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

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.

Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss

“…The average ferritin levels in both types of hair loss were significantly lower when compared to controls (p < 0.001). Another study conducted in 2022 explored ferritin levels in premenopausal and postmenopausal women with FPHL [136]. Statistically significant lower ferritin levels <70 µg/L were found only in premenopausal women with FPHL (p = 0.01).…”

Do androgens really play a major role in the pathophysiology of androgenetic alopecia?

“…This appears to be related to lifestyle [24], stress [25][26][27][28], environmental contamination by heavy metals and increased exposure to endocrine disruptors29, [30][31][32][33][34][35][36][37]. In addition to that, the frequency of androgenetic alopecia has increased in the general population, appearing earlier and earlier within each generation [38][39][40][41][42][43][44]; and, as we know, the severity of AGA increases over time, both in men and women after the age of 30, a period in which the production of some hormones begins to decline, including androgens [38][39][40][41][42][43][44][45][46][47]. This scenario suggests something paradoxical in relation to the androgenic pathway of AGA pathophysiology, something that O'Tar and Norwood already approached about AGA in women in 2001 [47].…”