Treatment of low serum ferritin in females with alopecia by oral iron.

Background: Hair loss affects over 25% of women in developed countries. Three hair disorders, androgenetic alopecia, telogen effluvium and alopecia areata which account for most cases of nonscarring alopecia in women. Iron deficiency has been reported in the majority of women presenting with diffuse hair loss. Iron has important function in oxidation- reduction reactions, collagen synthesis, and as a co-factor for enzymes. Objectives: To assess the percentage of the low serum ferritin hair loss females and their response to oral iron replacement therapy. Materials and methods : a prospective cohort study conducted in at Marjan teaching hospital from August 2013 to January 2015. It included 72 female complained from diffuse hair loss were enrolled in this study. Full history was taken from all patients and physical examinations were done both general examination and local examination of the scalp including pull test. Patients were sent to complete blood examinations, serum ferritin. Patients divided in to three groups according to their response to treatment. Before the treatment the severity of hair loss was assess by VAS. Results: Fifty two patients met criteria of inclusion. Their serum ferritin levels range between (1.4-14.4) with mean 6.16±3.30 their hemoglobin levels were (8.3-13.4) with mean ±SD 11.98±1.22. Group I patients included 27 patients (51.9%), their severity of hair loss before treatment was assess by VAS which was 9.18±0.84, after two week of treatment the score become 7.33±1.03, P value is < 0.0001; confidence interval 95% = ( 1.477 to 2.277). in group II patients which included 12 patients (23%), their severity of hair loss before treatment was assess by VAS which was 9.33±0.49, after two week of treatment the score become 9.08±0.66, P value is 0.081 considered not significant; confidence interval 95% = (-0.037 to 0.537). The other thirteen patients (25%) represented the third group. All the patients in this group didn′t show any response to treatment Conclusion: Measurement of serum ferritin level should be done to all patients with chronic telogen effluvium before starting other anti-hair loss modalities. Iron replacement is a safe drug with a few side effects and indicated to all females with low serum ferritin level