Document Type : Original Article
Authors
1 Sulaimaniyah General Directorate of Health - Research Department, Sulaimaniyah, Iraq
2 Department of Nursing, College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaimaniyah, Iraq
3 Community Medicine, College of Medicine, University of Sulaimani, Iraq
Abstract
Background: Androgenetic alopecia (AGA) is a common form of hair loss that significantly affects individuals’ self-esteem,
psychological well-being, and quality of life. This study aimed to investigate the prevalence, epidemiology, pathophysiology, and clinical implications of AGA among adults in Sulaimani Governorate, Iraq.
Methods: A cross-sectional study was conducted in Sulaimani Governorate from September 2022 to December 2023. A stratified sampling method was used to select 1,438 participants aged 18 years and older. Data were collected through a researcherdesigned questionnaire and clinical examinations using the Ludwig and Norwood-Hamilton scales. Descriptive statistics, logistic regression, and Pearson’s chi-square test were used for
data analysis.
Results: The study population consisted of 49.7% males (n=715) and 50.3% females (n=723), with mean ages of 32.23±10.04 and 31.46±11.19 years, respectively. Females exhibited a higher incidence of sudden hair loss (27.5%) compared to males (18.3%). Significant risk factors included a family history of hair loss (OR=1.29, 95% CI: 1.23–1.35, P=0.001) and recent general operations (OR=1.07, 95% CI: 1.01–1.15, P=0.023). Additionally, the use of flat irons/curling irons (OR=1.09, 95% CI: 1.10–1.18, P=0.001) and frequent use (>3 times/week) (OR=1.04, 95% CI: 1.02–1.35, P=0.002) were associated with increased hair loss.
Conclusion: This study provides important insights into the epidemiology and risk factors of AGA in Sulaimani Governorate, Iraq. The findings underscore the need for targeted prevention and treatment strategies that consider the distinct characteristics of the local population. Further research is warranted to investigate the genetic and environmental factors that contribute to AGA in this region.
Keywords
- Wolff H, Fischer TW, Blume-Peytavi U. The Diagnosis and Treatment of Hair and Scalp Diseases. Dtsch Arztebl Int. 2016; 113(21):377-86. doi: 10.3238/arztebl.2016.0377. PubMed PMID: 27504707; PubMed Central PMCID: PMC4908932.
- He H, Xie B, Xie L. Male pattern baldness and incidence of prostate cancer: A systematic review and meta-analysis. Medicine (Baltimore). 2018; 97(28):e11379. doi: 10.1097/MD.0000000000011379. PubMed PMID: 29995779; PubMed Central PMCID: PMC6076190.
- Anastassakis K, Anastassakis K. The Psychological Effects of AGA/FPHL2022. 283-99 p.
- Varothai S, Bergfeld WF. Androgenetic alopecia: an evidence-based treatment update. Am J Clin Dermatol. 2014; 15(3):217-30. doi: 10.1007/s40257-014-0077-5. PubMed PMID: 24848508.
- Kavak A, Yeşildal N, Parlak AH, Gökdemir G, Aydoğan I, Anul H, et al. Alopecia areata in Turkey: demographic and clinical features. J Eur Acad Dermatol Venereol. 2008; 22(8):977-81. doi: 10.1111/j.1468-3083.2008.02699.x. PubMed PMID: 18384559.
- Kim BJ, Kim JY, Eun HC, Kwon OS, Kim MN, Ro BI. Androgenetic alopecia in adolescents: a report of 43 cases. J Dermatol. 2006; 33(10):696-9. doi: 10.1111/j.1346-8138.2006.00161.x. PubMed PMID: 17040499.
- Xu F, Sheng YY, Mu ZL, Lou W, Zhou J, Ren YT, et al. Prevalence and types of androgenetic alopecia in Shanghai, China: a community-based study. Br J Dermatol. 2009; 160(3):629-32. doi: 10.1111/j.1365-2133.2008.08909.x. PubMed PMID: 19016703.
- Abdin R, Zhang Y, Jimenez JJ. Treatment of Androgenetic Alopecia Using PRP to Target Dysregulated Mechanisms and Pathways. Front Med (Lausanne). 2022; 9:843127. doi: 10.3389/fmed.2022.843127. PubMed PMID: 35372424; PubMed Central PMCID: PMC8965895.
- Swerdloff RS, Dudley RE, Page ST, Wang C, Salameh WA. Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels. Endocr Rev. 2017; 38(3):220-254. doi: 10.1210/er.2016-1067. PubMed PMID: 28472278; PubMed Central PMCID: PMC6459338.
- Miranda BH, Charlesworth MR, Tobin DJ, Sharpe DT, Randall VA. Androgens trigger different growth responses in genetically identical human hair follicles in organ culture that reflect their epigenetic diversity in life. FASEB J. 2018; 32(2):795-806. doi: 10.1096/fj.201700260RR. PubMed PMID: 29046359; PubMed Central PMCID: PMC5928870.
- Ludwig E. Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. Br J Dermatol. 1977; 97(3):247-54. doi: 10.1111/j.1365-2133.1977.tb15179.x. PubMed PMID: 921894.
- Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975; 68(11):1359-65. doi: 10.1097/00007611-197511000-00009. PubMed PMID: 1188424.
- Kacar SD, Soyucok E, Bagcioglu E, Ozuguz P, Coskun KS, Asık AH, et al. The Perceived Stigma in Patients with Alopecia and Mental Disorder: A Comparative Study. Int J Trichology. 2016; 8(3):135-40. doi: 10.4103/0974-7753.189005. PubMed PMID: 27625566; PubMed Central PMCID: PMC5007920.
- Wang TL, Zhou C, Shen YW, Wang XY, Ding XL, Tian S, et al. Prevalence of androgenetic alopecia in China: a community-based study in six cities. Br J Dermatol. 2010; 162(4):843-7. doi: 10.1111/j.1365-2133.2010.09640.x. PubMed PMID: 20105167.
- Can G, Demir M, Erol O, Aydiner A. A comparison of men and women's experiences of chemotherapy-induced alopecia. Eur J Oncol Nurs. 2013; 17(3):255-60. doi: 10.1016/j.ejon.2012.06.003. PubMed PMID: 22901547.
- Lolli F, Pallotti F, Rossi A, Fortuna MC, Caro G, Lenzi A, et al. Androgenetic alopecia: a review. Endocrine. 2017; 57(1):9-17. doi: 10.1007/s12020-017-1280-y. PubMed PMID: 28349362.
- Lee SH, Kang H, Lee WS. Association between Family History and Male Androgenetic Alopecia with Female Pattern Hair Loss. Ann Dermatol. 2023; 35(5):348-354. doi: 10.5021/ad.22.221. PubMed PMID: 37830416; PubMed Central PMCID: PMC10579574.
- Hatsbach de Paula JN, Basílio FMA, Mulinari-Brenner FA. Effects of chemical straighteners on the hair shaft and scalp. An Bras Dermatol. 2022; 97(2):193-203. doi: 10.1016/j.abd.2021.02.010. PubMed PMID: 35058079; PubMed Central PMCID: PMC9073307.
- Olsen EA, Callender V, McMichael A, Sperling L, Anstrom KJ, Shapiro J, et al. Central hair loss in African American women: incidence and potential risk factors. J Am Acad Dermatol. 2011; 64(2):245-52. doi: 10.1016/j.jaad.2009.11.693. PubMed PMID: 21075478.
- Jusuf NK. The Relationship between Types of Hair Coloring with Hair Damages and Scalp Problems in Medical Students of University Sumatera Utara, Indonesia. International Archives of Medicine. 2016;9. 69. doi: 10.3823/1940.
- Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb). 2019; 9(1):51-70. doi: 10.1007/s13555-018-0278-6. PubMed PMID: 30547302; PubMed Central PMCID: PMC6380979.
- Devjani S, Ezemma O, Kelley KJ, Stratton E, Senna M. Androgenetic Alopecia: Therapy Update. Drugs. 2023; 83(8):701-715. doi: 10.1007/s40265-023-01880-x. PubMed PMID: 37166619; PubMed Central PMCID: PMC10173235.
)