General Characteristics of Hair in Eating Disorders

June 2012 in “ Springer eBooks ”

Marilyn Zabielinski, Antonella Tosti

anorexia nervosa bulimia hypertrichosis lanuginosa telogen effluvium hair fragility nutritional deficiencies hypopigmentation trichotillomania hirsutism androgens androgenetic alopecia metabolic syndrome insulin resistance minoxidil finasteride AN AGA Rogaine Propecia

From the encyclopedia

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Studysummary Eating disorders can cause various hair problems, and while hair loss in these disorders is linked to metabolic syndrome, treatment focuses on specific medications and lifestyle changes for the syndrome. Our plain-language summary of this paper — not a Tressless recommendation.

In the 2012 document, Marilyn Zabielinski and Antonella Tosti examined the impact of eating disorders on hair characteristics, finding that anorexia nervosa (AN) and bulimia commonly lead to conditions such as hypertrichosis lanuginosa (77% of 62 AN patients), telogen effluvium (67% of 122 bulimia patients and 61% of AN patients), and hair fragility due to nutritional deficiencies. They also reported hypopigmentation in severe malnutrition and trichotillomania in 5% of 1,453 patients with AN or bulimia. Obesity-related hirsutism was linked to excess androgens. The document also explored the connection between androgenetic alopecia (AGA) and metabolic syndrome, citing studies that found significant associations between the two, although results varied regarding insulin resistance. The authors concluded that hair characteristics are indicative of nutritional and hormonal imbalances and that while AGA is associated with metabolic syndrome, its primary treatments remain minoxidil and finasteride, with lifestyle changes recommended for metabolic syndrome.

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Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

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198 citations , October 2011 in “Journal der Deutschen Dermatologischen Gesellschaft”

This article discusses the development of an evidence-based guideline for treating androgenetic alopecia and reports no new research results.

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This study concluded that patients with metabolic syndrome, regardless of androgenetic alopecia presence, were more insulin resistant than those with only androgenetic alopecia or healthy controls, indicating no true association between alopecia and insulin resistance.

research S1 Guideline for Diagnostic Evaluation in Androgenetic Alopecia in Men, Women, and Adolescents

151 citations , August 2010 in “British Journal of Dermatology”

This guideline reviews the diagnosis of androgenetic alopecia and offers expert consensus recommendations tailored to males, females, and adolescents, but reports no new clinical results.

research Androgenetic Alopecia and Cardiovascular Risk Factors in Men and Women: A Comparative Study

110 citations , July 2010 in “Journal of The American Academy of Dermatology”

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research Association of Androgenetic Alopecia with Metabolic Syndrome in Men: A Community-Based Survey

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research Skin Signs in Anorexia Nervosa

48 citations , September 2009 in “Dermato-endocrinology”

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research Visually Scoring Hirsutism

288 citations , June 2009 in “Human reproduction update”

This review examines various methods for assessing hair growth in women, highlighting the usefulness of the mFG visual scoring method for diagnosing hirsutism despite its limitations.

research The Androgen Excess and PCOS Society Criteria for the Polycystic Ovary Syndrome: The Complete Task Force Report

1540 citations , October 2008 in “Fertility and Sterility”

This review discusses the definition of polycystic ovary syndrome proposed by the AE-PCOS Society Task Force, emphasizing hyperandrogenism, ovarian dysfunction, and excluding related disorders, while noting potential variations needing more research.

research Low Prevalence of Twisted Hair in Anorexia Nervosa

16 citations , June 2005 in “Clinical and Experimental Dermatology”

In this study of 30 severe anorexia nervosa patients, true acquired pili torti was not found although twisted hair was observed in 6.6% of cases.

research Cutaneous Manifestations of Eating Disorders

33 citations , April 2002 in “Journal of Cutaneous Medicine and Surgery”

This review discusses the skin conditions linked to eating disorders and emphasizes that treating the underlying disorder often improves these dermatological symptoms.

research A Placebo-Controlled, Double-Blind Crossover Study of Fluoxetine in Trichotillomania

180 citations , November 1991 in “American Journal of Psychiatry”

This study found that fluoxetine did not demonstrate short-term efficacy in treating trichotillomania in a placebo-controlled, double-blind crossover setting.