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2022, Number 2

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Dermatología Cosmética, Médica y Quirúrgica 2022; 20 (2)

Postpartum and lactation: A true cause of telogen effluvium?

Briseño-Gascón G, Leal-Osuna SE

Language: Spanish
References: 60
Page: 225-230
PDF size: 114.99 Kb.


ABSTRACT

Introduction: postpartum effluvium or gravidarum telogen is described as a common cause of telogen effluvium, however, its origin as well as the clinical and trichoscopic signs throughout pregnancy and after delivery have not been properly studied. As dermatologists we must know the available literature to date, to offer the best options and follow-up to patients suffering from this type of hair loss.
Objective: to know the cause of postpartum effluvium and the best therapeutic options reported to date.
Methods: the information search was carried out through PubMed, using different mesh terms, with articles published from January 1960 to December 2021.
Results: a total of 29 articles were obtained. Most of them focus on changes in follicular dynamics during pregnancy and lactation. So far there are only two clinical studies of postpartum effluvium, the first conducted in 1960 and the second in 2013.
Conclusions: hair loss in the months after delivery is a frequent cause of dermatological consultation due to anxiety. The classic dermatological literature mentions postpartum as a cause of telogen effluvium, however, there are no studies that demonstrate its causality. It’s necessary to carry out trials that allow us to evaluate patients during and after their pregnancy with objective methods to have a better understanding of their pathophysiology and develop therapeutic options to their needs.


REFERENCES

  1. Jafferany M y Patel A, Trichopsychodermatology: the psychiatricand psychosocial aspects of hair disorders, Dermatol Ther 2020; 33(1):131-4.

  2. Park AM, Khan S y Rawnsley J, Hair biology: growth and pigmentation,Facial Plast Surg Clin North Am 2018; 26(4):415-24.

  3. Schneider MR, Schmidt-Ullrich R y Paus R, The hair follicle as a dynamicminiorgan, Curr Biol 2009; 19(3):132-42.

  4. Paus R y Foitzik K, In search of the “hair cycle clock”: a guided tour,Differentiation 2004; 72(9-10): 489-511.

  5. Stenn KS y Paus R, Controls of hair follicle cycling, Physiol Rev 2001;81(1):449-94.

  6. Park AM, Khan S y Rawnsley J, Hair biology: growth and pigmentation,Facial Plast Surg Clin North Am 2018; 26(4):415-24.

  7. Koch SL, Tridico SR, Bernard BA, Shriver MD y Jablonski NG, Thebiology of human hair: a multidisciplinary review, Am J Hum Biol 2020;32(2):1-17.

  8. Botchkarev VA y Paus R, Molecular biology of hair morphogenesis:development and cycling, J Exp Zool B Mol Dev Evol 2003; 298(1):164-80.

  9. Al-Nuaimi Y, Baier G, Watson RE, Chuong CM y Paus R, The cyclinghair follicle as an ideal systems biology research model, Exp Dermatol2010; 19(8):707-13.

  10. Higgins CA, Westgate GE y Jahoda CA, From telogen to exogen:mechanisms underlying formation and subsequent loss of the hairclub fiber, J Invest Dermatol 2009; 129(9):2100-8.

  11. Piérard-Franchimont C y Piérard GE, Alterations in hair follicle dynamicsin women, Biomed Res Int 2013; 1:1-5.

  12. Piérard-Franchimont C, Petit L, Loussouarn G, Saint-Léger D y PiérardGE, The hair eclipse phenomenon: sharpening the focus on the haircycle chronobiology, Int J Cosmet Sci 2003; 25(6):295-9.

  13. Messenger AG, Hair through the female life cycle, Br J Dermatol 2011;165 Suppl 3:2-6.

  14. Malkud S, Telogen effluvium: a review, J Clin Diagn Res 2015; 9(9):1-3.

  15. Rebora A, Proposing a simpler classification of telogen effluvium, SkinAppendage Disord 2016; 2(1-2):35-8.

  16. Headington JT, Telogen effluvium. New concepts and review, ArchDermatol 1993; 129:356-63.

  17. Rebora A, Telogen effluvium: a comprehensive review, Clin CosmetInvestig Dermatol 2019; 12:583-90.

  18. Phillips TG, Slomiany WP y Allison R, Hair loss: common causes andtreatment, Am Fam Physician 2017; 96(6):371-8.

  19. Asghar F, Shamim N, Farooque U, Sheikh H y Aqeel R, Telogen effluvium:a review of the literature, Cureus 2020; 12(5):1-7.

  20. Eastham JH, Postpartum alopecia, Ann Pharmacother 2001; 35(2):255-8.

  21. Millikan L, Hirsutism, postpartum telogen effluvium, and male patternalopecia, J Cosmet Dermatol 2006; 5(1):81-6.

  22. Harfmann KL y Bechtel MA, Hair loss in women, Clin Obstet Gynecol2015; 58(1):185-99.

  23. Fernandes LB y Amaral WN, Clinical study of skin changes in low andhigh-risk pregnant women, An Bras Dermatol 2015; 90(6):822-6.

  24. Rebora A, Guarrera M y Drago F, Postpartum telogen effluvium, J EurAcad Dermatol Venereol 2016; 30(3):518.

  25. Snarskaya ES, Olisova OY, Makatsariya AD, Kochergin NG, RadetskayaL, Bitsadze V y Khizroeva J, Skin pathologies in pregnancy, J Perinat Med2019; 47(4)-371-80.

  26. Rudnicka L, Olszewska M, Rakowska A y Slowinska M, Trichoscopyupdate, J Dermatol Case Rep 2011; 5:82-8.

  27. Torres F y Tosti A, Trichoscopy: an update, G Ital Dermatol Venereol2014; 149:83-91.

  28. Rudnicka L, Olszewska M y Rakowska A, Atlas of trichoscopy, NuevaYork, Springer, 2013.

  29. Dhurat RS, Agrawal S, Sharma A y Ghate S, Pigtail hair in acute telogeneffluvium: lest we forget!, Indian Dermatol Online J 2020; 11(3):444-5.

  30. Contin LA y Rocha VB, Acute telogen effluvium triad after resolution,An Bras Dermatol 2021; 96(5):605-8.

  31. Bergfeld WF, Telogen effluvium. En Hordinsky M (ed.), Hair and scalpdiseases, Nueva York, Informa Healthcare 2008; 1:125.

  32. Nissimov J y Elchalal U, Scalp hair diameter increases during pregnancy,Clin Exp Dermatol 2003; 28(5):525-30.

  33. Muallem MM y Rubeiz NG, Physiological and biological skin changesin pregnancy, Clin Dermatol 2006; 24(2):80-3.

  34. Piérard-Franchimont C y Piérard GE, Paroxismal reactions of the scalp,Rev Med Liege 2004; 59:180-5.

  35. Conrad F y Paus R, Estrogens and the hair follicle, J Dtsch Dermatol Ges2004; 2(6):412-23.

  36. Ohnemus U, Uenalan M, Inzunza J, Gustafsson JA y Paus R, Thehair follicle as an estrogen target and source, Endocrine Reviews 2006;27(6):677-706.

  37. Thornton MJ, Oestrogen functions in skin and skin appendages, ExpertOpin Ther Targets 2005; 9(3):617-29.

  38. Mirmirani P, Hormones and clocks: do they disrupt the locks? Fluctuatingestrogen levels during menopausal transition may influenceclock genes and trigger chronic telogen effluvium, Dermatol Online J2016; 22(5):13030.

  39. Piérard GE, Piérard-Franchimont C, Marks R et al., eemco guidance forthe assessment of hair shedding and alopecia, Skin Pharmacol Physiol2004; 17:98-110.

  40. Tulchinsky D, Hobel CJ, Yeager E y Marshall JR, Plasma estrone, estradiol,estriol, progesterone, and 17-hydroxyprogesterone in humanpregnancy, Am J Obstet Gynecol 1972; 112:1095-100.

  41. Ostrom KM, A review of the hormone prolactin during lactation, ProgFood Nutr Sci 1990; 14:1-43.

  42. Wosu AC, Valdimarsdóttir U, Shields A et al., Correlates of cortisol inhuman hair: implications for epidemiologic studies on health effectsof chronic stress, Ann Epidemiol 2013; 23:797-811.

  43. Krumbholz A, Anielski P, Reisch N et al., Diagnostic value of concentrationprofiles of glucocorticosteroids and endocannabinoids in hair,Ther Drug Monit 2013; 35:600-7.

  44. Agren UM, Tammi M y Tammi R, Hydrocortisone regulation of hyaluronanmetabolism in human skin organ culture, J Cell Physiol 1995;164:240-8.

  45. Westergren-Thorsson G, Norman M, Bjornsson GE et al., Differentialexpressions of mrna for proteoglycans, collagens and transforminggrowth factor-b in the human cervix during pregnancy and involution,Biochimica et Biophysica Acta 1998; 1406:203-13.

  46. Hjelm AM, Barchan K, Malmström A et al., Changes of the uterineproteoglycan distribution at term pregnancy and during labour, Eur JObstet Gynacol Reprod Biol 2002; 100:146-51.

  47. Akerud A, Dubicke A, Sennström M et al., Differences in heparansulfate production in cervical fibroblast cultures from women undergoingterm and preterm delivery, Acta Obstet Gynecol Scand 2008;87:1220-8.

  48. Gilmore S y Sinclair R, Chronic telogen effluvium is due to a reductionin the variance of anagen duration, The Australasian Journal of Dermatology2010; 51(3):163-7.

  49. Chien Yin GO, Siong-See JL y Wang ECE, Telogen effluvium: a reviewof the science and current obstacles, J Dermatol Sci 2021; 101(3):156-63.

  50. Mirallas O y Grimalt R, The postpartum telogen effluvium fallacy, SkinAppendage Disord 2016; 1(4):198-201.

  51. Lynfield YL, Effect of pregnancy on the human hair cycle, J Invest Dermatol1960; 35:323-7.

  52. Gizlenti S y Ekmekci TR, The changes in the hair cycle during gestationand the post-partum period, J Eur Acad Dermatol Venereol 2014;28:878-81.

  53. Mehta N y Larson L, Pharmacotherapy in pregnancy and lactation, ClinChest Med 2011; 32:43-52.

  54. Skelton JB, Postpartum alopecia, Am J Obstet Gynecol 1966; 94(1):125-9.

  55. Söltz-Szöts J, Treatment of the chronic postpartum hair loss withovulation inhibitors, Z Haut Geschlechtskr 1969; 44(12):433-6.

  56. Thom E, Pregnancy and the hair growth cycle: anagen inductionagainst hair growth disruption using Nourkrin® with Marilex®, aproteoglycan replacement therapy, J Cosmet Dermatol 2017; 16(3):421-7.

  57. Thom E, Nourkrin: objective and subjective effects and tolerability inpersons with hair loss, J Int Med Res 2006; 34:514-9.

  58. Thom E, Wadstein J, Thom EW et al., Treatment of hair thinning andhair aging with specific lectican and leucine proteoglycans. A review, JAppl Cosmetol 2014; 32:105-15.

  59. Brenner FM y Oldoni C, Telogen effluvium and female pattern hairloss: is there correlation?, An Bras Dermatol 2019; 94(4):486-7.

  60. Bittencourt C, Ferraro DA, Soares TC, Moraes AM y Cintra ML,Chronic telogen effluvium and female pattern hair loss are separateand distinct forms of alopecia: a histomorphometric and immunohistochemicalanalysis, Clin Exp Dermatol 2014; 39(8):868-73.




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