Key Points
Question
What is the prevalence and magnitude of layperson stigma toward individuals with varying degrees of alopecia?
Findings
In this cross-sectional online survey study of 2015 laypersons’ responses to images of individuals with alopecia, endorsement of every stigma item increased across scales of stereotypes and social distance as the severity of alopecia increased, as did the percentage of respondents believing the individual pictured had a medical condition. Recognition of alopecia as a medical condition varied by the race and sex of the individual pictured and was associated with decreased alopecia-related stigma.
Meaning
Alopecia-related stigma among laypersons exists across a multitude of social and professional scenarios and may be influenced by recognition of alopecia as a medical condition.
Importance
Perceived stigma among patients with alopecia is associated with impaired quality of life; however, the magnitude of laypersons’ stigma toward individuals with alopecia is unknown.
Objective
To determine the prevalence and magnitude of laypersons’ stigma toward individuals with varying degrees of alopecia and whether stigma increases with increased severity of alopecia.
Design, Setting, and Participants
This was a cross-sectional study using an internet survey administered to a convenience sample of adult respondents in the US participating on the Amazon Mechanical Turk platform. Portrait images of 6 individuals without hair loss were created using artificial intelligence and stock images. Each portrait was edited to create 2 additional versions, 1 with scalp hair loss and 1 with complete hair loss, for a total of 18 images. On January 9 to 10, 2020, the survey presented each internet respondent with 1 randomly selected portrait to be used in answering a series of stigma-related questions from 3 domains: stereotypes, social distance, and disease-related myths; the third domain was presented only to respondents who believed that the individual pictured had a medical condition.
Main Outcomes and Measures
The main outcome was the prevalence and magnitude of stigma of laypersons toward individuals with alopecia and the percentage of laypersons who believed the individual pictured had a medical condition as recorded in survey responses.
Results
The survey was completed by 2015 respondents (99.9
Conclusions and Relevance
This cross-sectional survey study found that stigmatizing attitudes of laypersons toward patients with alopecia exist across a multitude of social and professional scenarios. Stigma prevalence and magnitude vary by alopecia severity and possibly by whether alopecia is believed to be a medical condition.
