Nonscarring scalp alopecia: Which laboratory analysis should we perform on whom?

Background/aim: Vitamins and minerals are thought to play an essential but not entirely clear role in developing, preventing, and treating nonscarring alopecia. Telogen effluvium, androgenetic alopecia, and alopecia areata are the most common forms of nonscarring alopecias. We would like to present a different perspective on laboratory abnormalities in patients with nonscarring alopecia. Materials and methods: A total of 467 patients (287 females, 180 males) were included retrospectively: One hundred and sixty patients in the telogen effluvium group, 101 patients in the androgenetic alopecia group, 99 patients in the alopecia areata group, and 107 patients in the hair loss group (patients who could not be diagnosed with any nonscarring alopecia and wanted to have an analysis due to the complaint of hair loss). Sociodemographic data, diagnostic distribution, and laboratory findings (hemoglobin, ferritin, vitamin B12, vitamin D, and TSH) were evaluated and compared. Results: The most common diagnosis was telogen effluvium in females and androgenetic alopecia in males. In women, hemoglobin (12.2% vs. 1.1%) and ferritin deficiencies (22.3% vs. 8.9%) were significantly higher than in men (p < 0.001, p < 0.001) Ferritin, hemoglobin, and vitamin B12 levels were significantly lower, and the number of patients with vitamin D, ferritin, hemoglobin and vitamin B12 deficiencies were significantly higher in the telogen effluvium group compared to the other groups. Laboratory abnormalities were detected least in the hair loss group. Conclusion: The number of patients with the highest abnormalities in all parameters was observed in the telogen effluvium group and females; therefore, we mainly suggest examining female patients with telogen effluvium first. We may prefer not to immediately investigate the laboratory abnormalities and follow up patients with some treatments in the hair loss group.

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