October 25, 2016
Journal of Drugs in Dermatology
TAKE-HOME MESSAGE
This retrospective study sought to determine the vitamin and mineral deficiency rates of patients with telogen effluvium. The authors found these patients to have deficiencies in ferritin (45.2% of patients), vitamin D (33.9%), and zinc (9.6%).
– Anna Wile, MD
Written by Joseph C English III MD
Telogen effluvium (TE) is commonly seen in dermatologic practice and is often a very distressing process to the patient at hand. Although the inciting event may be hard to determine, it may represent a skin sign of systemic disease. Such causes can be emotional (stress, anxiety, or depression), physical (thyroid disease, weight loss/gain, starting/stopping medications, any illness/surgery) or a combination of both. This retrospective study demonstrates that patients may also have vitamin D, zinc, and ferritin deficiencies. Replacement of these may shorten the course of TE in some patients; however, the deficiencies may not be the only inciting factor in others. But maintaining proper physiologic levels may promote optimal hair growth and health.
By listening and examining the patient, followed by evaluation of thyroid function, complete blood count, iron/ferritin, vitamin D and zinc levels, you can offer your patient a comprehensive examination.
Abstract
Telogen effluvium is one of the most common forms of non-scarring alopecia for which patients present to a dermatologist. It is a challenging disorder to treat and study, primarily owing to its multifactorial etiology which includes both physiologic and non-physiologic factors. Nutritional deficiency has been purported to contribute to hair shedding, and a patient’s clinical history usually aids in directing laboratory evaluation. Many prior studies have either supported or failed to find a correlation between telogen effluvium and deficiencies in vitamins and minerals, in particular, vitamin D, ferritin, vitamin B12, folate, and zinc. We performed a retrospective cross-sectional study of patients with telogen effluvium in the greater Pittsburgh, Pennsylvania area, and measured the rates of these deficiencies. Our results demonstrate that the prevalence of vitamin D, ferritin, and zinc deficiencies is non-trivial and therefore justifies including these laboratory studies in initial clinical evaluation.