A Clinical Study of Diffuse Hair Loss in Women in Tertiary Care Hospital

Background: Diffuse hair loss is a common complaint encountered by dermatologists in their daily clinical practice. About one-third of women experience hair loss (alopecia) at some time in their lives, as many as two-thirds suffer hair thinning or bald spots. Alopecia can severely affect a woman's emotional well-being and quality of life. Various underlying factors individually or in combination contribute to the pathogenesis. Objectives: To determine causes of diffuse hair loss in women and to find the association between probable causes and relevant laboratory parameters, wherever applicable. Materials and Methods: One hundred and seven women with diffuse hair loss were included in the study. Detailed history and clinical local examination including hair pull test and hair dermoscopy, microscopy, investigations including semi-investigative tests were done in all study subjects. Specific laboratory investigations were done. Results: Among 107 patients, 36 (33.6%) presented with acute onset hair loss while rest had chronic hair loss. Acute telogen effluvium, telogen effluvium, Chronic Telogen Effluvium (CTE), Female Pattern Hair Loss (FPHL) were common presentations. Telogen Effluvium (TE) (49.5%) was the commonest type of diffuse hair loss. Incidence of ATE were highest in the age group of 18-30 years (52.6%), whereas CTE (52.3%) and FPHL (60%) in 30-40 years. Psychological stress (11.2%) and iron deficiency anaemia (10.3%) were the most common underlying aetiological factors for TE. Most cases of CTE were idiopathic. No significant relationship was observed between CTE, haemoglobin level and serum ferritin level. Out of 10 patients with FPHL, low haemoglobin level was observed in 3 (33.3%) and low serum ferritin level in 8 (80%).43 patients with menstrual irregularities underwent hormonal workup and USG Pelvis. PCOS on USG was found in 17 patients. FSH: LH ratio abnormality was most common finding on hormonal workup. Conclusion: Diffuse hair loss is a multifactorial condition. A detailed history, thorough clinical examination and appropriate investigations help to identify the causative factors and treat them accordingly.