Burden, Trends, Associated Diseases and Predictions of Alopecia Areata in China, Japan, South Korea, and Globally: A GBD 2023 Analysis

Abstract

Background Alopecia areata (AA) causes non-scarring hair loss and substantial psychosocial burden, yet its trends, comorbidities, and future burden in East Asia remain underexplored. Methods Global Burden of Disease(GBD) Study 2023 data from 1990–2023 were analyzed for the world, China, Japan, and South Korea. Age-standardized incidence (ASIR), prevalence (ASPR), and disability-adjusted life-year (DALY) rates were assessed by region, sex, and age. Joinpoint regression quantified temporal trends. Ecological correlations with associated diseases and socio-demographic Index (SDI) were examined. Burden through 2046 was projected using United Nations population estimates. Results In 2023, Japan and South Korea had higher ASIR and ASPR than China and global averages. Females bore greater burden; incidence peaked in young-to-middle-aged adults. Global age-standardized rates(ASRs) declined (1990–2023), while rates remained stable in China and persistently high in Japan and South Korea. AA correlated with atopic dermatitis, iron deficiency anemia, and thyroid disorders. Higher SDI was associated with lower incidence in Japan, South Korea, and globally, but not in China. Substantial cases are projected through 2046. Conclusion AA burden varies by region, sex, and age, and will continue to be a major public health issue. Clinicians should be particularly attentive to women and East Asian patients. While the etiology appears multifactorial, causality remains to be confirmed at the individual level. Nevertheless, these findings support more vigilant screening and tailored prevention in high-risk East Asian populations.