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Dermatology238 papers

Endocrine alopecia

Last edited: 4/14/2026

Overview

Endocrine alopecia refers to hair loss conditions influenced by hormonal imbalances, including those related to thyroid disorders, adrenal diseases, and other endocrine dysfunctions. These conditions can manifest as nonscarring alopecias with varied presentations and underlying etiologies 710.

Diagnosis

  • Clinical History: Detailed assessment of hormonal status, medication use, and family history 710.
  • Physical Examination: Identification of pattern and distribution of hair loss 16.
  • Laboratory Tests: Thyroid function tests, adrenal hormone levels, vitamin D levels, and complete blood count 710.
  • Scalp Biopsy: Histopathologic evaluation to rule out scarring alopecia and confirm nonscarring types 1624.
  • Dermoscopy: Useful for distinguishing between different types of nonscarring alopecia 16.

    • Management

  • Hormonal Therapy: Correction of underlying hormonal imbalances (e.g., thyroid hormone replacement, cortisol supplementation) 710.
  • Nutritional Support: Supplementation with vitamins and minerals, particularly vitamin D, if deficient 10.
  • Topical Treatments: Use of minoxidil for androgenetic alopecia, though efficacy in endocrine-related alopecia may vary 15.
  • Psychological Support: Counseling and support to address psychological impacts of hair loss 30.
  • Alternative Therapies: Emerging options like topical JAK inhibitors (e.g., ruxolitinib) for alopecia are under investigation 13.

    • Special Populations

  • Pregnancy: Endocrine emergencies like hyperthyroidism or hyperparathyroidism require careful management to avoid adverse fetal outcomes 11.
  • Pediatrics: Transition from pediatric to adult care for chronic endocrine diseases is crucial; alopecia may be a symptom requiring specialized attention 17.
  • Elderly: Increased prevalence of vitamin D deficiency and its impact on endocrine health should be considered 10.

    • Key Recommendations

  • Evaluate Hormonal Status: Routinely assess thyroid and adrenal function in patients with nonscarring alopecia (Evidence: Moderate 710).
  • Consider Nutritional Deficiencies: Screen for vitamin D deficiency, especially in patients with autoimmune endocrine disorders (Evidence: Moderate 10).
  • Tailored Psychological Support: Provide psychological counseling alongside medical treatment to address the psychosocial impact of alopecia (Evidence: Expert opinion 30).
  • Monitor and Correct Hormonal Imbalances: Implement appropriate hormonal therapy based on laboratory findings to manage underlying endocrine disorders (Evidence: Moderate 710).

    • References

    1 Sparano C, Canu L, Perigli G, Santoro R, Pradella S, Grazzini G et al.. Use and utility of endocrine multidisciplinary tumour board: an appraisal from a tertiary centre. Frontiers in endocrinology 2025. link 2 Young V, Beach RA. The Dermatologist is Out? Assessment of Dermatologists in Ontario Accepting Ontario Health Insurance Plan (OHIP) Referrals for Hair Loss Evaluation. Journal of cutaneous medicine and surgery 2025. link 3 Wang L, Chen S, Wu M, Zhou L. Comparative analysis of adverse event profiles of lanreotide and octreotide in somatostatin-responsive endocrine and neoplastic diseases. Scientific reports 2025. link 4 . What is traction alopecia?. Pediatric dermatology 2024. link 5 Duan J, He XH, Li SJ, Xu HE. Cryo-electron microscopy for GPCR research and drug discovery in endocrinology and metabolism. Nature reviews. Endocrinology 2024. link 6 Nasrullah A, Azharuddin S, Young M, Kejas A, Dumont T. Endocrine Emergencies in the Medical Intensive Care Unit. Critical care nursing quarterly 2022. link 7 Öner Ü, Akdeniz N. Nonscarring scalp alopecia: Which laboratory analysis should we perform on whom?. Turkish journal of medical sciences 2022. link 8 Kalra S, Unnikrishnan AG, Jacob JJ. Endocrine first aid. JPMA. The Journal of the Pakistan Medical Association 2021. link 9 Colin-Pierre C, Untereiner V, Sockalingum GD, Berthélémy N, Danoux L, Bardey V et al.. Hair Histology and Glycosaminoglycans Distribution Probed by Infrared Spectral Imaging: Focus on Heparan Sulfate Proteoglycan and Glypican-1 during Hair Growth Cycle. Biomolecules 2021. link 10 Savastio S, Cinquatti R, Tagliaferri F, Rabbone I, Bona G. Vitamin D effects and endocrine diseases. Minerva pediatrica 2020. link 11 Goodier CG. Endocrine Emergencies in Obstetrics. Clinical obstetrics and gynecology 2019. link 12 Richardson V, Agidi AT, Eaddy ER, Davis LS. Ten pearls every dermatologist should know about the appropriate use of relaxers. Journal of cosmetic dermatology 2017. link 13 Boca S, Berce C, Jurj A, Petrushev B, Pop L, Gafencu GA et al.. Ruxolitinib-conjugated gold nanoparticles for topical administration: An alternative for treating alopecia?. Medical hypotheses 2017. link 14 Campo D, D'Acunzo V. Doctors and baldness: a five thousand year old challenge. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia 2016. link 15 Wu M, Yu Q, Li Q. Differences in reproductive toxicology between alopecia drugs: an analysis on adverse events among female and male cases. Oncotarget 2016. link 16 Vidal CI. Overview of Alopecia: A Dermatopathologist's Perspective. Missouri medicine 2015. link 17 Kapellen TM, Kiess W. Transition of adolescents and young adults with endocrine diseases to adult health care. Best practice & research. Clinical endocrinology & metabolism 2015. link 18 Marcucci G, Cianferotti L, Beck-Peccoz P, Capezzone M, Cetani F, Colao A et al.. Rare diseases in clinical endocrinology: a taxonomic classification system. Journal of endocrinological investigation 2015. link 19 Paus R, Langan EA, Vidali S, Ramot Y, Andersen B. Neuroendocrinology of the hair follicle: principles and clinical perspectives. Trends in molecular medicine 2014. link 20 Plikus MV. At the dawn of hair research - testing the limits of hair follicle regeneration. Experimental dermatology 2014. link 21 Ramos-e-Silva M, Pirmez R. Disorders of hair growth and the pilosebaceous unit: facts and controversies. Clinics in dermatology 2013. link 22 Szabó PM, Butz H, Igaz P, Rácz K, Hunyady L, Patócs A. Minireview: miRomics in endocrinology: a novel approach for modeling endocrine diseases. Molecular endocrinology (Baltimore, Md.) 2013. link 23 Cossman JP, Ladizinski B, Lee KC. Pigmented concealing powders for the hair loss patient. Journal of cosmetic dermatology 2013. link 24 Tailor A, Asher RG, Craig PJ, Groves RW, Fenton DA, Stefanato CM. The current state of play in the histopathologic assessment of alopecia: two for one or one for two?. Journal of cutaneous pathology 2013. link 25 Luchins KR, Baker KC, Gilbert MH, Blanchard JL, Liu DX, Myers L et al.. Application of the diagnostic evaluation for alopecia in traditional veterinary species to laboratory rhesus macaques (Macaca mulatta). Journal of the American Association for Laboratory Animal Science : JAALAS 2011. link 26 Scheede S, Herpens A, Burmeister F, Oltrogge B, Saenger K, Schmidt-Rose T et al.. Qualification of a new and precise automatic tool for the assessment of hair diameters in phototrichograms. Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) 2011. link 27 Jimenez F, Izeta A, Poblet E. Morphometric analysis of the human scalp hair follicle: practical implications for the hair transplant surgeon and hair regeneration studies. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2011. link 28 Hedenmalm K, Sundström A, Spigset O. Alopecia associated with treatment with selective serotonin reuptake inhibitors (SSRIs). Pharmacoepidemiology and drug safety 2006. link 29 Bassett RJ, Burton GG, Robson DC. Recurrent flank alopecia in a Tibetan Terrier. Australian veterinary journal 2005. link 30 Mulinari-Brenner F, Bergfeld WF. Hair loss: diagnosis and management. Cleveland Clinic journal of medicine 2003. link 31 Müller-Röver S, Handjiski B, van der Veen C, Eichmüller S, Foitzik K, McKay IA et al.. A comprehensive guide for the accurate classification of murine hair follicles in distinct hair cycle stages. The Journal of investigative dermatology 2001. link 32 Fruscella P. Hair microtransplantation by the use of needles. Aesthetic plastic surgery 1998. link 33 Chiu HC, Chang CH, Chen JS, Jee SH. Human hair follicle dermal papilla cell, dermal sheath cell and interstitial dermal fibroblast characteristics. Journal of the Formosan Medical Association = Taiwan yi zhi 1996. link 34 Stough DB, Spencer DM, Schauder CS. New devices for scalp reduction. Intraoperative and prolonged scalp extension. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 1995. link 35 Meirson D, Reyes BA, Geronemus R. Presuturing in alopecia reductions. The Journal of dermatologic surgery and oncology 1990. link 36 Ohmori K. Free scalp flap. Plastic and reconstructive surgery 1980. link 37 Kubba R, Rook A. Congenital triangular alopecia. The British journal of dermatology 1976. link

    Original source

    1. [1]
      Use and utility of endocrine multidisciplinary tumour board: an appraisal from a tertiary centre. — Sparano C, Canu L, Perigli G, Santoro R, Pradella S, Grazzini G et al. Frontiers in endocrinology (2025)
    2. [2]
      The Dermatologist is Out? Assessment of Dermatologists in Ontario Accepting Ontario Health Insurance Plan (OHIP) Referrals for Hair Loss Evaluation. — Young V, Beach RA Journal of cutaneous medicine and surgery (2025)
    3. [3]
      Comparative analysis of adverse event profiles of lanreotide and octreotide in somatostatin-responsive endocrine and neoplastic diseases. — Wang L, Chen S, Wu M, Zhou L Scientific reports (2025)
    4. [4]
      What is traction alopecia? Pediatric dermatology (2024)
    5. [5]
      Cryo-electron microscopy for GPCR research and drug discovery in endocrinology and metabolism. — Duan J, He XH, Li SJ, Xu HE Nature reviews. Endocrinology (2024)
    6. [6]
      Endocrine Emergencies in the Medical Intensive Care Unit. — Nasrullah A, Azharuddin S, Young M, Kejas A, Dumont T Critical care nursing quarterly (2022)
    7. [7]
      Nonscarring scalp alopecia: Which laboratory analysis should we perform on whom? — Öner Ü, Akdeniz N Turkish journal of medical sciences (2022)
    8. [8]
      Endocrine first aid. — Kalra S, Unnikrishnan AG, Jacob JJ JPMA. The Journal of the Pakistan Medical Association (2021)
    9. [9]
      Hair Histology and Glycosaminoglycans Distribution Probed by Infrared Spectral Imaging: Focus on Heparan Sulfate Proteoglycan and Glypican-1 during Hair Growth Cycle. — Colin-Pierre C, Untereiner V, Sockalingum GD, Berthélémy N, Danoux L, Bardey V et al. Biomolecules (2021)
    10. [10]
      Vitamin D effects and endocrine diseases. — Savastio S, Cinquatti R, Tagliaferri F, Rabbone I, Bona G Minerva pediatrica (2020)
    11. [11]
      Endocrine Emergencies in Obstetrics. — Goodier CG Clinical obstetrics and gynecology (2019)
    12. [12]
      Ten pearls every dermatologist should know about the appropriate use of relaxers. — Richardson V, Agidi AT, Eaddy ER, Davis LS Journal of cosmetic dermatology (2017)
    13. [13]
      Ruxolitinib-conjugated gold nanoparticles for topical administration: An alternative for treating alopecia? — Boca S, Berce C, Jurj A, Petrushev B, Pop L, Gafencu GA et al. Medical hypotheses (2017)
    14. [14]
      Doctors and baldness: a five thousand year old challenge. — Campo D, D'Acunzo V Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia (2016)
    15. [15]
      Differences in reproductive toxicology between alopecia drugs: an analysis on adverse events among female and male cases. — Wu M, Yu Q, Li Q Oncotarget (2016)
    16. [16]
      Overview of Alopecia: A Dermatopathologist's Perspective. — Vidal CI Missouri medicine (2015)
    17. [17]
      Transition of adolescents and young adults with endocrine diseases to adult health care. — Kapellen TM, Kiess W Best practice & research. Clinical endocrinology & metabolism (2015)
    18. [18]
      Rare diseases in clinical endocrinology: a taxonomic classification system. — Marcucci G, Cianferotti L, Beck-Peccoz P, Capezzone M, Cetani F, Colao A et al. Journal of endocrinological investigation (2015)
    19. [19]
      Neuroendocrinology of the hair follicle: principles and clinical perspectives. — Paus R, Langan EA, Vidali S, Ramot Y, Andersen B Trends in molecular medicine (2014)
    20. [20]
      At the dawn of hair research - testing the limits of hair follicle regeneration. — Plikus MV Experimental dermatology (2014)
    21. [21]
      Disorders of hair growth and the pilosebaceous unit: facts and controversies. — Ramos-e-Silva M, Pirmez R Clinics in dermatology (2013)
    22. [22]
      Minireview: miRomics in endocrinology: a novel approach for modeling endocrine diseases. — Szabó PM, Butz H, Igaz P, Rácz K, Hunyady L, Patócs A Molecular endocrinology (Baltimore, Md.) (2013)
    23. [23]
      Pigmented concealing powders for the hair loss patient. — Cossman JP, Ladizinski B, Lee KC Journal of cosmetic dermatology (2013)
    24. [24]
      The current state of play in the histopathologic assessment of alopecia: two for one or one for two? — Tailor A, Asher RG, Craig PJ, Groves RW, Fenton DA, Stefanato CM Journal of cutaneous pathology (2013)
    25. [25]
      Application of the diagnostic evaluation for alopecia in traditional veterinary species to laboratory rhesus macaques (Macaca mulatta). — Luchins KR, Baker KC, Gilbert MH, Blanchard JL, Liu DX, Myers L et al. Journal of the American Association for Laboratory Animal Science : JAALAS (2011)
    26. [26]
      Qualification of a new and precise automatic tool for the assessment of hair diameters in phototrichograms. — Scheede S, Herpens A, Burmeister F, Oltrogge B, Saenger K, Schmidt-Rose T et al. Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) (2011)
    27. [27]
      Morphometric analysis of the human scalp hair follicle: practical implications for the hair transplant surgeon and hair regeneration studies. — Jimenez F, Izeta A, Poblet E Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (2011)
    28. [28]
      Alopecia associated with treatment with selective serotonin reuptake inhibitors (SSRIs). — Hedenmalm K, Sundström A, Spigset O Pharmacoepidemiology and drug safety (2006)
    29. [29]
      Recurrent flank alopecia in a Tibetan Terrier. — Bassett RJ, Burton GG, Robson DC Australian veterinary journal (2005)
    30. [30]
      Hair loss: diagnosis and management. — Mulinari-Brenner F, Bergfeld WF Cleveland Clinic journal of medicine (2003)
    31. [31]
      A comprehensive guide for the accurate classification of murine hair follicles in distinct hair cycle stages. — Müller-Röver S, Handjiski B, van der Veen C, Eichmüller S, Foitzik K, McKay IA et al. The Journal of investigative dermatology (2001)
    32. [32]
      Hair microtransplantation by the use of needles. — Fruscella P Aesthetic plastic surgery (1998)
    33. [33]
      Human hair follicle dermal papilla cell, dermal sheath cell and interstitial dermal fibroblast characteristics. — Chiu HC, Chang CH, Chen JS, Jee SH Journal of the Formosan Medical Association = Taiwan yi zhi (1996)
    34. [34]
      New devices for scalp reduction. Intraoperative and prolonged scalp extension. — Stough DB, Spencer DM, Schauder CS Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (1995)
    35. [35]
      Presuturing in alopecia reductions. — Meirson D, Reyes BA, Geronemus R The Journal of dermatologic surgery and oncology (1990)
    36. [36]
      Free scalp flap. — Ohmori K Plastic and reconstructive surgery (1980)
    37. [37]
      Congenital triangular alopecia. — Kubba R, Rook A The British journal of dermatology (1976)
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