Bullying in Patients with Alopecia Areata

Poster featuring discussion of Alopecia




Assistant Professor of Pediatrics

Project Summary

This summer I was fortunate to study the psychological effects of Alopecia Areata on pediatric patients with Dr. Leslie Castelo-Soccio at the Children’s Hospital of Philadelphia Dermatology office.  Alopecia Areata is a genetic autoimmune disorder that causes the patient’s immune system to attack his or her hair follicles.  Alopecia Areata can present as small patches of hair loss on the scalp, loss of all scalp hair, or loss of all scalp and body hair, including eyelashes, eyebrows, nose, and ear hair.  66% of Alopecia Areata patients are diagnosed before the age of 30, which means that children and young adults are disproportionately represented in the Alopecia population.

Alopecia affects an extremely visible part of the body, and thus it can cause acute psychological distress to effected individuals.  Particularly in the pediatric population, bullying and isolation are common challenges faced by Alopecia patients.  In an effort to gauge the psychological toll a condition has on a patient, physicians employ “Quality of Life,” or QoL, surveys.  There are several QoLs currently available for adult Alopecia patients, which ask about both general psychological impacts as well as adult-specific impacts such as employment.  There is no current QoL survey that analyzes the psychological effects of alopecia on pediatric patients.

I worked with Dr. Castelo to conduct surveys of pediatric Alopecia patients and their families in order to analyze the prevalence of bullying and emotional distress among these individuals.  We then used this data to create suggestions for future pediatric Alopecia QoL surveys.  I also worked to create support resources for CHOP Alopecia patients, including an educational poster to hang in the waiting room of the dermatology office, advice pamphlets to give out to patients and their families, a children’s book for parents to read to their young children, and support groups for children of different age groups and their families.  I hope that these resources will help affected patients develop tools to deal with bullying if it occurs and will help them feel less isolated by their condition.

This project taught me a lot about Alopecia Areata and how to create and conduct clinical research projects.  More broadly, it cemented my desire to pursue a medical career by allowing me to witness the day-to-day work life of pediatric dermatologists, from shadowing Dr. Castelo in clinic, to sitting in on lunch meetings where the doctors discussed interesting and difficult cases.  This was an invaluable addition to my educational experience at Penn.  In my pre-med classes I learn a lot of the science necessary to become a physician, but only by actually working in a medical office is it possible to really experience what it would be like to be a doctor. This experience will be hugely beneficial when making the decision about whether or not to apply to medical school.