Quantification of levels of biotin and copper in serum and hair samples of women with chronic telogen effluvium

Women presenting with diffuse hair loss is a commonchallenging problem encountered by the dermatologists. The most common cause istelogen effluvium which is often triggered by endocrine, nutritional orautoimmune etiologies. However, in chronic telogen effluvium (CTE) wherein thehair loss lasts for more than 6 months, the precipitant is often not identifiedand it is often a routine practice to supplement these patients with biotin andmicronutrients like zinc, copper, iron and selenium. The rationale ofsupplementation is based on the observation that alopecia is one of many consequencesassociated with biotin, copper and zinc deficiencies. However till date thereare no evidences to support deficiency of biotin or these micronutrients andthere are no clinical trials to demonstrate their supplementation to beeffective in hair loss (CTE).  This isalso the case with iron deficiency, which is often believed to be a cause ofhair loss (CTE) , wherein the literature reports are inconsistent regardingrole of iron supplementation. Some nutritional supplements are, however,approved as drugs not requiring prescriptions and not reimbursable by healthcare insurers. In addition, it has also been reported that excessive intakes ofnutritional supplements may actually cause hair loss and are not recommended inthe absence of a proven deficiency.

Hence, we propose to study the levels of biotin andcopper in serum and hair of women with chronic telogen effluvium in comparisonto those without hair loss. If a deficiency of biotin and copper is observed inthose with hair loss, we would like to estimate the cut off levels at whichhair loss occurs.