Female Pattern Hair Loss Patients Research Articles

A Prospective Self-controlled Clinical Trial of Nonactivated Low Leukocyte PRP in Female Pattern Hair Loss Patients of Childbearing Age.

Alopecia significantly affects the mental health and social relationship of women since childbearing age, highlighting the need for a safe, effective, and convenient treatment. The authors have conducted a prospective self-controlled trial involving 15 female patients at childbearing age with alopecia. These patients received a subcutaneous scalp injection of platelet-rich plasma once every 4 weeks for 3 treatments in total. Outcome measurements were included below: changes in hair density (hair/cm2), hair follicle density (hair follicle/cm2), and overall photographic assessment (improved or not) at 4, 12, and 24 weeks right after the first treatment. Comparing the photographs taken before and after the intervention, 67% of patients' hair density increased from 151 ± 39.82 hairs/cm2 (preintervention) to 170.96 ± 37.14 hairs/cm2 (at 24-week follow-up), representing an approximate increase of 19 hairs/cm2. Meanwhile, hair follicle density increased by approximately 15 follicles/cm2 after 24 weeks since the first treatment, rising from 151.04 ± 41.99 follicles/cm2 to 166.72 ± 37.13 follicles/cm2. The primary adverse reactions observed were local swelling and pain due to injections. Local injection of nonactivated platelet-rich plasma with low leukocytes concentration could be an effective strategy to alleviate alopecia symptoms in female patients.

Efficacy and safety of botulinum toxin A in the treatment of female pattern hair loss.

Female pattern hair loss (FPHL) is the most prevalent type of alopecia among adult women. Presently, topical minoxidil stands as the sole treatment endorsed by the FDA. Addressing cases of FPHL in individuals who develop contact dermatitis in response to minoxidil can pose a challenge for dermatologists. To assess the efficacy and safety of subcutaneous injections of Botulinum Toxin Type A (BTA) in treating FPHL. Enrolled outpatients with FPHL who exhibited an allergic reaction to minoxidil solution. Diagnosis of FPHL was established through clinical examination and trichoscopy. Inclusion criteria involved patients with no prior treatment within the last year and without any comorbidities. BTA, specifically 100 units, was mixed with 2mL of 0.9% normal saline. Twenty injection target sites, spaced 2-3cm apart, were symmetrically marked on the hairless area of the scalp. A dosage of five units was intradermally injected at each target site. Representative photographs and dermoscopic images of the scalp were captured before and after 3months of treatment. A total of 10 FPHL, aged between 26 and 40years, were included. The average age was 30.3±4.64years, and all patients had a positive family history of Androgenetic Alopecia. The average duration of the disease was 3.70±1.42years. According to patients' self-assessment, after 1month of treatment, 10 FPHL patients reported experiencing moderate to marked improvement in symptoms related to scalp oil secretion. Three months later, dermatological assessments showed that three had mild improvement, six had no change, and one had a worsening condition. No adverse effects were observed. Our study suggests that the effectiveness of BTA for FPHL is limited to 3months. However, it can be considered for tentative use after effective communication with patients. The long-term efficacy and safety of BTA in treating FPHL require further observation and study.

A clinical study on the efficacy of minoxidil liniment in treating female pattern hair loss

Purpose: To investigate the clinical effect of low and high-dose minoxidil liniment in treating female pattern hair loss.
 Methods: A total of 280 female pattern hair loss patients admitted to the dermatology clinic of Lujiang County People's Hospital of Anhui Province, China from October 2020 to October 2021 were randomly divided into control and study groups comprising 140 patients in each group. Ludwig staging in the two groups included 35 cases of Type I, 80 cases of Type II, and 25 cases of Type III in control group; 40 cases of Type I, 74 cases of Type II, and 26 cases of Type III in study group. Control group was treated with 1 mL (7 sprays) of 2 % minoxidil liniment, twice daily for 6 months. Study group was treated with 1 mL (7 sprays) of 5 % minoxidil liniment. Efficacy of low and high-dose minoxidil liniment was determined according to the area and degree of hair loss before and after treatment, and the incidence of adverse responses was recorded.
 Results: After treatment for 3 months, the effective rates of control and study groups were 34.3 and 41.4 %, respectively. Effective rates of control and study groups were 57.1 and 72.9 % respectively after 6 months of treatment. There was no significant difference in effective rates after 3 and 6 months of treatment (p > 0.05). 
 Conclusion: Both 2 and 5 % minoxidil liniments demonstrate clinical efficacy in female pattern hair loss in a dose-dependent manner.

Diffuse Alopecia: Clinical, Trichoscopic, Histopathological and Immunohistochemical Challenges in the Diagnosis

Abstract Background Diffuse alopecia is characterized by a general loss of hair with no patches of full baldness. In dermatology, diffuse hair loss, particularly in women, is a common complaint. Common illnesses such as telogen effluvium, androgenetic alopecia, and widespread alopecia areata can be difficult to distinguish. The clinical signs of these three types of alopecia may be identical. Aim of Work The current study aimed to study the clinical, trichoscopic findings, histopathological in patients with acute diffuse hair shedding: female pattern hair loss (FPHL), acute telogen effluvium (TE) and alopecia areata incognita (AAI). Immunohistochemistry analysis for CD3 was done for differentiation and detection of the prognostic values of these markers. Subjects and methods: The study included 40 patients with acute diffuse hair shedding within the last 6 months with the diagnoses of AAI, TE, FPHL. All patients were subjected to full history recording, general and local examination. Hair evaluation was performed through trichoscopic assessment and punch scalp biopsy that was analyzed by hematoxylin and eosin and immunohistochemical analysis for CD3. Results Trichoscopic assessment of studied patients revealed that hair diameter diversity was significantly presented in FPHL patients. Number of thin hairs in frontal area, number of hair units with one hair, and vellus hairs were significantly presented in FPHL and TE+ FPHL patients compared to TE patients. Short regrowing hair was significantly presented in TE patients and TE +FPHL patients compared to FPHL patients. Peripilar sign and empty hair follicles in frontal area were significantly presented in FPHL patients. Multiple upright regrowing hair in all areas was significantly presented in TE+ FPHL patients. Conclusion FPH and TE represents common types of hair loss disease, each with specific trichoscopic and histochemical findings.

Female Pattern Hair Loss and Negative Psychological Impact: Possible Role of Brain-derived Neurotrophic Factor (BDNF).

Female Pattern Hair Loss (FPHL) is considered the most common type of hair loss in females. Women with FPHL may suffer from psychological distress and defective social functioning. Patients with psychiatric and neurodegenerative disorders almost have a deficient brain and blood brain-derived neurotrophic factor levels (BDNF). This serum BDNF level may act as a diagnostic marker for negative psychological impact in FPHL patients. Evaluate the levels of serum BDNF in patients with FPHL and correlate its level to the severity of alopecia and the degree of psychological impact. Forty-six female patients with FPHL and 41 healthy age-matched female volunteers as a control were included in the study. Patients filled out a Dermatology Life Quality Index questionnaire. Both patients and controls filled Beck Depression Inventory, Beck Anxiety Inventory, and Perceived Stress Scale (PSS) questionnaires. Serum levels of BDNF were measured for all the participants using the ELISA technique. Patients with FPHL had significantly lower levels of BDNF and significantly higher Beck depression inventory score and PSS questionnaire scores. There is a significant negative correlation between serum levels of BDNF and Beck Depression Inventory, Beck Anxiety Inventory, and PSS questionnaire scores. Patients with FPHL are at a high risk to develop chronic stress and depression. The serum level of BDNF is a good predictor for the assessment of chronic stress and depression in FPHL patients.

Radiofrequency Current at 448 Khz For Female Pattern Hair Loss: Cellular Bases For Redensification Improvement

Objective: Capacitive-Resistive Electrothermal Therapies (CRET) have proven effective in tissue regeneration. This study analyzes the response to 448-kHz CRET treatment in 20 patients with Female Pattern Hair Loss (FPHL) and in woman’s Dermal Papilla Cells (DPC). Methods: Patients received ten 20-minute CRET sessions over an 8-week interval. Three months after the last session, the effects of the treatment were trichoscopically analysed. DPC were CRET stimulated intermittently for 12, 24 or 48 h and the effects on cell proliferation and expression of several proteins involved in cell proliferation were analysed. Results: Trichoscopic data revealed generalized, statistically significant hair redensification (10 – 15 % over pre-treatment values) in all the treated scalp areas. In-vitro electrostimulation significantly increased DPC proliferation and expression of the proteins involved in cell proliferation. Since dysregulation of DPC proliferation is the main factor underlying abnormal hair loss, it is likely that electrically-induced DPC proliferation is involved in the redensifying effects obtained in the trichological study. Conclusion: The results of the trichological study in FPHL patients and those of the experimental study in woman’s DPC are consistent with each other and suggest that 448-kHz CRET could be effective both for hair redensification and hair loss prevention.

Serum nuclear factor E-2-related factor 2 in female pattern hair loss.

Female pattern hair loss (FPHL) is a common dermatological complaint with multifactorial etiology. Nuclear factor erythroid-2-related factor 2 (NRF2) is a transcription factor that has a major role in protection from ROS-induced apoptosis. To investigate the relationship between Nrf2 and systemic oxidative stress in FPHL patients. This case-control study included 30 patients with FPHL and 30 age- and sex-matched healthy volunteers as a control group. Serum NRF2, total antioxidant capacity (TAC), and total oxidant capacity (TOC) were measured by ELISA, and oxidative stress index (OSI) was calculated. The serum level of TOC and OSI was found to be significantly higher (p≤0.001 for both) while serum level of NRF2 and TAC was found to be significantly lower in cases than controls (p<0.001 for both). There were a significant negative correlation between TAC and BMI (p=0.03, r=-0.391) and a significant positive correlation between OSI and BMI (p=0.04, r=0.365). There were a significant positive correlation between serum level of NRF2 and TAC (p=0.003, r=0.532) and a significant negative correlation between serum the level of NRF2 and TOC (p=0.02, r=-0.418) and OSI (p=0.003, r=-0.395). Systemic oxidative stress in FPHL may be, at least in part, due to NRF2 deficiency. NRF2 activators may help in treatment of this disease. NRF2 deficiency has no role in disease severity. Healthy diet and body weight reduction may help in improving oxidative stress and subsequently improving FPHL.

Comorbid laboratory abnormalities in female pattern hair loss patients

Background: Female pattern hair loss (FPHL) is the main cause of alopecia in women and has a debilitating impact on the quality of life. However, certain comorbid conditions causing hair loss are often masked by FPHL and may remain undetected. Hence, it is imperative to identify them to administer appropriate treatment. The necessity of laboratory tests to evaluate these comorbidities in patients with FPHL has not been established. Objectives: This study aimed to identify the frequency of comorbid abnormalities detected by laboratory tests in patients with FPHL. Methods: Routine laboratory test results of patients with FPHL, who visit our hair clinic for the first time, were retrospectively collected and analyzed. These tests assessed the serum testosterone, thyroid-stimulating hormone, free thyroxin, zinc and ferritin levels, hemoglobin, as well as antinuclear antibody (ANA), and rapid plasma reagin test results. The correlation between age and hair loss severity and the frequency of comorbidities was evaluated using subgroup analysis. Results: Among the 356 patients with FPHL, coexisting zinc deficiency, iron depletion, and thyroid abnormalities were common and present in 41.7%, 39.7%, and 11.3% of them, respectively. The rate of concomitantly increased ANA titers was relatively low (4.4%), while that of syphilis and high serum testosterone levels was extremely low (0.3% and 0%, respectively). Younger patients (<50 years) with FPHL had a higher rate of coexisting iron deficiency than patients in the older age group. Conclusion: Testing for concomitant iron depletion, zinc deficiency, and thyroid disease is recommended in female patients with FPHL.

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

Objective: To study the clinical features and associated factors of female pattern hair loss (FPHL) in premenopausal and menopausal women patients.&#x0D; 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.&#x0D; 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 &lt; 70 µg/L and premenopausal FPHL (OR 5.51, 95% CI 2.26-15.14, P = 0.01).&#x0D; Conclusion: Maternal family history of AGA seems to have a greater influence on premenopausal FPHL. Low serum ferritin levels &lt; 70 µg/L were significantly associated with FPHL in premenopausal women.

Female pattern hair loss among Saudi women and hematological changes associated with it - case controlled study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Female pattern hair loss is a problematic condition. The availability of a rapid indicator is crucial. The current study compared female pattern hair loss patients with healthy controls regarding hematological parameters and vitamin D levels.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; We included 78 females with female pattern hair loss and 50 healthy subjects in the control group. We collected a detailed medical history and performed a systematic clinical examination. Blood samples were collected including complete blood count, serum ferritin, and vitamin D.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A significant increase in positive family history and acne among the study than the control group. Most patients had mild disease (55.1%). Female pattern hair loss was significantly associated with a reduction in red blood cell count, hemoglobin, hematocrit, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, red cell distribution width, serum ferritin and serum vitamin D. Among the patient’s group, the disease severity was positively correlated with disease duration and patient age. The correlation with duration was moderate (r=0.366). The disease duration was positively correlated with body mass index and negatively correlated with red blood cell count, hemoglobin concentration, hematocrit, red cell indices, ferritin and vitamin D. Disease duration was also inversely correlated with vitamin D levels.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Family history, body mass index, acne, hirsutism and irregular period were high among Saudi women. The disease was moderately severe. FPHL was associated with a significant reduction in hematological parameters and lower serum ferritin that indicated iron deficiency could play a crucial role in the development or progression of the disease. As a preventable etiology, restoring iron stores may provide at least an adjunct therapeutic option.&lt;/p&gt;

Bicalutamide improves minoxidil-induced hypertrichosis in female pattern hair loss: A retrospective review of 35 patients

Bicalutamide improves minoxidil-induced hypertrichosis in female pattern hair loss: A retrospective review of 35 patients

333 Poor perifollicular vascularization is associated with nutrient insufficiency and a quiescent metabolic phenotype in intermediate hair follicles from patients with female pattern hair loss

Female pattern hair loss (FPHL) is a non-scarring form of alopecia, resulting from premature catagen induction leading to telogen effluvium and progressive transformation of terminal (t) scalp hair follicles (HFs) into intermediate/miniaturized (i/m) HFs. Currently available treatment strategies, are often combined with nutritional supplements. However, data supporting nutrient deficiency in FPHL HFs are lacking. Therefore, we attempted to investigate this by asking whether any changes can be seen in perifollicular vascularization in FPHL and by examining HF nutritional status and metabolism in affected and non-affected HFs. CD31 quantification revealed significantly reduced numbers of perifollicular blood vessels in the relatively unaffected (occipital) but most prominently in the affected (parietal) scalp from FPHL patients compared to occipital scalp from healthy donors. This was accompanied by changes in the interfollicular expression of angiogenesis- associated growth factors VEGF and thrombospondin-1. Metabolic analyses showed that nutrients important for adequate hair growth such as biotin, pantothenic acid, L-cysteine, and L-glutamic acid were decreased in iHFs compared to tHFs in affected FPHL scalp skin. iHFs also displayed a more quiescent metabolic phenotype, characterized by a lower rate of aerobic glycolysis and glutaminolysis during organ culture. Yet, lesional t or i/m FPHL HFs were capable of taking up labelled exogenous nutrients when these were added in excess into the organ culture medium. Taken together, our data suggest that t and i/m HFs in FPHL affected scalp skin are poorly vascularized which likely compromises nutrient delivery to the HFs and that nutrient supplementation may be capable in principle to correct this deficiency.

Female Pattern Hair Loss in Female and Male: A Quantitative Trichoscopic Analysis in Chinese Han Patients.

Objectives: To investigate the trichoscopic features of female pattern hair loss (FPHL) in Chinese Han patients and analyze the difference between male and female patients with FPHL.Materials and Methods: Trichoscopic images were taken in four different scalp areas, including right frontal hairline, vertex, right parietal and occipital areas. Hair density, hair shaft diameter, vellus hair ratio and single hair follicle unit ratio were counted manually and analyzed.Results: Seventy-three subjects were enrolled in this study, including 38 patients with FPHL (28 females and 10 males) and 35 normal controls without hair loss. The hair density and hair shaft diameter of FPHL patients reduced in the whole scalp. Vellus hair ratio and single hair follicle unit ratio were both increased in FPHL compared to normal controls. The vertex was the most affected area and the hair shaft diameter showed the most significant difference. Parietal and occipital area were also affected in FPHL. The reduction or increase was correlated with the severity of Ludwig staging. Very few gender differences were detected in male and female FPHL patients.Conclusion: FPHL patients showed decreased hair density and hair shaft diameter, accompanied by increased vellus hair ratio and single hair follicle unit ratio. Parietal and occipital area can be also affected in FPHL, though not as severe as in vertex area. FPHL in male basically has the same characteristic as those in female patients.Limitation: The main limitation of the study is the small sample size which only enrolled 10 male FPHL patients, in comparison to the female cases. The findings could not be representative of the normal population with the limited sample size.

Female Pattern Hair Loss: Why the Follicular Unit Transplantation Surgical Technique Remains a Good Option.

Female pattern hair loss is a common nonscarring alopecia that can present with several patterns of decreased hair density. The condition is very bothersome to affected women, and although there are multiple nonsurgical options, surgical follicular unit transplantation remains one of the most effective options. A retrospective chart review was performed of the senior author's (C.O.U.) experience and technique of follicular unit transplantation for treatment of female pattern hair loss. A total of 751 patients with female pattern hair loss underwent follicular unit transplantation over the past 31 years. Average patient age was 48 years. Patients with small areas of hair loss made up 40 percent of the group (Ludwig stage I), those with medium-sized areas constituted 45 percent (Ludwig stage II), and those with large areas constituted 15 percent (Ludwig stage III). The average operative time was 3 hours 21 minutes. One hundred thirty-five patients (18 percent) underwent a second replacement, at an average period of 4 years after the procedure, because of the progressive nature of female pattern hair loss. Complications included donor-site scar widening in six patients and folliculitis in 17 patients. Follicular unit transplantation is an excellent option for treatment of female pattern hair loss patients, as there is no need to shave the recipient sites, operative times are shorter than for follicular unit excision techniques, and the incidence of complications is very low. Therapeutic, IV.

Prediction of therapeutic outcomes of female pattern hair loss patients based on clinical features with application of artificial intelligence

Prediction of therapeutic outcomes of female pattern hair loss patients based on clinical features with application of artificial intelligence

16232 Analysis of androgen excess and association with polycystic ovary syndrome in female-pattern hair loss before 30 years of age

Pathogenesis of female-pattern hair loss (FPHL) is known to be related with androgen, but its role in the FPHL is not fully understood. Polycystic ovarian syndrome (PCOS) is the most common androgen excess disorder in women. Based on the pathophysiologic commonality, there can be meaningful assiociation of these two disease, and it can be helpful to understand the role of androgen in FPHL We investigated this study to identify the characteristics of young FPHL in regard to androgenic traits and connection with PCOS. We reviewed the clinical features, laboratory data, ultrasonographic features of ovary, and trichoscopic findings in mid-frontal area in FPHL subjects under 30 years old. A total of 50 female patients were enrolled. The mean age of the patients was 21.5 years old. Most subjects (30/50, 60%) were satisfied with Rotterdam criteria of PCOS. A fifth of subjects (11/50, 22%) showed hyperandrogenism signs of acne or hirsutism in addition to FPHL. The ratio of abnormal value (50.0%, n = 30) in antimüllerian hormone (AMH) was higher than that of total testosterone (22.0%, n = 50) and DHEA-S (20.0%, n = 50). All of hormones showed more proportion of abnormality in FPHL with PCOS than FPHL without PCOS patients. In FPHL patients under 30 years old, it is likely that PCOS was prevalent. So overall clinical, biochemical, and sonographic evaluation should be conducted to examine the presence of PCOS. AMH may be more helpful in detecting FPHL compared with classic androgens for its higher abnormality ratio.

Novel "After Minoxidil" spray improves topical minoxidil compliance and hair style manageability.

Topical minoxidil is the only US FDA-approved drug for the treatment of female pattern hair loss (FPHL). While the safety profile of topical minoxidil is excellent, the efficacy of minoxidil in hair growth is extremely low. A recent survey of 8000 people observed that only 4% of hair loss patients using an over-the-counter minoxidil were very satisfied with their results. In contrast, in clinical studies with an intervening physician, approximately 30%-40% of patients demonstrate an appreciable benefit. Compliance with topical drug regimens is often a major obstacle, limiting their effectiveness. Topical minoxidil leaves a greasy residue on the hair, which is especially problematic for women who do not wash their hair daily. We set out to develop an "After Minoxidil" companion spray to minoxidil that removes residual minoxidil from the hair, where it is not needed, yet leaves minoxidil on the scalp where it is required. We hypothesized that improving the cosmetic properties of minoxidil would improve patient compliance with the drug and subsequently improve clinical outcomes. A cohort of 20 FPHL patients was recruited to use the novel "After Minoxidil" spray and report changes in hair quality on a Likert scale. In our cohort of FPHL patients, the novel "After Minoxidil" spray restored ease of styling and reduced greasiness to preminoxidil level in 65% and 85% of subjects, respectively. The average reduction in perceived greasiness was 78%. Importantly, 70% of subjects interviewed stated they would likely continue to use the minoxidil and "After Minoxidil" treatment regimen for 6 months, vs 0% willing to use minoxidil alone. The novel "After Minoxidil" spray improved ease of hair styling and reduced greasiness following application of topical minoxidil; thus, the novel "After Minoxidil" spray may help improve drug compliance and efficacy.

Serum 25 hydroxyvitamin D levels in alopecia areata, female pattern hair loss, and male androgenetic alopecia in a Chinese population.

It has been suggested that low vitamin D levels may affect the development of hair loss. Our aim was to evaluate the serum 25-hydroxy vitamin D [25(OH)D] status in Chinese patients with alopecia areata (AA), female pattern hair loss (FPHL), and male androgenetic alopecia (MAGA) compared with healthy individuals. We performed a case-control study including 443 AA patients, 657 FPHL patients, 777 MAGA patients, and 2070 normal controls (1064 male and 1006 female healthy individuals) from 2015 to 2017 to analyze the correlation of serum 25(OH)D levels and hair loss in a Chinese population. Serum 25(OH)D levels stratified by age, sex, and season were compared between patients and healthy individuals. AA patients' serum 25(OH)D levels were statistically lower than that of controls (P<.0001, α=.05). Serum 25(OH)D levels of FPHL patients (P<.0001, α=.05) and MAGA patients (P=.0005, α=.05) were also significantly lower than counterpart control subjects. Our findings suggest an association between serum 25(OH)D levels and alopecia areata, female pattern hair loss, or male androgenetic alopecia in a Chinese population.

Significant relationship between temporal hair loss and other scalp areas in female pattern hair loss.

Female pattern hair loss affects the central scalp, sparing the frontal hairline. The temporal area can also be affected by hair loss. We investigated the degree of temporal hair loss and correlation of other sites of scalp hair loss in Korean female pattern hair loss patients. A total of 109 women with female pattern hair loss were enrolled in this retrospective analysis. We measured hair density and thickness in five scalp sites including the frontal, vertex, occipital and bilateral temporal areas by phototrichogram. Frontal and vertex area hair loss were classified according to the Basic and Specific (BASP) classification, and temporal scalp and occiput areas were also assessed. Eighty-nine patients showed temporal hair loss. The mean of the hair density was lowest in the temporal area among all scalp areas. Total and thick hair densities of the frontal scalp were correlated with those of the vertex, temporal scalp and occiput in descending order, and hair thickness of the frontal scalp was more related with that of the temporal scalp than the vertex. In this study, temporal involvement is evident in female pattern hair loss. We suggest that temporal involvement should be added to pattern hair loss classification, especially BASP classification.

Vitamin D Receptor Gene Polymorphisms Taq-1 and Cdx-1 in Female Pattern Hair Loss.

Background:Female pattern hair loss (FPHL) is an important cause of hair loss in adult women and has a major impact on patient’s quality of life. It evolves from the progressive miniaturization of follicles that leads to a subsequent decrease of hair density, leading to non-scarring diffuse alopecia, with characteristic clinical, dermoscopic, and histological patterns. Vitamin D receptor (VDR) is expressed in follicular keratinocytes and dermal papilla cells and is shown to have important role in hair growth and regulation of hair cycle. VDR polymorphism was not extensively investigated in hair disorders including FPHL.Aim:To investigate the association between VDR gene polymorphism (Cdx-1 and Taq-1) and FPHL to explore if these polymorphisms affect the disease occurrence or influence its clinical presentation.Methods:A case-control study was conducted on 30 female patients with FPHL and 30 age-matched female healthy subjects, as a control group. Degree of hair loss was assessed by Ludwig grading. VDR gene polymorphisms, Taq-1 and Cdx-1 were investigated by real time polymerase chain reaction.Results:CC genotype, TC genotype, and T allele of Taq-1 were more prevalent in FPHL patients than in control group. They increased disease risk by 12.6, 2.1, and 2.9 folds, respectively. AA genotype, GA genotype, and G allele of Cdx-1 were significantly more prevalent among FPHL patients than in control group. They increased disease risk by 7.5, 5.2, and 5.5 folds, respectively.Conclusion:Taq-1 and Cdx-1 can be considered as risk factors for FPHL. They may play role in disease persistence rather than disease initiation. This association may be explained by failure of new anagen growth and decreased proliferation of hair follicle stem cells. Further studies are recommended to confirm current findings.