NonScarring Diffuse Hair Loss in Women: a Clinico-Etiological Study from tertiary care center in North-West India.

Background: Diffuse hair loss (DHL) is a common problem in adult women and has a major impact on quality of life. Ascertaining the etiological diagnosis is a challenging task in such patients. Satisfactory treatment can only be instituted after ascertaining the cause of hair loss.

Objective: To study the clinico-epidemiological profile of nonscarring DHL in females and to ascertain its underlying etiological factors.

Study Design: Of a total of 110 females, who presented with nonscarring DHL to the outpatient dermatology department, 100 qualified for inclusion in the study. A detailed history, clinical examination, and laboratory investigations were performed in all the patients. Statistical analysis was performed on the data collected.

Results: Of 100 cases of DHL which were included in the study, commonest was chronic telogen effluvium (CTE) (62%), followed by female pattern hair loss (FPHL) (22%) and acute telogen effluvium (ATE) (16%). Incidence of hair loss was highest in 21-40 years age group. Psychological stress was seen to be a precipitating factor in 18 patients and found most commonly in women belong to CTE group (n-16, 25.8%). Hemoglobin levels ranged from 80 to 142 gm/L (mean: 119 ± 110). Low hemoglobin level (<120 gm/L) was observed in 57% patients. Total serum ferritin <10 ng/mL was seen in 20 patients, vitamin B12 < 211 pg/mL in 76 cases, vitamin D3 < 30 ng/mL in 81 cases. Subclinical hypothyroidism was present in 11% cases.

Conclusions: Nonscarring DHL is a multifactorial condition with highest incidence in 21- to 40-year age group. Serum ferritin, serum vitamin B12, and D3 levels seem to have a contributing role in the pathogenesis of hair loss, and their supplementation may be needed for a faster regrowth of hair in all cases of hair loss irrespective of the pattern.