Published: 2021-12-24

Clinicopathological, trichoscopic and biochemical parameters in females with patterned hair loss

Krishnendra Varma, Aishwarya Mahadik, Ujjwal Kumar, Somya Agrawal


Background: Hair has no vital functions in humans but its loss from the scalp can create a sense of negative body image and anxiety. The term ‘female pattern hair loss’ is explained by decrease in hair fiber production and their eventual miniaturization. To evaluate the clinicopathological, trichoscopic and biochemical parameters in females with patterned hair loss.

Methods: 37 females in age group of 18-45 years complaining of reduction in hair volume with diffuse thinning over the crown were included in our study after applying inclusion and exclusion criteria. Detailed history was taken and clinical examination was done. Written consent and ethical clearance from Institutional Ethical Committee was taken. Ludwig grading, evaluation of other clinical signs of hyperandrogenism and trichoscopy was done. These females then underwent histopathological examination. 10 ml blood was withdrawn to assess anemic, thyroid and hormonal profile in these females.

Results: Out of 37 females examined majority of the females had Ludwig grade 1 hair loss. Serum levels of testosterone were found significantly related to clinical signs of hyperandrogenism. Hair diameter variability and peri pilar sign formed the majority in trichoscopy (62.2% each). The most common histopathological finding was perifollicular infiltrate (70.3%).

Conclusions: FPHL can contribute to severe psychological distress. Despite its high prevalence, its diagnosis and treatment still impose several difficulties in clinical practice. Although hormonal factors are believed to contribute, its pathogenesis still remains elusive.


Female pattern hair loss, Histopathology, Trichoscopy, Hormonal profile

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