The Comparison of Trichoscopic Findings in Female Pattern Hair Loss (FPHL) and Chronic Telogen Effluvium (CTE) in Female Patients

Background: Chronic hair loss is a major complaint in middle-aged females. It is sometime difficult to differentiate between female pattern hair loss (FPHL) and chronic telogen effluvium (CTE) in female patients. Trichoscopy is a non-invasive technique that can help to distinguish between FPHL and CTE.

Aims: To compare the trichoscopic findings in female pattern hair loss (FPHL) and chronic telogen effluvium (CTE) in female patients.

Materials and Methods: It is a cross sectional prospective comparative study carried out in the department of dermatology, Acharya Vinoba Bhave Rural Hospital affiliated to Jawaharlal Nehru Medical College, Wardha, Maharashtra. Adult female patients with ages ranging from 30 to 60 years old complaining of diffuse hair loss were included in the study. Patients with scarring alopecia were excluded from the study. Patients were divided into two groups consisting of 20 patients in each group. Group A and B included patients with FPHL and CTE respectively. Trichoscan (SIF hair analysis system) was performed on frontal region of the scalp.

Results: Hair diameter variability was significantly seen in FPHL. Hair diameter was reduced in FPHL (0.045) as compared to chronic telogen effluvium (0.063) with statistical difference between them. Hair density was significantly reduced in FPHL (32 ± 12.24) as compared to CTE (60.66 ± 18.12). Vellus hair density was significantly more in FPHL (22.4 ± 14.3) as compared to chronic telogen effluvium (7.73 ± 6.71). Single hair unit was more in FPHL (65 ± 17.08) as compared to chronic telogen effluvium. Density of yellow dots is more significantly observed in female pattern hair loss as compared to chronic telogen effluvium.

Conclusion: Trichoscopic features based on hair shaft diameter, hair follicular density, vellus hairs, yellow dots and variability in hair shaft diameter can easily help to distinguish female pattern hair loss from chronic telogen effluvium. This differentiation can help dermatologists to plan better and specific management of hair loss in female patients.