Systematic review and meta-analysis on alopecia areata and skin cancer risk

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Frontiers in Medicine Published May 11, 2026 Medically reviewed May 11, 2026 DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Consider the inverse association with melanoma in alopecia areata, but note the evidence is limited by substantial heterogeneity.

This is a systematic review and meta-analysis examining the association between alopecia areata and the incidence of skin cancers, including melanoma, basal cell carcinoma, and squamous cell carcinoma. The synthesis included eight studies, six of which were used in the quantitative analysis.

The authors found a statistically significant reduction in melanoma incidence, with an odds ratio of 0.58 (95% CI, 0.36-0.94; p = 0.028). For overall skin cancer risk, the association was reduced but not statistically significant (OR 0.58; 95% CI, 0.27-1.22). Directionally reduced but non-significant associations were noted for basal cell carcinoma (OR 0.43; 95% CI, 0.11-1.75) and squamous cell carcinoma (OR 0.66; 95% CI, 0.28-1.57).

The authors acknowledge substantial heterogeneity, with high between-study heterogeneity (I2 >80% for BCC and SCC). Safety data were not reported.

The review provides important baseline context for patient counseling and for interpreting long-term safety data as systemic therapies, including JAK inhibitors, are increasingly used. The certainty of the evidence is limited by the noted heterogeneity.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

IntroductionSkin cancers are the most common malignancy worldwide, and identifying populations with altered risk is essential for informing prevention and surveillance strategies. Emerging evidence suggests that alopecia areata (AA) may be associated with reduced skin cancer risk, potentially reflecting enhanced cytotoxic immune activity.MethodsWe conducted a systematic review and meta-analysis to evaluate the incidence of skin cancers in patients with AA. PubMed, Embase, Scopus, and ClinicalTrials.gov were searched through July 2025. Of 1, 039 records identified, eight studies met inclusion criteria, with six included in the quantitative synthesis.ResultsAA was associated with a statistically significant reduction in melanoma incidence (OR 0.58; 95% CI, 0.36-0.94; p = 0.028). Overall skin cancer risk was reduced but not statistically significant (OR 0.58, 95% CI, 0.27-1.22). Pooled estimates for basal cell carcinoma (OR 0.43; 95% CI, 0.11-1.75) and squamous cell carcinoma (OR 0.66; 95% CI, 0.28-1.57) suggested directionally reduced associations, but did not reach statistical significance. Between-study heterogeneity was high (I2 >80% for BCC and SCC), however sensitivity analyses, including leave-one-out tests, confirmed the stability of the protective trend.DiscussionThese findings suggest that AA is not associated with increased skin cancer risk and demonstrates an inverse association with melanoma incidence, although substantial heterogeneity and sensitivity analyses warrant cautious interpretation. These results provide important baseline context for patient counseling and for interpreting longterm safety data as systemic therapies, including JAK inhibitors, are increasingly used.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251123793.