A Noninvasive Method to Diagnose Chronic Telogen Effluvium

Chronic telogen effluvium (CTE) and mild female pattern hair loss (FPHL) require different treatment protocols, yet the two can be difficult to differentiate. In many cases, biopsies are used to diagnose the cause of chronic hair loss in women, but there may be an effective, noninvasive method available, according to a new study published in the International Journal of Dermatology (July 2016).

Caroline Bittencourt MD, et al, investigated the use of the washing method to differentiate CTE from mild FPHL by recruiting 20 patients with CTE and 17 with FPHL—the diagnoses were established through clinical, laboratory and histological studies. The patients were asked to abstain from washing their hair for five days, and then shampoo and collect all hair shed in the process. The researchers counted the hair shafts and divided them into two groups: greater or lesser than 3cm.

The hair count was high (438) in the CTE group and, in all 20 cases, less than 10% of the shed hairs were shorter than 3cm. In patients with FPHL, the mean count was lower (215) and with one exception short hairs (less than 3cm) comprised more than 10% of the total shed. When compared to baseline histology, the greater the number of long hairs shed correlated with a higher density of terminal follicles. In addition, the CTE group presented a greater number of patients with serum iron values less than 70 μg/dl. No significant difference was seen in ferritin levels between the two groups.

The authors conclude: “The washing test can be useful to avoid biopsy procedures. Iron serum levels are possibly an additional parameter that may improve CTE diagnosis if combined with an earlier test.”