The Impact of Obesity on the Folliculosebaceous Unit

The document discusses the relationship between obesity and its effects on the folliculosebaceous unit, particularly focusing on hirsutism and alopecia. A study by Yang et al. is referenced, which found a positive correlation between higher body mass index (BMI) and the severity of hair loss in 189 men with androgenetic alopecia (AGA). The document then presents a subgroup analysis from a larger cohort study conducted by Mirmirani and Carpenter on children and adolescents, which included 248,775 subjects. This study found that while alopecia was not significantly associated with BMI, rates of hirsutism were significantly higher in overweight or obese subjects compared to those of normal weight. Additionally, girls with diagnosed hirsutism had a higher rate of polycystic ovary syndrome (PCOS) than those with alopecia. The document suggests that obesity may influence hair characteristics through nonandrogen and inflammatory signals, as well as androgens, and recommends weight loss as a primary treatment for obese children and adolescents with hirsutism. The authors acknowledge the complexity of the interaction between genetic, hormonal, metabolic, and nutritional factors on the folliculosebaceous unit and indicate that further research is needed to fully understand these effects.