Clinico-epidemiological study of female pattern hair loss (FPHL) with special reference to obesity and menstrual disorders in a tertiary care centre in North Eastern India

Introduction: Female pattern hair loss (FPHL) is the most common hair loss disorder in women. Initial signs may develop during the age between 21-40 years of age leading to a progressive hair loss with a characteristic pattern distribution. Women diagnosed with FPHL may undergo significant impairment of quality of life. The present study was done to find out the clinical profiles of FPHL and its correlation with obesity and menstrual irregularities in MGM Medical College & LSK Hospital, Kishanganj, Bihar. Methods: This was a cross-sectional study where a total of 100 patients in a semi-urban tertiary care hospital that caters both urban and rural population of Bihar and adjacent areas of West Bengal. The study was conducted over the period of one year. Detailed history, physical examination and routine investigations were recorded for all patients. Results: Maximum (n=12) patients were in 21-25 years, followed by age group 25- 30 (n=11), and least in 31-40 (n=8) age group, the mean age was being 25.575 years. Maximum number of patients were suffering from disease from <1 years duration. Family history of FPHL either in the paternal or maternal relatives, does not influence it’s the age of onset or severity. Obesity and PCOS are some of risk factors which should be addressed in patients with FPHL, for better treatment response and hence compliance. Hypothyroidism is one of the cause of FPHL The mean and SD value of Hb was 10.802 and + 1.139; and the serum ferritin level the values we found were 44.645 and +21.211 respectively. The P value was <0.001 which is statistically significant. The mean and SD value of prolactin was 22.821 and + 10.799. In case of T3 level the values we found were 0.873 and +0.514 respectively. The score of Ludwig scale is -16. 42.5% (17) patients fall in grade II, 15(37.5%) patients fall in grade I and 8 (20%) patient fall in grade III. The result of hair pull test of the study group, Maximum number of patients i.e. 30 (75%) patients showed greater than 10% and 10 (25%) showed less than 10%. Showing Distribution of patients according to Ludwing scale and age group. From the above table we found that majority of patients i.e. 17(42.5%) patients belonged to Ludwing scale-II. Among these 17 patients maximum number of patients (58.3%) belonged to 21-25 years of age group. 16 patients (40%) belonged to Ludwing scale-I, in this group prevalence rate higher among the patients belonged to 26-30 years of age group i.e. 6(54.5%), and 8 patients belonged to Ludwing scale-III, in this group prevalence rate was higher 15-20 years age group 3(33.3%) patients. Conclusion: FPHL is a very common, non scarring form of hair loss occurring most commonly in postmenopausal women. Although hormonal factors and genetic predisposition contribute to FPHL, the complete mechanism remains elusive and the most affected women have normal androgen levels. Owing to the high prevalence of FPHL in Indian woman, while dealing with diffuse hair loss in females, we should consider FPHL as one of the aetiology and assess for the risk factors associated with it