Biochemical and trichological characterization of diffuse alopecia in women

    August 1990 in “British Journal of Dermatology
    D. H. Rushton, Ian Ramsay, Kenneth James, Michael Norris, J. J. H. Gilkes
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    TLDR Diffuse alopecia in women may be related to androgens and iron deficiency, and basic hormone and nutrient screening is useful.
    In 1990, a study was conducted on 100 pre-menopausal Caucasian females with diffuse alopecia, aged 14 to 54, to assess hair characteristics and biochemical, hematological, and endocrine factors, comparing them with 20 controls. Significant changes in hair values were found, with a higher percentage of vellus and telogen hairs in the subjects. While 54.5% had elevated androgenic hormones, no correlation with hair loss was found. Notably, 72.0% had low serum ferritin levels, suggesting iron's role in hair health. The study concluded that diffuse alopecia in women may be androgen-dependent, similar to genetic hair loss in men, and coined the term "diffuse androgen-dependent alopecia." It suggested that extensive laboratory tests are generally unnecessary, but basic screening for certain hormones and nutrients could be beneficial. The study questioned the need to demonstrate androgen excess before anti-androgen therapy and indicated that the response to such therapy is an area for further research.
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