Significance of iron levels in patients with non-cicatricial alopecias: a cross sectional study
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20214470Keywords:
Hair loss, Alopecia, Iron deficiency, TrichogramAbstract
Background: Among all the nutritional causes of hair loss, iron levels are found to be important key nutrient. Synthesis of hair involves many steps which require iron as a cofactor. The intention of present study is to evaluate relationship between iron and hair loss. The objectives of the study are to study the clinical patterns, demographic and epidemiological factors associated with hair loss and to find association between iron study parameter (Hb, serum iron, serum ferritin, TIBC) and hair loss.
Methods: The study was a cross section- observational study, conducted among the patients with diagnosed non-cicatricial alopecias from June 2018 to April 2019. A total of 50 study participants were recruited. Specific investigations like hair pull test and trichogram were done. Chi square test was applied and p<0.05 was considered significant.
Results: Among the total 50 participants 35 (70%) were males and 15 (30%) were females. Mean (±SD) age was 44 (±9.5) years. Mean (SD) of haemoglobin, serum iron, TIBC and ferritin are 9.6 (±2.6), 75.5 (±50), 365 (±54) and 106 (±87) respectively. Trichogram result proves telogen hair- 22 (44%), dystrophic hair loss- 14 (28%) and anagen hair loss-14 (28%). Hair pull test was positive in 27 (54%). Higher proportion of male pattern hair loss was associated with lower haemoglobin and low serum ferritin levels. (p value -0.046, 0.031)
Conclusions: Significant association was found between the diagnosis of non cicatricial alopecia and mean values of haemoglobin and serum ferritin with lower haemoglobin and low serum ferritin was mostly associated with male pattern hair loss.
References
Hunt N, McHale S. The psychological impact of alopecia. BMJ. 2005;331:951-53.
Dinh QQ, Sinclair R. Female pattern hair loss: current treatment concepts. Clin Interv Aging. 2007;2:189-99.
Habif TP. Hair diseases. In: Habif TP, editor. Clinical Dermatology: A color guide to diagnosis and therapy, 5th edn. St. Louis: Mosby. 2010;920-22.
Non-anemic iron deficiency as an etiologic factor in diffuse loss of hair of the scalp in women. Acta Derm Venereol. 1963;43:562-9.
Recommendations to prevent and control iron deficiency in the United States: Centers for Disease Control and Prevention. MMWR Recomm Rep. 1998;47:1-29.
Otberg N, Shapiro J. Hair growth disorders. In: Fitzpatrick’s Dermatology in General Medicine. Goldsmith LA, Katz SI, Gilcherst BA, Paller AS, Lefeell DJ, Wolff K, Eds. McGraw-Hill, New York, NY, USA, 8th edition. 2012;979-1008.
Elston DM. Commentary: Iron deficiency and hair loss: problems with measurement of iron. Journal of the American Academy of Dermatology. 2010;63(6):1077-82.
Elledge SJ, Zhou Z, Allen JB. Ribonucleotide reductase: regulation, regulation, regulation. Trends in biochemical sciences. 1992;17(3):119-23.
Zheng Y, Eilertsen KJ, Ge L, Zhang L, Sundberg JP, Prouty SM et al. Scd1 is expressed in sebaceous glands and is disrupted in the asebia mouse. Nature genetics. 1999;23(3):268.
Hard S. Non-anemic iron defficiency as an etiologic factor in diffuse loss of hair of the scalp in women. Acta dermato-venereologica. 1963;43:562-9.
Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. Journal of the American Academy of Dermatology. 2006;54(5):824-44.
Larsson LG, Ivhed I, Gidlund M, Pettersson U, Vennström B, Nilsson K. Phorbol ester-induced terminal differentiation is inhibited in human U-937 monoblastic cells expressing a v-myc oncogene. Proceedings of the National Academy of Sciences. 1988;85(8):2638-42.
Beaumont C, Dugast I, Renaudie F, Souroujon M, Grandchamp B. Transcriptional regulation of ferritin H and L subunits in adult erythroid and liver cells from the mouse. Unambiguous identification of mouse ferritin subunits and in vitro formation of the ferritin shells. Journal of Biological Chemistry. 1989;264(13):7498-504.
Centers for Disease Control and Prevention. Recommendations to prevent and control iron deficiency in the United States. MMWR Recomm Report. 1998;47:1-29.
Olsen EA, Reed KB, Cacchio PB, Caudill L. Iron deficiency in female pattern hair loss, chronic telogen effluvium, and control groups. Journal of the American Academy of Dermatology. 2010;63(6):991-9.
Gonul M, Cakmak SK, Soylu S, Kilic A, Gul U. Serum vitamin B12, folate, ferritin, and iron levels in Turkish patients with alopecia areata. Indian Journal of Dermatology, Venereology, and Leprology. 2009;75(5):552.
Esfandiarpour I, Farajzadeh S, Abbaszadeh M. Evaluation of serum iron and ferritin levels in alopecia areata. Dermatology online journal. 2008;14(3).
Bregy A, Trüeb RM. No association between serum ferritin levels> 10 μg/l and hair loss activity in women. Dermatology. 2008;217(1):1-6.
Sinclair R. There is no clear association between low serum ferritin and chronic diffuse telogen hair loss. British Journal of Dermatology. 2002;147(5):982-4.
Deo K, Sharma YK, Wadhokar M, Tyagi N. Clinicoepidemiological Observational Study of Acquired Alopecias in Females Correlating with Anemia and Thyroid Function. Dermatol Res Pract. 2016;2016:6279108.
Kantor J, Kessler LJ, Brooks DG, Cotsarelis G. Decreased serum ferritin is associated with alopecia in women. J Invest Dermatol. 2003;121:985-8.
Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol. 2002;27(5):396-404.
Moeinvaziri M, Mansoori P, Holakooee K, Naraghi SZ, Abbasi A. Iron status in diffuse telogen hair loss among women. Acta Dermatovenerol Croat. 2009;17:279-84.
Park SY, Na SY, Kim JH, Cho S, Lee JH. Iron Plays a Certain Role in Patterned Hair Loss. J Korean Med Sci. 2013;28:934-8.
Gowda D, Premalatha V, Imtiyaz DB. Prevalence of Nutritional Deficiencies in Hair Loss among Indian Participants: Results of a Cross-sectional Study. Int J Trichology. 2017;9(3):101-4.