DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20214906

Female pattern hair loss among Saudi women and hematological changes associated with it - case controlled study

Amal O. Al balbeesi

Abstract


Background: Female pattern hair loss is a problematic condition. The availability of a rapid indicator is crucial. The current study compared female pattern hair loss patients with healthy controls regarding hematological parameters and vitamin D levels.

Methods: We included 78 females with female pattern hair loss and 50 healthy subjects in the control group. We collected a detailed medical history and performed a systematic clinical examination. Blood samples were collected including complete blood count, serum ferritin, and vitamin D.

Results: A significant increase in positive family history and acne among the study than the control group. Most patients had mild disease (55.1%). Female pattern hair loss was significantly associated with a reduction in red blood cell count, hemoglobin, hematocrit, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, red cell distribution width, serum ferritin and serum vitamin D. Among the patient’s group, the disease severity was positively correlated with disease duration and patient age. The correlation with duration was moderate (r=0.366). The disease duration was positively correlated with body mass index and negatively correlated with red blood cell count, hemoglobin concentration, hematocrit, red cell indices, ferritin and vitamin D. Disease duration was also inversely correlated with vitamin D levels.

Conclusions: Family history, body mass index, acne, hirsutism and irregular period were high among Saudi women. The disease was moderately severe. FPHL was associated with a significant reduction in hematological parameters and lower serum ferritin that indicated iron deficiency could play a crucial role in the development or progression of the disease. As a preventable etiology, restoring iron stores may provide at least an adjunct therapeutic option.


Keywords


Female pattern hair loss, Hematological parameters, Ferritin, Vitamin D, Thyroid function

Full Text:

PDF

References


Ramos PM, Miot HA. Female Pattern Hair Loss: a clinical and pathophysiological review. A Bras Dermatol. 2015;90:529-43.

Koo JY, Shellow WV, Hallman CP, Edwards JE. Alopecia areata and increased prevalence of psychiatric disorders. Int J Dermatol. 1994;33:849-50.

Egger A, Resnik SR, Aickara D, Maranda E, Kaiser M, et al. Examining the Safety and Efficacy of Low-Level Laser Therapy for Male and Female Pattern Hair Loss: A Review of the Literature. Skin Appendage Disord. 2020;6:259-67.

Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, et al. Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. Int J Women Dermatol. 2018;19:203-11.

Coleman E. Types and Treatment of Hair Loss in Men and Women. Plast Surg Nurs. 2020;40(1):6-19.

Carmina E, Azziz R, Bergfeld W. Female pattern hair loss and androgen excess: a report from the multidisciplinary androgen excess and PCOS committee. J Clin Endocrinol Metab. 2019;104:2875-91.

Dhurat R, Saraogi P. Hair evaluation methods: merits and demerits. Int J Trichology. 2009;1:108-19.

Tamashunas NL, Bergfeld WF. Man, and female pattern hair loss: Treatable and worth treating. Cleve Clin J Med. 2021;88:173-82.

Manabe M, Tsuboi R, Itami S, Osada SI, Amoh Y, et al. Drafting Committee for the Guidelines for the Diagnosis and Treatment of Male- and Female-Pattern Hair Loss. Guidelines for the diagnosis and treatment of both male-pattern and female-pattern hair loss, 2017 version. J Dermatol. 2018;45:1031-43.

Kim YS, Jeong KH, Kim JE, Woo YJ, Kim BJ, et al. Repeated Microneedle Stimulation Induces Enhanced Hair Growth in a Murine Model. Ann Dermatol. 2016;28:586-92.

Inference for Means: Comparing Two Independent Samples. Available at: https://www.stat.ubc.ca/~ rollin/stats/ssize/n2.html. Accessed on 05 August 2021.

McDonald KA, Shelley AJ, Colantonio S, Becker J. Hair pull test: Evidence-based update and revision of guidelines. J Am Acad Dermatol. 2017;76:472-7.

Sadick N, Arruda S. Understanding Causes of Hair Loss in Women. Dermatol Clin. 2021;39:371-4.

Althobaiti ADA, Alzahrani AHJ, Alhunaki RNM, Alshamrani HM, Malawi IA. Hair loss among Saudi Females, Taif University, Taif, Saudi Arabia. Egyptian J Hospital Med. 2018;70(11):1887-90.

Su LH, Chen LS, Chen HH. Factors associated with female pattern hair loss and its prevalence in Taiwanese women: a community-based survey. J Am Acad Dermatol. 2017;69:69-77.

Tandon S, Arora P, Gautam RK, Bhardwaj M, Garga U, et al. Correlation between Clinical Features, Biochemical Parameters, and Histopathological Findings in Women with Patterned Baldness: A Study from North India. J Cutan Aesthet Surg. 2019;12:42-8.

Lee WS, Ro BI, Hong SP, Bak H, Sim WY, et al. A new classification of pattern hair loss that is universal for men and women: basic and specific (BASP) classification. J Am Acad Dermatol. 2007;57:37-46.

El Samahy MH, Fahmy HM, El Sawaf SI, Mostafa AE. Lyophilized growth factor intralesional injection in female pattern hair loss: A clinical and trichoscopic study. Dermatol Ther. 2021;34:e14867.

Siah TW, Muir-Green L, Shapiro J. Female Pattern Hair Loss: A Retrospective Study in a Tertiary Referral Center. Int J Trichology. 2016;8:57-61.

Alquaiz AM, Gad Mohamed A, Khoja TA. Prevalence of anemia and associated factors in child bearing age women in riyadh, saudi arabia. J Nutrition Metabolism. 2013;636585.

Al-asady HMK, Al-dulaimy NH. Assessment of Some Hematological Parameter in People with Hair Loss. Indian J Public Health Res Develop. 2019;10(8):105-8.

Coogan PF, Bethea TN, Cozier YC, Bertrand KA, Palmer JR, et al. Association of type 2 diabetes with central-scalp hair loss in a large cohort study of African American women. Int J Womens Dermatol. 2019;6:261-6.

AlQuaiz AM, Kazi A, Fouda M, Alyousefi N. Age and gender differences in the prevalence and correlates of vitamin D deficiency. Arch Osteoporos. 2018;13(1):49.

Zhao J, Sheng Y, Dai C, Qi S, Hu R. Serum 25 hydroxyvitamin D levels in alopecia areata, female pattern hair loss, and male androgenetic alopecia in a Chinese population. J Cosmet Dermatol. 2020;19:3115-21.

Rasheed H, Mahgoub D, Hegazy R, El-Komy M, Abdel Hay R, et al. Serum ferritin and vitamin d in female hair loss: do they play a role? Skin Pharmacol Physiol. 2013;26(2):101-7.

Al-Buhairan AM, Oluboyede OA. Determination of serum iron, total iron-binding capacity and serum ferritin in healthy Saudi adults. Ann Saudi Med. 2001;21(12):100-3.

Kantor J, Kessler LJ, Brooks DG, Cotsarelis G. Decreased serum ferritin is associated with alopecia in women. J Invest Dermatol. 2003;121:985-8.

Camaschella C. Iron deficiency. Blood. 2019;133:30-9.

Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The role of vitamins and minerals in hair loss: a review. Dermatol Ther (Heidelb). 2019;9:51-70.

Yip L, Rufaut N, Sinclair R. Role of genetics and sex steroid hormones in male androgenetic alopecia and female pattern hair loss: an update of what we now know. Australas J Dermatol. 2011;52:81-8.

Guo EL, Katta R. Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatol Pract Concept. 2017;31:1-10.

Olsen EA, Reed KB, Cacchio PB, Caudill L. Iron deficiency in female pattern hair loss, chronic telogen effluvium, and control groups. J Am Acad Dermatol. 2010;63:991-9.

Tsuboi R, Itami S, Inui S, Ueki R, Katsuoka K, et al. Guidelines Planning Committee for the Management of Androgenetic Alopecia. Guidelines for the management of androgenetic alopecia. J Dermatol. 2012;39:113-20.