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PRSonally Speaking

Tuesday, April 23, 2013

Articles of Interest Sneak Peek: The Contribution of Endogenous and Exogenous Factors to Male Alopecia: A Study of Identical Twins
At least twice a month, PRSonally Speaking posts full abstracts of interesting or potentially controversial articles from a future issue. This 'sneak preview' of a hot article is meant to give you some food for thought and provide you with topic for conversation among colleagues.
When the article is published in print with the May issue, it will be FREE for a period of Two Months, to help the conversation continue in the PRS community and beyond. So read the abstract, join the conversation and spread the word.
This week we present the introduction to "The Contribution of Endogenous and Exogenous Factors to Male Alopecia: A Study of Identical Twins" by Guyuron et al.
Background: The purpose of this study is to investigate the potential contribution of environmental factors and testosterone on male alopecia.
Methods: Ninety-two identical male twins were recruited from 2009 to 2011. A comprehensive questionnaire was completed followed by the acquisition of sputum samples for testosterone analysis and standardized digital photography. Frontal (FHL), temporal (THL), and vertex (VHL) hair loss were assessed from these photographs. Hair loss was then correlated with survey responses and testosterone levels between twin pairs. Two independent, blinded observers also rated the photographs for hair thinning.

Results: While age and genetics were the predominant factors, increased smoking duration (p <0.001) and presence of dandruff (p =0.028) were significantly associated with increased FHL. Increased exercise duration (p =0.002), consumption of >4 alcoholic drinks per week (p =0.042), and increased money spent on hair-loss products (p =0.050) were all associated with increased THL. Daily hat use (p =0.050), higher body mass index (p =0.012), and higher testosterone levels (p =0.040) were associated with decreased THL. Factors that were significantly associated with increased VHL included abstinence from alcohol consumption (p =0.030), consumption of >4 alcoholic drinks per week (p = 0.004), increased smoking duration (p =0.047), increased exercise duration (p =0.050), and increased stress duration (p =0.010). Lower BMI, more children, increased caffeine consumption, history of skin disease, and abstinence from alcohol were significantly associated with increased hair thinning scores (p <0.05).

Conclusions: This study offers substantial evidence that exogenous factors may have a clinically significant impact on hair loss.


Stress and Vertex Hair Loss. Twins A and B, both 43 years of age. Twin B reported an increased duration of stress and had a lower BMI compared to Twin A. Twin B had an associated 0.17 increase in vertex hair loss.

The full article will be published with the May 2013 issue of PRS, and will be free online for non-subscribers. Until then, we hope this "sneak peek" will pique your interests and start a healthy, meaningful conversation.