Thinner hair strands, greasy scalps could signal early-onset female pattern hair loss

Patients with early-onset female pattern hair loss (eFPHL) have thinner hair shafts and manifest androgen-related features, such as scalp greasiness and hirsutism, reports a recent study.

The study included 63 eFPHL patients (mean age 27.3 years) who were prospectively evaluated for demographic and hormonal characteristics that could differentiate them from 341 healthy controls (mean age 29.1 years). Genetic assessment of single-nucleotide polymorphisms (SNPs) around 30 candidate genes associated with eFPHL was also performed.

Hair shaft density was significantly decreased in eFPHL patients than in controls by 85.9 percent in the frontal area, 79.0 percent in the vertex area, and 77.0 percent in the parieto-temporal area (p<0.001 for all). Similarly, the cross-sectional area of the vertex hair shaft was 89 percent smaller in patients than in controls (p=0.006). Despite such differences, standardized break stress did not differ between groups.

In addition, androgen-related features, such as greasy scalps (66.7 percent vs 44.3 percent; p=0.003), polycystic ovary syndrome (33.3 percent vs 8.5 percent); p<0.001), hirsutism (30.2 percent vs 4.1 percent; p<0.001), and frequent folliculitis (23.8 percent vs 7.3 percent; p<0.001), were all significantly more common in eFPHL patients vs controls.

These specific hair and hormonal features in eFPHL patients may be driven by genetic alterations, the researchers said, pointing out that their analysis found that “a total of 49 SNPs located around PPARGC1A, FSHB, CYP19A1, ABCC4, and CYP11B2 were found to be significant in eFPHL.”