1. Normality was assessed using the Kolmogorov\u0026ndash;Smirnov test, with p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, leading to the use of non-parametric tests. Descriptive statistics were followed by appropriate inferential analyses, including chi-square tests, the Fisher exact test, and the Mann-Whitney test.\u003c/p\u003e \u003cp\u003eTable-1 Age distribution of participants\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN Females\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5(6.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10(13.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15(20.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u0026ndash;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15(20.27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32(43.24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47(63.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e36\u0026ndash;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(4.05%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7(9.45%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10(13.5)%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e46 or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(1.35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1(1.35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(2.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24(32.43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50(67.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74(100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMode\u0026thinsp;\u0026minus;\u0026thinsp;26\u0026ndash;35 and std deviation- 0.672.\u003c/p\u003e \u003cp\u003e43.2% of participants correctly identified alopecia as hair loss from the scalp and other body areas, while 54.1% believed it referred only to scalp hair loss and 2.7% thought it was an infection with pus formation (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Less than half (44.6%) of participants knew that daily hair loss of more than 50\u0026ndash;100 strands constitute a medical condition called alopecia. Only 20.3% of students were confident about the pathogenesis of the hair growth and loss cycle, while 55.4% were aware of hair fall but still lacked confidence in the details of its pathogenesis (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). A total of 71.6% of participants reported that they would seek care from a general practitioner or dermatologist for early alopecia symptoms (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as represented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e83.8% of students were aware that if a person starts to develop symptoms and does not undergo any treatment for alopecia, the time interval to become completely bald depends on the type of alopecia, as some types progress slowly and others progress more rapidly (p\u0026thinsp;=\u0026thinsp;0.036). Regarding awareness of the causes of alopecia, the majority of participants (71.6%) were aware of increasing age and heredity, as represented in Table\u0026nbsp;2.\u003c/p\u003e \u003cp\u003eTable-2 Gender distribution on Awareness of cause of alopecia.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness of Causes of Alopecia\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePearson chi square value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003esignificance (2 sided)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDue to excess Androgen Hormone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15(20.27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26(35.13%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41(55.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.395\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eincrease in Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17(22.97%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36(48.64%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53(71.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.917\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaving hair tied tightly for long time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5(6.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31(41.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36(48.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfections on scalp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13(17.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30(40.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43(58.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.634\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHereditary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14(18.91%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39(52.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53(71.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.079\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAuto immune disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11(14.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31(41.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42(56.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.727\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.189\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12(16.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25(33.78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37(50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen asked about causes and symptoms of various types of alopecia, most of them (60.8%) answered correctly for the AGA, the results for others are as represented in figure-2 below.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e75.7% of respondents were aware of hair transplants and stem cell transplants as surgical treatments for alopecia, result for rest of the treatment options is as shown in Table\u0026nbsp;3.\u003c/p\u003e \u003cp\u003eTable-3 Awareness of treatment options of Alopecia.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTreatment options of Alopecia\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePearson chi square value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAsymptotic Significance (2-sided)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHair transplant and stem cell transplant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17(22.97%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39(52.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56 (75.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.452\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.501\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMinoxidil and finasteride as treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9(12.16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17(22.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26(35.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.768\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCorticosteroid and Immunotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5(6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22(29.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27(36.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.756\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLaser therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6(8.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19(25.67%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25(33.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.268\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccupuncture and Holistic Medicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4(5.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12(16.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16(21.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.515\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.473\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShampoos and conditioner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10(13.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8(10.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18(24.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.804\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eLikert scale was used to assess awareness of consequences of alopecia as represented in Table-4. Independent Samples test Mann Whitney U test was conducted to measure association between awareness of alopecia and gender which suggested significant difference in awareness between male and female regarding the statement that alopecia is just cosmetic issue, no further treatment needed only.\u003c/p\u003e \u003cp\u003eTable-4 Percentage distribution of Likert scale for Awareness of consequences of Alopecia\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabd\" border=\"1\"\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatement\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSomewhat disagree\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNeither disagree nor agree\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSomewhat agree\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe treatment course of Alopecia is quite expensive.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7(9.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17(23%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31(41.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e16(21.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e74(100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlopecia is just a Cosmetic Issue, no treatment needed.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43(58.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12(16.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13(17.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2(2.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4(5.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e74(100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlopecia is public health issue.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19(25.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7(9.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16(21.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21(28.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11(14.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e74(100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlopecia affects personal and marital associations.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4(5.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11(14.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20(27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e27(36.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e12(16.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e74(100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlopecia has negative psychological impact.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6(8.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14(18.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21(28.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e30(40.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e74(100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlopecia patients often get victims of stigmatisation of being bald.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7(9.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1(1.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14(18.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12(16.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e40(54.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e74(100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlopecia patients should be encouraged to accept their condition and should not be made fun of.\u003c/p\u003e \u003cp\u003eAlopecia friendly and inclusive environment should be maintained by raising awareness about alopecia at every levels.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7(9.5%)\u003c/p\u003e \u003cp\u003e5(6.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1(1.4%)\u003c/p\u003e \u003cp\u003e0(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14(18.9%)\u003c/p\u003e \u003cp\u003e8(10.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12(16.2%)\u003c/p\u003e \u003cp\u003e12(16.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e40(54.1%)\u003c/p\u003e \u003cp\u003e49(66.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e74(100%)\u003c/p\u003e \u003cp\u003e74(100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRegarding overall awareness, only 17.3%(n\u0026thinsp;=\u0026thinsp;13) of students had high level of awareness of alopecia, 62.2% (n\u0026thinsp;=\u0026thinsp;46) had medium level of awareness and 20.3% (n\u0026thinsp;=\u0026thinsp;15) had low level of awareness of alopecia with no significant difference in awareness scores in between male and female students.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to assess the level of awareness of alopecia among students at the School of Health and Society, a cohort presumed to have a solid foundation in health promotion and disease prevention. This research addressed a notable gap in the literature, as few studies have evaluated alopecia awareness in the general population. Overall, the results showed that most students possessed a moderate level of alopecia knowledge, with 62.2% (n\u0026thinsp;=\u0026thinsp;46) categorized as medium level, 17.3% (n\u0026thinsp;=\u0026thinsp;13) as high level, and 20.3% (n\u0026thinsp;=\u0026thinsp;15) as low level of awareness.\u003c/p\u003e \u003cp\u003eLess than half of respondents (43.2%) correctly identified alopecia as hair loss affecting the scalp or any part of the body, while 54.1% held misconceptions, such as believing alopecia was limited to scalp hair loss, was contagious, or was merely a cosmetic issue. These findings were lower than those reported by Alzubaidy et al. (2023), whose participants were patients with alopecia and therefore likely held more precise, personalized cognitive illness representations (CIRs) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA total of 83.8% of students were aware that if one begins to develop symptoms and does not undergo any treatment for alopecia, the time interval to become completely bald depends on the type of alopecia, as some forms progress slowly while others progress more rapidly (χ\u0026sup2; test, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). In addition, 20.3% of students were confident about the pathogenesis of the hair fall cycle. While 55.4% of students were aware of hair fall, they still lacked confidence in the details of its pathogenesis (χ\u0026sup2; test, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05; p\u0026thinsp;=\u0026thinsp;0.04). Despite having a health-related background, the results suggest a very low level of awareness regarding the pathogenesis of the hair fall cycle.\u003c/p\u003e \u003cp\u003eA majority of respondents (71.6%) reported that they would consult a general practitioner or dermatologist upon noticing early symptoms of alopecia, whereas fewer students opted for hair clinics, herbal or vitamin supplements, or cosmetic products. Female students were more likely to understand the prognosis of alopecia and to be more aware of the pathology of the hair fall cycle compared to male students (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). They were also significantly more inclined to seek professional medical care. This difference may be attributed to the greater psychosocial impact of hair loss among females or their increased likelihood of discussing and researching cosmetic and dermatological concerns [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOn average, 60.35% of students were aware of potential causes of hair loss, most commonly age, hereditary factors, autoimmune disorders, and excess androgens. This aligns with one previous study, which reported high awareness rates for hormones, stress, and aging in androgenetic alopecia (AGA) [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. However, 50% of students erroneously selected cancer as a direct cause of alopecia, indicating misunderstanding; cancer itself does not cause alopecia, but its treatments (chemotherapy/radiotherapy) can damage hair follicles and lead to hair loss [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eKnowledge of specific alopecia types varied. A total of 60.8% correctly answered questions on symptoms and causes of AGA, whereas 40.5% correctly identified symptoms and the autoimmune etiology of alopecia areata (AA), and 47.3% knew about trichotillomania. Lower awareness of other types of alopecia in compared to AGA may be due to their lower prevalence. Trichotillomania, which is more common in children and associated with stress responses, emphasizes the importance of parental awareness for early intervention [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRegarding treatment, 75.7% were more aware of surgical options like hair transplants than of topical/oral medications or corticosteroids. This trend may be influenced by increased global interest in hair transplantation [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. In contrast, fewer students knew about drugs like minoxidil and finasteride, likely due to their prescription requirement and associated side effects, which reduce public visibility. Notably, 24.3% selected shampoos and conditioners as treatments, with male students more likely to do so, perhaps indicating a tendency to perceive alopecia as a less serious issue [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eStudents were generally aware of alopecia\u0026rsquo;s psychosocial impacts, acknowledging its potential to cause anxiety, depression, low self-esteem, and reduced quality of life-a concern supported by illness perception theory and previous research [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. More than half recognized that alopecia treatment can be costly, which is quite similar to findings from a previous study [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhile this study provides a strong initial insight, its cross-sectional design, self-reported data, and single-university sample limit causal interpretation and generalizability. The findings highlight the need for broader, longitudinal research to capture more diverse and evolving awareness levels.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study highlights the need for enhanced education, public awareness campaigns, accessible support services, affordable treatments, and further research to improve alopecia understanding, reduce stigma, and strengthen prevention and early detection strategies in both academic and community settings.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eConflicts of Interest\u003c/h2\u003e \u003cp\u003eThe authors declare no conflicts of interest.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNo funding was received for this study.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003ePK designed the study, collected data and performed data analysis with the support of PC. PK drafted the manuscript with the support of DA. AP and PBD performed the statistical analysis and made comments on the first draft. All authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGrimalt R. Psychological aspects of hair disease. J Cosmet Dermatol. 2005;4(2):142\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/j.1473-2165.2005.40218.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1473-2165.2005.40218.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCastelo-Soccio L. Diagnosis and Management of Alopecia in Children. 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Int J women\u0026rsquo;s dermatology. 2023;9(4):e118\u0026ndash;118. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/jw9.0000000000000118\u003c/span\u003e\u003cspan address=\"10.1097/jw9.0000000000000118\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-9312281/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9312281/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAlopecia is a medical disorder causing hair loss, affecting millions globally. Despite its prevalence, public awareness and understanding of the condition remain limited, potentially hindering early diagnosis, access to support, and well-being for individuals living with the condition. This research aimed to assess the current level of awareness of Alopecia among postgraduate health students.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA quantitative approach was administered to a representative sample of students at the School of Health and Society, gathering data on participants' knowledge of Alopecia symptoms, causes, treatment options, and psychosocial impact. 74 students took part in an online survey. Survey data were analysed using descriptive statistics and inferential tests to identify patterns and associations between awareness of alopecia and the gender of students.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003e17.3%(n\u0026thinsp;=\u0026thinsp;13) of students had a high level of overall awareness of alopecia, 62.2% (n\u0026thinsp;=\u0026thinsp;46) had a medium level of awareness, and 20.3% (n\u0026thinsp;=\u0026thinsp;15) had a low level of awareness of alopecia, with no significant difference in awareness scores between male and female students. However, despite having a health background, only 20.3% of them felt confident that they knew the pathogenesis of the hair fall cycle. Female respondents were more aware of the prognosis and pathogenesis of alopecia and more likely to visit health care professionals than compared to male participants (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05)\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe vast majority of respondents had moderate awareness of alopecia. This fact stresses the importance of awareness campaigns and interventions among both health students and general students\u003c/p\u003e","manuscriptTitle":"Awareness, knowledge, and perceptions of alopecia among UK postgraduate students: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-06 08:17:24","doi":"10.21203/rs.3.rs-9312281/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4f1a0fa7-d291-4e9d-bc07-9b0aba43a95d","owner":[],"postedDate":"April 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-12T22:24:01+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-06 08:17:24","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9312281","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9312281","identity":"rs-9312281","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}