The etiology of hair loss is multifactorial with contributions from genetic predisposition, pathological states, pharmacotherapy, and nutritional inadequacies. While nutritional deficiencies can lead to hair loss, exact data are often lacking. Furthermore, evidence base to support routine screening of nutritional deficiencies and the efficacy of nutritional supplementation in reversing hair loss is still in accrual and is currently inconclusive. Nutritional inadequacies are a wide‑spread population problem in India. A relative paucity of data on the specificity of a causal association between hair loss and nutrition in Indian trichology merits investigation.
We did a cross‑sectional study, a total of 100 adult participants between 18 and 40 years of age with diffuse hair loss, i.e., generalized nonscarring loss of scalp hair with >100 strands lost/day continuously irrespective of duration were enrolled in the study. Patients with alopecia areata or cicatricial hair loss and those reporting usage of nutritional supplements in the past 6 weeks were not included in this study. All enrolled study participants underwent scalp examination with a hair pull test and trichoscopy after the detail medical history. All participants underwent laboratory investigations which included iron profile, serum vitamin B12 level, amino acid levels, folate, serum zinc, serum copper, and biotinidase level. The study was conducted between October 2015 and December 2015. The study was approved by the Institutional Ethics Committee. A signed informed consent was obtained from all the participants.
A relatively higher proportion of participants with telogen effluvium had iron deficiency. Transferrin saturation and ferritin levels were low in patients with FPHL (female pattern hairloss) and TE as compared to patients with MPHL (male pattern hairloss). Deficiencies of essential amino acids and nonessential were noted in participants with hair loss, but these deficiencies were not specific to the type of hair loss. Histidine deficiency was seen in 77.78% of participants with TE compared to 91.67% and 97.08% of those with FPHL and MPHL, respectively. Leucine (observed in all participants with FPHL and 97.06% with MPHL, 98.15% of participants with TE), Valine (75%, 47.06%, and 70.37% of participants with FPHL, MPHL, and TE), Isoleucine, Alanine, cysteine, Asparagine deficiency was observed.
Hair loss is a common problem in the community which causes an adverse impact on the psychological aspects of a person. Although nutritional deficiencies are implicated in the pathogenesis of hair loss, there is paucity of the comprehensive laboratory analysis of nutritional status in participants with hair loss. This study was conducted to evaluate the prevalence of various micronutrients such as essential and nonessential amino acids, vitamins, and minerals in participants with hair loss. The results of our study demonstrate noticeable prevalence of amino acid and micronutrient deficiencies in otherwise healthy participants with hair loss irrespective of the type of alopecia. From the observations of the study, it appears that the nutritional status plays an important role in all types of hair loss. In people with nutritional deficiencies, supplementation might be useful in preventing hair loss.
- Dr. Bani Anand, Founder & Managing Director, Hairline International Hair & Skin Clinic