Background: There are cutaneous illnesses that could be exacerbated or precipitated by stress, including alopecia areata, psoriasis, and even vitiligo. Psychological sequelae mainly affected by serotonin have been studied among these patients. Objective: Assessment of blood serotonin levels in alopecia areata and vitiligo patients for psychological impacts. Patients and Methods: 15 individuals with vitiligo, 15 with alopecia areata, and 15 healthy age and sex matched controls were studied in this study. A modified version of the Social Readjustment Rating Scale (SRRS) was used to quantify the stress index, and blood serotonin levels were also measured to study the role of stress in alopecia areata and vitiligo. Results: Patients who had alopecia areata as well as vitiligo had considerably greater serum serotonin levels than controls. In the vitiligo group, there was a strong positive connection between serum serotonin, the vitiligo area scoring index (VASI) score, and the stress index. On the other hand, no positive correlation was found between serum serotonin and both severity of alopecia tool (SALT) score and stress index in alopecia areata group. Conclusion: In both alopecia areata and vitiligo, psychological stress appears to play a significant role as a triggering factor and we should pay attention to psychiatric role to get proper treatment for such chronic diseases.