**4.4 Effects of alopecia on quality of life**

Quality of life is a broad concept. It assesses whether it limits the patient's ability to perform a normal role in their daily life, as well as the burden and outcomes of the treatments offered. It is defined as patients' subjective perception of its impact on their physical, psychological, and social functioning [67]. Quality of life in diseases such as alopecia areata is a strong and important indicator of the disease on social relations, daily activities and psychosocial status [67]. The effectiveness of treatment in alopecia areata, the social and financial burden of the disease can be evaluated using quality of life indicators [68]. In a case-control prospective study involving 115 women with alopecia and 97 control patients of the same age, alopecia was found to significantly affect female sexual functioning, reducing desire, arousal, lubrication, orgasm, and satisfaction [69]. A meta-analysis of 2530 patients showed that alopecia significantly reduces patients' quality of life [70]. As a result of studies using various quality of life tools, it has also been shown that alopecia has a detrimental effect on the quality of life of patients and that there is an improvement in quality of life with improvement in disease status [71, 72].
