Association of non-scarring alopecia and vitamin D levels: A case control study

Authors

  • Zareen Saqib Department of Dermatology, Khawaja Muhammad Safdar Medical College & Allama Iqbal Memorial Teaching Hospital Sialkot
  • Rutaba Kiran Department of Dermatology, King Edward Medical University & Mayo Hospital Lahore
  • Mahwash Rana Department of Dermatology, Continental Medical College, Lahore
  • Sadaf Naveed Khan Realisticure Skin and Aesthetic Clinic
  • Hafiza Sidra Seemi Combined Military Hospital Lahore
  • Zahida Rani Department of Dermatology, Khawaja Muhammad Safdar Medical College & Allama Memorial Teaching Hospital Sialkot
  • Ayaz Khan

Keywords:

Non scarring alopecia, Vitamin D deficiency, Diffuse hair loss

Abstract

Objective To determine the association between non scarring alopecia and vitamin D levels.   Methods 69 patients with non-scarring alopecia and 69 age matched controls were enrolled in the study using non purposive consecutive sampling, after taking informed consent. Serum vitamin D and haemoglobin levels were determined and compared for both groups.   Results The mean age of the case group was 26.35±8.96 years while that of the control was 31.36±9.6 years. 93% cases and 83% controls belonged to the female gender while only 17 individuals were males. There was no difference in dietary habits between the two groups, and about 15% individuals from both groups were vegetarians. The hair pull test was positive in 42% cases and 13% controls. The hemoglobin levels were comparable in both groups although about 7% cases and none of the controls had severe anemia. More than half the cases and controls had Vitamin D deficiency and almost one third had Vitamin D insufficiency with cases having a slightly lower mean Vitamin D level of 23.12±16.70 and controls having a mean of 23.75±18.63. The Chi square test for comparison of vitamin D levels between two groups has p value of 0.06 which is statistically not significant.   Conclusion Vitamin D deficiency is frequently associated with non-scarring alopecia. Vitamin D levels should be measured as routine investigation in patients of hair loss. However, we also found comparable prevalence of vitamin D insufficiency in the control population, so we recommend food fortification with vitamin D to alleviate this problem at community level.  

Author Biographies

Zareen Saqib, Department of Dermatology, Khawaja Muhammad Safdar Medical College & Allama Iqbal Memorial Teaching Hospital Sialkot

Assistant Professor Dermatology

Zahida Rani, Department of Dermatology, Khawaja Muhammad Safdar Medical College & Allama Memorial Teaching Hospital Sialkot

Professor & Head

References

Sajjad U, Jaffar N, Asad Ali Khan M, Abbas K, Ghafoor R, Khan A et.al. Frequency of hair fall, its awareness and hair care practices among adult population. J Pak Assoc Dermatol. 2022;32(32):388-95.

Mostafa, W.Z.; Hegazy, R.A. Vitamin D and the skin: Focus on a complex relationship: A review. J Adv Res. 2015;6:793-804.

Lehmann B. Role of the vitamin D3 pathway in healthy and diseased skin-facts, contradictions and hypotheses. Exp Dermatol. 2009;18(2):97-108.

Demay, M.B.; MacDonald, P.N.; Skorija, K.; Dowd, D.R.; Cianferotti, L.; Cox, M. Role of the vitamin D receptor in hair follicle biology. J Steroid Biochem Mol Biol. 2007;103:344-6.

Bikle, D.D.; Elalieh, H.; Chang, S.; Xie, Z.; Sundberg, J.P. Development and progression of alopecia in the vitamin D receptor null mouse. J Cell. Physiol. 2006;207:340-53.

Sakai, Y.; Kishimoto, J.; Demay, M.B. Metabolic and cellular analysis of alopecia in vitamin D receptor knockout mice. J Clin Investig. 2001;107:961-6.

Bikle DD. Vitamin D: Production, Metabolism and Mechanisms of Action. [Updated 2021 Dec 31]. In: Feingold KR, Anawalt B, Blackman MR, et al. editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278935/

Verman P Mahendra, Christina Mary P Paul, Rajan P, R Preethi, Premkumar, R Priya, S Priyanka, Rajeshkumar. Study on hairfall with hair related problems among males of ages 18-50 year: Study on Chennai based population. J Clin Diagnost. 2018;12(10):9-12.

Birch MP, Lalla SC, Messenger AG. Female pattern hair loss. Clin Exp Dermatol. 2002;27(1):3837.

Mady LJ, Ajibade DV, Hsaio C, Teichert A, Fong C, Wang Y, Christakos S, Bikle DD. The Transient Role for Calcium and Vitamin D during the Developmental Hair Follicle Cycle. J Invest Dermatol. 2016;136(7):1337-45.

Gerkowicz A, Chyl-Surdacka K, Krasowska D, Chodorowska G. The Role of Vitamin D in Non-Scarring Alopecia. Int J Mol Sci. 2017;18(12):2653

Saini K, Mysore V. Role of vitamin D in hair loss: A short review. J Cosmet Dermatol. 2021;20(11):3407-14.

Riaz H, Finlayson AE, Bashir S, Hussain S, Mahmood S, Malik F, Godman B. Prevalence of Vitamin D deficiency in Pakistan and implications for the future. Expert Rev Clin Pharmacol. 2016;9(2):329-38.

Cashman KD. Vitamin D deficiency: Defining prevalence, causes and strategies of addressing. Calcif Tissue Int. 2020;106:14-29.

Conic RRZ, Piliang M, Bergfeld W, Atanaskova-Mesinkovska N. Vitamin D status in scarring and nonscarring alopecia. J Am Acad Dermatol. 2021;85(2):478-80.

Moneib H, Fathy G, Ouda A. Possible association of female-pattern hair loss with alteration in serum 25-hydroxyvitamin D levels. Egypt J Dermatol Venerol. 2014;34:15-20.

Rasheed H, Mahgoub D, Hegazy R, El-Komy M, Abdel Hay R, Hamid MA, Hamdy E. Serum ferritin and vitamin d in female hair loss: Do they play a role? Skin Pharmacol Physiol. 2013;26:101-7.

Banihashemi M, Nahidi Y, Meibodi NT, Jarahi L, Dolatkhah M. Serum Vitamin D3 Level in Patients with Female Pattern Hair Loss. Int J Trichol. 2016;8:116–20.

Baig JA, Sheikh SA, Islam I, Kumar M. Vitamin D status among vegetarians and non-vegetarians. J Ayub Med Coll Abbottabad. 2013;25(1-2):152-5.

Oslen EA, Reed KB, Cacchio PB, Caudill L. Iron deficiency in female pattern hair loss, chronic telogen effluvium and control groups. J Am Acad Dermatol. 2010;63(6):991-9.

Bell NH, Greene A, Epstein S, Oexmann MJ, Shaw S, Shary J. Evidence for alteration of the vitamin D-endocrine system in blacks. J Clin Invest. 1985;76(2):470-3.

Matsuoka LY, Wortsman J, Dannenberg MJ, Hollis BW, Lu Z, Holick MF. Clothing prevents ultraviolet-B radiation-dependent photosynthesis of vitamin D3. J Clin Endocrinol Metab. 1992;75(4):1099-103.

Downloads

Published

2024-10-11

Issue

Section

Original Articles

Most read articles by the same author(s)

1 2 3 4 5 6 > >>