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The contribution of exogenous factors to alopecia: A study of identical male twins
Bardia Amirlak, James Gatherwright, Ali Totonchi, David Rowe, Bahman Guyuron
Department of Plastic Surgery, Case Western Reserve University, Cleveland, Ohio
2010-03-31
Presenter: Bardia Amirlak
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction: Male pattern baldness is thought to be the result of a complex interaction of endogenous and exogenous factors.The individual contributions of these parameters has yet to be fully elucidated. One potential avenue for further investigation is the study of genetically identical twins.
Methods: During the Twins Day Festival in Twinsburg, Ohio, identical twins completed a comprehensive questionnaire, and standardized digital images were obtained. Midline, temporal, and vertex hair loss were measured using Adobe® Photoshop® Software and clinically evaluated using the Hamilton-Norwood scale. Data was analyzed via linear regression and univariate-analysis using the SPSS® software to determine the relationship between hair loss measurements, genetics, and questionnaire items. Analyses were adjusted for age when appropriate.
Results: A total of 44(22pairs) adult, male twins were used for the analyses. Working exclusively during the daytime(p=0.047), working more than 50 hours/week(p=0.012), increased sun exposure (p=0.020), increased number of marriages(p=0.032), divorce(p=0.038), stress at work(p=0.005) and smoking(p=0.016) all were significantly associated with increased hair loss. Moderate drinking (3-6drinks/wk) was associated with less vertex hair loss when compared to 0–2drinks/wk (p=0.030) and heavy drinkers(p=0.047). Moderate coffee consumption (3-5cups/day) was associated with decreased temporal hair loss when compared to those consuming >5cups/day(p=0.044). Longer daily exercise duration was significantly associated with decreased hair loss(p=0.005). While not statistically significant, there was a trend towards increased cumulative ejaculations over one's lifetime and decreased temporal hair loss(p=0.137).
Conclusion:This study offers statistical evidence that exogenous factors contribute to male pattern baldness and prompts further research into putative risk factor interventions and therapies.
