A Hospital-based Study to Determine Causes of Diffuse Hair Loss in Women

Diffuse hair loss is a common complaint encountered by dermatologists in their daily clinical practice. Hair loss in women is a distressing condition. Various underlying factors individually or in combination contribute to the pathogenesis.

To determine causes of diffuse hair loss in women and to find the association between probable causes and relevant laboratory parameters, wherever applicable.

One hundred and eighty women with diffuse hair loss were included in the study. Detailed history and clinical examination including hair pull test and hair microscopy were done in all study subjects. Specific laboratory investigations for determining iron deficiency anaemia, thyroid dysfunction and parasitic infestation were done.

Among 180 patients, 116 (64.44%) had telogen effluvium, 28 (15.55%) had CTE, 21 (11.66%) had FPHL and 1 (0.55%) had AE. Fourteen patients (7.77%) had more than one aetiological diagnosis of diffuse hair loss. TE was the commonest type of diffuse hair loss. Incidence of TE and FPHL were highest in the age group of 21-30 years, whereas CTE in 30-40 years. Psychological stress and iron deficiency anaemia were the most common underlying aetiological factors for TE, which is statistically significant (p<0.05). Out of 130 patients with TE, more than one aetiological factor was recorded in 10 cases whereas in 32 cases probable aetiological factors could not be elicited from history. Most cases of CTE were idiopathic. No significant relationship was observed between CTE, haemoglobin level and serum ferritin level. Out of 35 patients with FPHL, low haemoglobin level was observed in 6/20 (30%) and low serum ferritin level in 14/17 (82.35%).

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.