Clinical Characteristics of Female Patterned Hair Loss in Patients Attending Hair Clinic in Thailand

Authors

  • Warayuwadee Amornpinyo Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Rattapon Thuangtong Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Supisara Wongdama Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Daranporn Triwongwaranat Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

DOI:

https://doi.org/10.33192/smj.2022.3

Keywords:

Female pattern hair loss, androgenetic alopecia, family history, ferritin, premenopause

Abstract

Objective: To study the clinical features and associated factors of female pattern hair loss (FPHL) in premenopausal and menopausal women patients.

Materials and Methods: This is a retrospective chart review of FPHL patients visited hair clinic, Siriraj Hospital from June 2012 to May 2015. Demographic data, family history and history of hair loss were evaluated. Factors associated with FPHL were analysed.

Results: There were 267 patients (180 premenopausal women and 87 menopausal women) in this study. The mean age of onset of patients was 35.5±12 years (premenopausal FPHL) and 60.5±7 years (menopausal FPHL). Positive family history of androgenetic alopecia (AGA) was 48.3%, mainly in first-degree relatives. The data showed an increased incidence of FPHL with advancing age. The most common presentation is Ludwig grade I. The study showed that patients also have dyslipidemia (16.9%), hypertension (16.5%), diabetes mellitus (10.9%), hypothyroidism (4.9%), anemia (3.7%), and hyperthyroidism (2.9%). In multivariate analysis, significant associations were found between low ferritin level < 70 µg/L and premenopausal FPHL (OR 5.51, 95% CI 2.26-15.14, P = 0.01).

Conclusion: Maternal family history of AGA seems to have a greater influence on premenopausal FPHL. Low serum ferritin levels < 70 µg/L were significantly associated with FPHL in premenopausal women.

References

Chularojanamontri L, Silpa-archa N, Chaweekulrat P, Likitwattananurak C, Weerasubpong P, Junsuwan N, et al.

A Randomised Controlled Trial of the Efficacy and Safety of 0.25% Desoximetasone Cream (Topoxy) Compared With 0.25% Desoximetasone Cream (Topicorte) for the Treatment of Scalp Psoriasis. Siriraj Med J 2020;72:371-9.

Matthapan L, Bunyaratavej S, Leeyaphan C, Rujitharanawong C, Limphoka P, Prasong W, et al. Clinical Application of Toothbrush Technique for Specimen Collection of Tinea Capitis. Siriraj Med J 2019;71:165-7.

Paik JH, Yoon JB, Sim WY, Kim BS, Kim NI. The prevalence and types of androgenetic alopecia in Korean men and women. Br J Dermatol 2001;145:95-9.

Mansouri P, Mortazavi M, Eslami M, Mazinani M. Androgenetic alopecia and coronary artery disease in women. Dermatol Online J 2005;11:2.

Chaiyamahapurk S, Warnnissorn P. Prevalence and Pattern of Diseases of The Skin and Subcutaneous Tissue in A Primary Care Area in Thailand. Siriraj Med J. 2021;73:357-62.

Olsen EA. Female pattern hair loss. J Am Acad Derma Olsen tol 2001;45:S70-80.

Brough KR, Torgerson RR. Hormonal therapy in female pattern hair loss. Int J Womens Dermatol. 2017;3:53-7.

Arias-Santiago S, Gutierrez-Salmeron MT, Buendia-Eisman A, Girón-Prieto MS, Naranjo-Sintes R. Hypertension and aldosterone levels in women with early-onset androgenetic alopecia. Br J Dermatol 2010;162:786-9.

Arias-Santiago S, Gutierrez-Salmeron MT, Castellote-Caballero L, Buendía-Eisman A, Naranjo-Sintes R. Androgenetic alopecia and cardiovascular risk factors in men and women: a comparative study. J Am Acad Dermatol 2010;63:420-9.

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 2013;69:e69-77.

Vincent M, Yogiraj K. A Descriptive Study of Alopecia Patterns and their Relation to Thyroid Dysfunction. Int J Trichology 2013; 5:57-60.

Zaki MS, Ahmed IZ. Female pattern hair loss: the relation to metabolic syndrome in premenopausal women. J Egypt Woman Dermatol Soc 9:18-21.

Shilpashree P, Clarify S, Shashidhar T. An epidemiological study of female pattern hair loss at a referral centre in South India. Indian J Clin Exp Dermatol 2016;2:106-10.

Wang TL, Zhou C, Shen YW, Wang XY, Ding XL, Tian S, et al. Prevalence of androgenetic alopecia in China: a communitybased study in six cities. Br J Dermatol 2010;162:843-7.

Xu F, Sheng YY, Mu ZL, Lou W, Zhou J, Ren YT, et al. Prevalence and types of androgenetic alopecia in Shanghai, China: a community-based study. Br J Dermatol 2009;160:629-32.

Sherman S. Defining the menopausal transition. Am J Med. 2005;118 Suppl 12B:3-7.

Singal A, Sonthalia S, Verma P. Female pattern hair loss. Indian J Dermatol Venereol Leprol. 2013;79:626-40.

Gan DC, Sinclair RD. Prevalence of male and female pattern hair loss in Maryborough. J Investig Dermatol Symp Proc 2005;10: 184-9.

Ramos PM, Miot HA. Female Pattern Hair Loss: a clinical and pathophysiological review. An Bras Dermatol. 2015;90:529-43.26 Volume 74, No.1: 2022 Siriraj Medical Journal https://he02.tci-thaijo.org/index.php/sirirajmedj/index

Jung JG, Kim MH, Cinn YW. Comparison of androgenetic alopecia prevalence in paternal and maternal male family members of male androgenetic alopecia patients. Korean J Dermatol 2006;44:173-8.

Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Hairdressing and the prevalence of scalp disease in African adults. Br J Dermatol 2007;157:981-8.

Ravikiran SP, Syrti C, T S, An epidemiological study of female pattern hair loss at a referral centre in South India. Indian J Clin Exp Dermatol. 2016;2:106-10.

Lee WS, Lee HJ. Characteristics of androgenetic alopecia in asian. Ann Dermatol. 2012;24:243-52.

Salman KE, Altunay IK, Kucukunal NA, Cerman AA. Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic: hospital-based cross-sectional study in Turkey. An Bras Dermatol 2017;92:35-40.

Coenen JL, van Dieijen-Visser MP, van Pelt J, van Deursen CT, Fickers MM, van Wersch JW, et al. Measurements of serum ferritin used to predict concentrations of iron in bone marrow in anemia of chronic disease. Clin Chem 1991;37:560-3.

Hallberg L, Bengtsson C, Lapidus L, Lindstedt G, Lundberg PA, Hultén L. Screening for iron deficiency: an analysis based on bone-marrow examinations and serum ferritin determinations in a population sample of women. Br J Haematol 1993;85:787-98.

Punnonen K, Irjala K, Rajamaki A. Serum transferrin receptor and its ratio to serum ferritin in the diagnosis of iron deficiency. Blood 1997;89:1052-7.

Rushton DH, Ramsay ID. The importance of adequate serum ferritin levels during oral cyproterone acetate and ethinyl oestradiol treatment of diffuse androgen-dependent alopecia in women. Clin Endocrinol (Oxf) 1992;36:421-7.

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

Raichur S, Pandit A, Malleshappa A. Correlation of serum ferritin levels, in female patients with chronic diffuse hair loss: A cross sectional study. Indian J Health Sci Biomed Res. 2017; 10:190-5.

Park SY, Na SY, Kim JH, Cho S, Lee JH. Iron plays a certain role in patterned hair loss. J Korean Med Sci. 2013;28:934-8.

Bregy A, Trueb RM. No association between serum ferritin levels >10 microg/l and hair loss activity in women. Dermatology 2008;217:1-6.

Sinclair R. There is no clear association between low serum ferritin and chronic diffuse telogen hair loss. Br J Dermatol 2002;147:982-4.

Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J Am Acad Dermatol 2006;54:824-44.

Downloads

Published

01-01-2022

How to Cite

Amornpinyo, W. ., Thuangtong, R. ., Wongdama, S. ., & Triwongwaranat, D. . (2022). Clinical Characteristics of Female Patterned Hair Loss in Patients Attending Hair Clinic in Thailand. Siriraj Medical Journal, 74(1), 19–26. https://doi.org/10.33192/smj.2022.3

Issue

Section

Original Article