Differences in Demographic and Clinical Characteristics Among Subtypes of Female Pattern Hair Loss

Figures & data

Figure 1 Female pattern hair loss subtypes: (A) Ludwig subtype, diffuse hair thinning of the centroparietal scalp with frontal hairline preservation; (B) Olsen subtype, diffuse centroparietal hair thinning with breaching of frontal hairline resembling Christmas tree; and (C) Hamilton-Norwood subtype, recession of frontal hairline in bitemporal pattern and vertex hair thinning.

Table 1 Comparison of Demographics and Clinical Characteristics Among Subtypes of Female Pattern Hair Loss

Variables	Ludwig n = 265 (51.1)	Olsen n = 171 (32.9)	Hamilton-Norwood n = 83 (16.0)	P-value	Total n = 519
Age at diagnosis, year, mean ± SD	45.2 ± 14.3	43.8 ± 12.9	41.5 ± 13.1	0.09	45.6 ± 14.9
Age of onset, year, mean ± SD	39.1±12.9	39.7 ± 13.2	35.4 ± 11.8	0.03*	38.1 ± 13.1
Disease onset, n (%)				0.005*
●Early (< 40 years)	110 (41.5)	75 (43.9)	51 (61.4)		236 (45.5)
●Late	155 (58.5)	96 (56.1)	32 (38.6)		283 (54.5)
Duration of disease, year, median (IQR)	7 (1–10)	6 (1–8)	5 (1–9)	0.82	6 (2–9)
Disease severity^†, n (%)				0.638
●Grade I	102 (38.5)	69 (40.4)	35 (42.2)		206 (39.7)
●Grade II	96 (36.2)	67 (39.2)	33 (39.8)		196 (37.8)
●Grade III	67 (25.3)	35 (20.4)	15 (18.0)		117 (22.5)
Menstruation, n (%)				0.036*
●Regular	234 (88.3)	148 (86.5)	64 (77.1)		443 (85.3)
●Irregular	31 (11.7)	23 (13.5)	19 (22.9)		76 (14.7)
Infertility, n (%)	14 (5.3)	8 (4.7)	6 (7.2)	0.69	28 (5.4)
Menopause, n (%)	68 (25.7)	46 (26.9)	18 (21.6)	0.66	132 (25.4)
Alcohol consumption, n (%)				0.88
●No	246 (92.8)	158 (92.4)	75 (90.4)
●Current	10 (3.8)	7 (4.1)	5 (6.0)		22 (4.2)
●Previous	9 (3.4)	6 (3.5)	3 (3.6)		18 (3.5)
Smoking, n (%)				0.99
●No	256 (96.6)	165 (96.4)	80 (96.4)
●Current	4 (1.5)	2 (1.2)	1 (1.2)		7 (1.3)
●Previous	5 (1.9)	4 (2.4)	2 (2.4)		11 (2.1)
Family history of AGA, n (%)				0.61	387 (74.5)
●No	69 (26.0)	47 (27.5)	16 (19.3)		132 (25.5)
●Paternal	67 (25.3)	39 (22.8)	26 (31.3)		132 (25.5)
●Maternal	76 (28.7)	49 (28.6)	20 (24.1)		145 (27.9)
●Both	53 (20.0)	36 (21.1)	21 (25.3)		110 (21.1)

Notes: ^†The severity of the Hamilton-Norwood type was reclassified into three groups: grade I, Hamilton-Norwood types II–III; grade II, types IV–V; and grade III, types VI–VII. *Statistically significant.

Abbreviations: AGA, androgenetic alopecia; IQR, interquartile range; SD, standard deviation.

Table 2 Comparison of Comorbidities Among Subtypes of Female Pattern Hair Loss

Variables	Ludwig n = 265 (51.1)	Olsen n = 171 (32.9)	Hamilton-Norwood n = 83 (16.0)	P-value	Total n = 519
BMI, n (%)				0.039*
●< 25 kg/m^2	165 (62.2)	103 (60.2)	63 (75.9)		331 (63.8)
●≥ 25 kg/m^2	100 (37.8)	68 (39.8)	20 (24.1)		188 (36.2)
●Hypertension, n (%)	20 (7.5)	19 (11.1)	3 (3.6)	0.10	42 (8.1)
●CAD, n (%)	7 (2.6)	3 (1.8)	2 (2.4)	0.83	12 (2.3)
●Type 2 DM, n (%)	28 (10.6)	20 (11.7)	2 (2.4)	0.047*	50 (9.6)
●Dyslipidemia, n (%)	25 (9.4)	17 (9.9)	7 (8.4)	0.92	49 (9.4)
●PCOS, n (%)	25 (9.4)	12 (7.0)	15 (18.1)	0.02*	52 (10.0)
●Seborrhea, n (%)	52 (19.6)	29 (16.9)	25 (30.1)	0.045*	106 (20.4)
●Acne, n (%)	67 (25.3)	41 (23.9)	30 (36.1)	0.09	138 (26.6)
●Hirsutism, n (%)	18 (6.8)	13 (7.6)	12 (14.5)	0.08	43 (8.3)
●Atopy, n (%)	34 (12.8)	21 (12.3)	9 (10.8)	0.89	64 (12.3)
●Seborrheic dermatitis, n (%)	46 (17.4)	33 (19.3)	19 (22.9)	0.52	98 (18.9)
●Hypothyroidism, n (%)	7 (2.6)	6 (3.5)	2 (2.4)	0.83	15 (2.9)
●Hyperthyroidism, n (%)	6 (2.2)	4 (2.3)	3 (3.6)	0.78	13 (2.5)
●AITD, n (%)	10 (3.8)	5 (2.9)	3 (3.6)	0.89	18 (3.5)
●SLE, n (%)	4 (1.5)	4 (2.3)	3 (3.6)	0.49	11 (2.1)
●Iron deficiency anemia, n (%)	17 (6.4)	21 (12.3)	7 (8.4)	0.10	45 (8.7)
●CKD, n (%)	5 (1.8)	4 (2.3)	3 (3.6)	0.65	12 (2.3)
●Malignancy, n (%)	3 (1.1)	2 (1.2)	1 (1.2)	0.99	6 (1.1)

Note: *Statistically significant.

Abbreviations: AITD, autoimmune thyroid disease; BMI, body mass index; CAD, coronary artery disease; CKD, chronic kidney disease; DM, diabetes mellitus; PCOS, polycystic ovary syndrome; SLE, systemic lupus erythematosus.

Table 3 Multinomial Logistic Regression Analysis for Demographics, Clinical Characteristics, and Associated Comorbidities of Each Subtype of Female Pattern Hair Loss

Variables	Ludwig vs Olsen		Hamilton-Norwood vs Ludwig		Hamilton-Norwood vs Olsen
	Adjusted OR (95% CI)	P-value	Adjusted OR (95% CI)	P-value	Adjusted OR (95% CI)	P-value
Age at diagnosis, year	1.06 (0.73–3.35)	0.96	0.92 (0.69–3.16)	0.82	0.95 (0.81–3.62)	0.79
Age at disease onset, year	0.97 (0.58–4.23)	0.91	0.85 (0.53–2.69)	0.73	0.83 (0.48–3.97)	0.66
Early onset (<40 years)	0.95 (0.36–2.95)	0.64	2.14 (1.39–4.22)	0.02*	1.89 (1.03–3.92)	0.04*
Disease severity^†
●Grade I	Reference		Reference		Reference
●Grade II	0.95 (0.52–4.65)	0.43	1.07 (0.66–3.15)	0.39	1.02 (0.53–4.12)	0.51
●Grade III	1.12 (0.48–3.96)	0.38	0.84 (0.14–2.44)	0.82	0.91 (0.55–3.11)	0.47
Menstruation irregularity	0.94 (0.24–4.21)	0.42	1.94 (0.46–5.77)	0.31	1.82 (0.33–3.19)	0.48
BMI ≥ 25 kg/m^2	0.95 (0.16–2.91)	0.56	1.04 (0.45–3.14)	0.83	0.83 (0.25–2.94)	0.59
Hypertension	0.86 (0.27–4.33)	0.46	0.77 (0.02–3.29)	0.28	0.61 (0.04–3.74)	0.52
Type 2 DM	0.79 (0.42–2.46)	0.32	0.51 (0.03–0.82)	0.02*	0.68 (0.04–0.79)	0.03*
PCOS	1.12 (0.74–3.96)	0.36	2.02 (1.55–4.84)	0.03*	2.24 (1.89–5.31)	0.01*
Seborrhea	1.08 (0.45–4.52)	0.29	1.42 (0.82–3.38)	0.55	1.51 (0.88–4.56)	0.49
Acne	1.03 (0.35–2.99)	0.64	1.36 (0.69–3.89)	0.62	1.49 (0.41–4.16)	0.57
Hirsutism	0.92 (0.36–3.84)	0.43	1.83 (0.92–5.12)	0.32	1.66 (0.71–3.86)	0.52
Iron deficiency anemia	0.69 (0.26–5.24)	0.26	1.24 (0.49–4.16)	0.65	0.78 (0.38–3.59)	0.29

Notes: ^†The severity of the Hamilton-Norwood type was reclassified into three groups: grade I, Hamilton-Norwood types II–III; grade II, types IV–V; and grade III, types VI–VII. *Statistically significant.

Abbreviations: BMI, body mass index; CI, confidence interval; DM, diabetes mellitus; OR, odds ratio; PCOS, polycystic ovary syndrome.