Chronic diffuse hair loss in women: A case-control study with clinical correlation of serum iron profile and thyroid function

Snigdha N Hegde, Tonita Mariola Noronha


Background Although a benign disorder, hairfall is a major psycho-social stressor on the patient's life. In women, telogen effluvium and female pattern hair loss are major causes of alopecia. Chronic telogen effluvium is often confused with female pattern hair loss and requires a detailed work up which is essential for management. An array of nutritional factors such as deficiencies of iron, zinc and other micronutrients can contribute to hair loss.


Material and Methods A hospital based case control study was conducted in the department of Dermatology of a tertiary care teaching hospital in Mangalore from October 2016 to March 2018. A total of 50 females, aged between 18-50 years, with chronic diffuse hair loss of duration more than 6 months, daily hair loss count of more than 100 and positive hair pull test, attending the out-patient department were included as cases. Equal number of age matched healthy females were taken as controls. Serum iron profile and thyroid function parameters were assessed in both groups. Duration of chronic diffuse hair loss, mean hemoglobin, serum iron, serum ferritin, TIBC, T3, T4 and TSH levels were considered as primary outcome variables. IBM SPSS version 22 was used for statistical analysis.


Results The proportion of the mean duration of hair fall in cases was 11.12±5.35 months. The mean serum ferritin 37.25±25.74 ng/ml in cases and it was 40.62±32.24 ng/ml in controls. The mean TSH was 2.1±1.41 (mIU/mL) in cases and it was 2.11±1.09 (mIU/mL) in controls.


Conclusion This study could not find any statistically significant difference in any of the iron metabolism related parameters and thyroid function related parameters between cases and controls. No statistically significant correlation was found between duration of the chronic diffuse hair loss and outcome parameters. Hemoglobin alone is not enough and serum iron levels should be assessed in a patient with chronic diffuse hair loss.



Chronic diffuse hair loss; chronic telogen effluvium; female pattern hair loss; serum ferritin; iron deficiency

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