Background: Alopecia areata is a skin disease that affects patients’ quality of life and social participation. Objective: To quantify the economic burden of alopecia areata and to map health services utilization among patients with alopecia areata.Materials and methods: Prospective and retrospective data sources, using both top-down and bottom-up approaches to estimate direct and indirect costs and to map health service utilization associated with alopecia areata in Romania in 2022.Results: In our study, the total cost of alopecia areata in Romania for 2022 was estimated at 46.289 million EUR for adult patients and 1.89 million EUR for pediatric patients, encompassing both mild and severe cases. The breakdown reveals that both mild and severe cases incurred the highest costs due to associated expenses, medical services, and treatment. As for children, the highest alopecia-related expenses were represented by associated expenses and treatment costs (for both severity levels).Conclusion: This is the first study to quantify the burden of alopecia areata in Romania. Additional studies are needed due to a low sample size. However, considering our estimations based on external data sources, alopecia areata should be considered when planning health service distribution.