Serum ferritin and hair iron content in correlation to hair diameter and density: a case-control study

Androgenetic alopecia (AGA) is the most common non-scarring hair loss disorder in men due to susceptibility to testosterone. AGA causes cosmetic disturbances that affect confidence and quality of life. The correlation between low ferritin serum levels and AGA has been sufficiently proven in women but not in men. Thus, this study evaluated this correlation in Indonesian men. This case-control study included 33 men with AGA and 33 non-alopecia controls. Serum ferritin and hair iron levels were analyzed for differences using the Mann-Whitney U test. Their correlations with hair diameter and density were assessed using the Spearman correlation test. Serum ferritin (AGA vs. control, median: 222 vs. 232 ng/mL; p=0.758) and total hair iron levels (22.65 vs. 39.67 ng/mL; p=0.102) showed no significant differences between the groups. However, in men with milder AGA (grade <4), total hair iron level and hair diameter showed significant weak positive correlations (r=0.312, p=0.033). In the non-alopecia group, serum ferritin and total hair iron levels showed a significant weak negative correlation (r=-0.387, p=0.026). Hair iron levels were positively correlated with hair diameter in men with early AGA, suggesting a potential role in promoting hair thickness and highlighting its promise as a target for adjuvant therapy.