Hair loss and hyperprolactinemia in women

Abstract

In the literature of the past 30 years there are only some publications concerned with hair loss and hyperprolactinemia in women. Therefore, the relevance of hyperprolactinemia was evaluated in 40 women with diffuse alopecia.Hair loss was assessed by clinical appearance and the pluck trichogram. 82.5% of the female patients had diffuse hair loss and 17.5% had androgenetic alopecia.The highest prolactin values measured were 1390 ng/ml and 255 ng/ml. Six patients had values between 150-80.4 ng/ml and 10 between 79.1-51.7 ng/ml. All others had prolactin values below 50 ng/ml. Fifteen untreated patients with elevated prolactin levels could be followed up. Without any prolactin-inhibiting drugs, reductions and normalizations beside moderate fluctuations could be detected.Thyroid-specific diagnostics showed in 95% of the patients a normal thyroid function. 2.5% had a slight hyperthyreoidism and 2.5% had a slight hypothyreoidism. No female patient had clinical signs of androgenization and the determined androgens testosterone, androstendione and dihydroepiandrostendione were in the normal range.According to these results, moderate elevated prolactin levels in association with diffuse or androgenetic hair loss can be neglected as causative for the hair loss, because there is no evidence that they have an influence to the pattern, the extent or the duration of the hair loss. These results are supported by investigations of other authors who described only in high doses of prolactin an inhibiting effect on human hair follicles in vitro. Nevertheless, moderate constantly elevated prolactin levels should induce further diagnostics to exclude a prolactin-producing tumor of the pituitary gland.

Keywords: diffuse hair loss; hyperprolactinemia; women.

Figure 1.

57-y-old female patient with diffuse hair loss and a moderate elevated prolactin level of 75.5 ng/ml. Diffuse hair loss is characterized by an uniform shedding of the hair in central, parietal and occipital region of the head.

Figure 2.

The age of the 40 patients with elevated prolactin levels ranged from 18–80 y (mean 45.8).

Figure 3.

The illustration shows the fluctuation of the anagen hairs in the frontal region of the head. On average the anagen rate was 80.0%.

Figure 4.

The percentage of the telogen hairs in the frontal region of the head varied from 4–48% (mean 16.5).

Figure 5.

The illustration shows the fluctuation of the anagen hairs in the occipital region of the head. On average the anagen rate was 82.0%.

Figure 6.

The percentage of telogen hairs in the occipital region of the head varied from 4–33% (mean 15.6).

Figure 7.

Prolactin levels of the 40 patients with diffuse hair loss. The prolactin values ranged from 25.1–1390 ng/ml. Most of the patients had values below 150 ng/ml.