Alopecia epidemiology and demographics: Difference between revisions

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* Only limited studies on the prevalence of trichotillomania have been performed and these were done among U.S. university students, Israeli adolescents and older adults within the same community. The prevalence were between 500 per 100,000 to 2000 per 100,000. <ref name="pmid1938977">{{cite journal| author=Christenson GA, Pyle RL, Mitchell JE| title=Estimated lifetime prevalence of trichotillomania in college students. | journal=J Clin Psychiatry | year= 1991 | volume= 52 | issue= 10 | pages= 415-7 | pmid=1938977 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1938977  }} </ref> <ref name="pmid7559316">{{cite journal| author=King RA, Zohar AH, Ratzoni G, Binder M, Kron S, Dycian A | display-authors=etal| title=An epidemiological study of trichotillomania in Israeli adolescents. | journal=J Am Acad Child Adolesc Psychiatry | year= 1995 | volume= 34 | issue= 9 | pages= 1212-5 | pmid=7559316 | doi=10.1097/00004583-199509000-00019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7559316  }} </ref> <ref name="pmid19926375">{{cite journal| author=Duke DC, Keeley ML, Geffken GR, Storch EA| title=Trichotillomania: A current review. | journal=Clin Psychol Rev | year= 2010 | volume= 30 | issue= 2 | pages= 181-93 | pmid=19926375 | doi=10.1016/j.cpr.2009.10.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19926375  }} </ref>
* Only limited studies on the prevalence of trichotillomania have been performed and these were done among U.S. university students, Israeli adolescents and older adults within the same community. The prevalence were between 500 per 100,000 to 2000 per 100,000. <ref name="pmid1938977">{{cite journal| author=Christenson GA, Pyle RL, Mitchell JE| title=Estimated lifetime prevalence of trichotillomania in college students. | journal=J Clin Psychiatry | year= 1991 | volume= 52 | issue= 10 | pages= 415-7 | pmid=1938977 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1938977  }} </ref> <ref name="pmid7559316">{{cite journal| author=King RA, Zohar AH, Ratzoni G, Binder M, Kron S, Dycian A | display-authors=etal| title=An epidemiological study of trichotillomania in Israeli adolescents. | journal=J Am Acad Child Adolesc Psychiatry | year= 1995 | volume= 34 | issue= 9 | pages= 1212-5 | pmid=7559316 | doi=10.1097/00004583-199509000-00019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7559316  }} </ref> <ref name="pmid19926375">{{cite journal| author=Duke DC, Keeley ML, Geffken GR, Storch EA| title=Trichotillomania: A current review. | journal=Clin Psychol Rev | year= 2010 | volume= 30 | issue= 2 | pages= 181-93 | pmid=19926375 | doi=10.1016/j.cpr.2009.10.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19926375  }} </ref>
* Traction alopecia is more commonly seen among black populations with females being affected more often than males at a rate of about 31,000-32,000 per 100,000 women compared to about 2,300 per 100,000 men. Traction alopecia was seen in 18,000 per 100,000 girls between the ages of 5.4 to 14.3 years based on a study of African-American girls. An 8-month old girl was the youngest reported case in the study. <ref name="pmid29265342">{{cite journal| author=Aguado Lobo M, Jiménez-Reyes J| title=Traction alopecia. | journal=Int J Dermatol | year= 2018 | volume= 57 | issue= 2 | pages= 231-232 | pmid=29265342 | doi=10.1111/ijd.13846 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi? dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29265342  }} </ref>
* Traction alopecia is more commonly seen among black populations with females being affected more often than males at a rate of about 31,000-32,000 per 100,000 women compared to about 2,300 per 100,000 men. Traction alopecia was seen in 18,000 per 100,000 girls between the ages of 5.4 to 14.3 years based on a study of African-American girls. An 8-month old girl was the youngest reported case in the study. <ref name="pmid29265342">{{cite journal| author=Aguado Lobo M, Jiménez-Reyes J| title=Traction alopecia. | journal=Int J Dermatol | year= 2018 | volume= 57 | issue= 2 | pages= 231-232 | pmid=29265342 | doi=10.1111/ijd.13846 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi? dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29265342  }} </ref>
* Although considered to be a relatively common condition, the precise prevalence of telogen effluvium remains unknown. <ref name="pmid30237729">{{cite journal| author=Sant'Anna Addor FA, Donato LC, Melo CSA| title=Comparative evaluation between two nutritional supplements in the improvement of telogen effluvium. | journal=Clin Cosmet Investig Dermatol | year= 2018 | volume= 11 | issue=  | pages= 431-436 | pmid=30237729 | doi=10.2147/CCID.S173082 | pmc=6136400 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30237729  }} </ref>


===Incidence===
===Incidence===
* The overall incidence of alopecia areata is approximately 20.2 per 100,000 person-years. <ref name="pmid7791384">{{cite journal| author=Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ| title=Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989. | journal=Mayo Clin Proc | year= 1995 | volume= 70 | issue= 7 | pages= 628-33 | pmid=7791384 | doi=10.4065/70.7.628 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7791384  }} </ref>
* The overall incidence of alopecia areata is approximately 20.2 per 100,000 person-years. <ref name="pmid7791384">{{cite journal| author=Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ| title=Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989. | journal=Mayo Clin Proc | year= 1995 | volume= 70 | issue= 7 | pages= 628-33 | pmid=7791384 | doi=10.4065/70.7.628 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7791384  }} </ref>
* About 50,000 per 100,000 Caucasian males have androgenetic alopecia by the time they are 50 years old. This number rises up to about 80,000 per 100,000 by the age of 70 years. <ref name="pmid30034191">Mahmoudi H, Salehi M, Moghadas S, Ghandi N, Teimourpour A, Daneshpazhooh M (2018) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=30034191 Dermoscopic Findings in 126 Patients with Alopecia Areata: A Cross-Sectional Study.] ''Int J Trichology'' 10 (3):118-123. [http://dx.doi.org/10.4103/ijt.ijt_102_17 DOI:10.4103/ijt.ijt_102_17] PMID: [https://pubmed.gov/30034191 30034191]</ref>
* The incidence cutaneous lupus erythematosus is about 4.2 per 100,000 individuals, with the incidence being higher in males. <ref name="pmid25369985">{{cite journal| author=Jarukitsopa S, Hoganson DD, Crowson CS, Sokumbi O, Davis MD, Michet CJ | display-authors=etal| title=Epidemiology of systemic lupus erythematosus and cutaneous lupus erythematosus in a predominantly white population in the United States. | journal=Arthritis Care Res (Hoboken) | year= 2015 | volume= 67 | issue= 6 | pages= 817-28 | pmid=25369985 | doi=10.1002/acr.22502 | pmc=4418944 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25369985  }} </ref>


===Age===
===Age===
* Tinea capitis is more common among children and adolescents than in adults. <ref name="pmid24770502">Pires CA, Cruz NF, Lobato AM, Sousa PO, Carneiro FR, Mendes AM (2014) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24770502 Clinical, epidemiological, and therapeutic profile of dermatophytosis.] ''An Bras Dermatol'' 89 (2):259-64. [http://dx.doi.org/10.1590/abd1806-4841.20142569 DOI:10.1590/abd1806-4841.20142569] PMID: [https://pubmed.gov/24770502 24770502]</ref>
* Tinea capitis is more common among children and adolescents than in adults. <ref name="pmid24770502">Pires CA, Cruz NF, Lobato AM, Sousa PO, Carneiro FR, Mendes AM (2014) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24770502 Clinical, epidemiological, and therapeutic profile of dermatophytosis.] ''An Bras Dermatol'' 89 (2):259-64. [http://dx.doi.org/10.1590/abd1806-4841.20142569 DOI:10.1590/abd1806-4841.20142569] PMID: [https://pubmed.gov/24770502 24770502]</ref>
* The risk of androgenetic alopecia increases with age. Up to 80,000 per 100,000 Caucasian men over the age of 70 years have androgenetic alopecia compared to 50,000 per 100,000 in Caucasian men who are 50 years.
* Although the link between age and risk of telogen effluvium is currently unclear, it has been observed that elderly women are more susceptible to telogen effluvium after sustaining severe trauma or bleeding, having a high fever, or going through psychological stress <ref name="pmid23974577">{{cite journal| author=Grover C, Khurana A| title=Telogen effluvium. | journal=Indian J Dermatol Venereol Leprol | year= 2013 | volume= 79 | issue= 5 | pages= 591-603 | pmid=23974577 | doi=10.4103/0378-6323.116731 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23974577  }} </ref>. Studies have reported the incidence of telogen effluvium in children to be around 2.7% <ref name="pmid17919200">{{cite journal| author=Nnoruka EN, Obiagboso I, Maduechesi C| title=Hair loss in children in South-East Nigeria: common and uncommon cases. | journal=Int J Dermatol | year= 2007 | volume= 46 Suppl 1 | issue=  | pages= 18-22 | pmid=17919200 | doi=10.1111/j.1365-4632.2007.03457.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17919200  }} </ref>.


===Gender===
===Gender===
* In telogen effluvium, women are at higher predisposition than men.
* In telogen effluvium, women are at higher predisposition than men.
* Alopecia areata can occur in adults and children and distribution is about equal between the sexes <ref name="pmid29241771">{{cite journal| author=Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM | display-authors=etal| title=Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. | journal=J Am Acad Dermatol | year= 2018 | volume= 78 | issue= 1 | pages= 1-12 | pmid=29241771 | doi=10.1016/j.jaad.2017.04.1141 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29241771  }} </ref>.
* Alopecia areata can occur in adults and children and distribution is about equal between the sexes <ref name="pmid29241771">{{cite journal| author=Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM | display-authors=etal| title=Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. | journal=J Am Acad Dermatol | year= 2018 | volume= 78 | issue= 1 | pages= 1-12 | pmid=29241771 | doi=10.1016/j.jaad.2017.04.1141 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29241771  }} </ref>.
* Traction alopecia was seen most commonly in African-American females.
* Traction alopecia is seen most commonly in females, majority of whom are of African-American descent. <ref name="pmid29265342">{{cite journal| author=Aguado Lobo M, Jiménez-Reyes J| title=Traction alopecia. | journal=Int J Dermatol | year= 2018 | volume= 57 | issue= 2 | pages= 231-232 | pmid=29265342 | doi=10.1111/ijd.13846 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi? dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29265342  }} </ref>
* Cutaneous lupus erythematosus is more common in males than in females, with a ratio of about 59.4 per 100,000 versus 1.6 per 100,000. <ref name="pmid25369985">{{cite journal| author=Jarukitsopa S, Hoganson DD, Crowson CS, Sokumbi O, Davis MD, Michet CJ | display-authors=etal| title=Epidemiology of systemic lupus erythematosus and cutaneous lupus erythematosus in a predominantly white population in the United States. | journal=Arthritis Care Res (Hoboken) | year= 2015 | volume= 67 | issue= 6 | pages= 817-28 | pmid=25369985 | doi=10.1002/acr.22502 | pmc=4418944 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25369985  }} </ref>


===Race===
===Race===
* Traction alopecia was seen most commonly in African-American females.
* Traction alopecia is seen most commonly in African-American females. This is likely as a result of certain hairstyles that are more predominantly made by African-Americans <ref name="pmid29265342">{{cite journal| author=Aguado Lobo M, Jiménez-Reyes J| title=Traction alopecia. | journal=Int J Dermatol | year= 2018 | volume= 57 | issue= 2 | pages= 231-232 | pmid=29265342 | doi=10.1111/ijd.13846 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi? dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29265342  }} </ref>
* Caucasian males have the highest incidence of androgenetic alopecia. They are followed by Asian males, African-American males, and lastly, Native Americans and Eskimos. <ref name="pmid30034191">{{cite journal| author=Mahmoudi H, Salehi M, Moghadas S, Ghandi N, Teimourpour A, Daneshpazhooh M| title=Dermoscopic Findings in 126 Patients with Alopecia Areata: A Cross-Sectional Study. | journal=Int J Trichology | year= 2018 | volume= 10 | issue= 3 | pages= 118-123 | pmid=30034191 | doi=10.4103/ijt.ijt_102_17 | pmc=6028992 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30034191  }} </ref>
* Tinea capitis has a higher incidence among darker races. <ref name="pmid30511475">Owczarczyk-Saczonek A, Wygonowska E, Budkiewicz M, Placek W (2019) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=30511475 Serum sickness disease in a patient with alopecia areata and Meniere' disease after PRP procedure.] ''Dermatol Ther'' 32 (2):e12798. [http://dx.doi.org/10.1111/dth.12798 DOI:10.1111/dth.12798] PMID: [https://pubmed.gov/30511475 30511475]</ref>
* Tinea capitis has a higher incidence among darker races. <ref name="pmid30511475">Owczarczyk-Saczonek A, Wygonowska E, Budkiewicz M, Placek W (2019) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=30511475 Serum sickness disease in a patient with alopecia areata and Meniere' disease after PRP procedure.] ''Dermatol Ther'' 32 (2):e12798. [http://dx.doi.org/10.1111/dth.12798 DOI:10.1111/dth.12798] PMID: [https://pubmed.gov/30511475 30511475]</ref>
* Cutaneous lupus erythematosus is more common in males than in females, with a ratio of about 59.4 per 100,000 versus 1.6 per 100,000. <ref name="pmid25369985">{{cite journal| author=Jarukitsopa S, Hoganson DD, Crowson CS, Sokumbi O, Davis MD, Michet CJ | display-authors=etal| title=Epidemiology of systemic lupus erythematosus and cutaneous lupus erythematosus in a predominantly white population in the United States. | journal=Arthritis Care Res (Hoboken) | year= 2015 | volume= 67 | issue= 6 | pages= 817-28 | pmid=25369985 | doi=10.1002/acr.22502 | pmc=4418944 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25369985  }} </ref>
 


==References==
==References==

Revision as of 00:13, 14 January 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD

Overview

The epidemiology and demographics of alopecia varies by the type of alopecia as well as the age, race, sex, hygiene, haircare habits and health status of an individual. For example, in androgenetic alopecia, which has the highest prevalence of all the types of alopecia with about 50,000 per 100,000 men and 15,000 per 100,000 women worldwide, age and sex playing a role shown by the fact that men are more affected than women and post-menopausal women represent the highest proportion among females. In the case of alopecia areata, sex plays no role [1] but fair skinned races are more commonly affected and the prevalence is about 100-200 per 100,000 individuals [1] [2].

Epidemiology and Demographics

Prevalence

  • Androgenetic alopecia is believed to have a worldwide prevalence of about 50,000 per 100,000 men and 15,000 per 100,000 women with postmenopausal women making up the majority. [3]
  • Alopecia areata has a prevalence of 100-200 per 100,000 individuals [1] [2], and risk of about 2% over an individual's life. [1] [2]. The mean age for diagnosis of alopecia areata is 32 years in males and 36 years in females based on a study of the population of Olmsted County, Minnesota which was done between 1990 to 2009 [4].
  • Only limited studies on the prevalence of trichotillomania have been performed and these were done among U.S. university students, Israeli adolescents and older adults within the same community. The prevalence were between 500 per 100,000 to 2000 per 100,000. [5] [6] [7]
  • Traction alopecia is more commonly seen among black populations with females being affected more often than males at a rate of about 31,000-32,000 per 100,000 women compared to about 2,300 per 100,000 men. Traction alopecia was seen in 18,000 per 100,000 girls between the ages of 5.4 to 14.3 years based on a study of African-American girls. An 8-month old girl was the youngest reported case in the study. [8]
  • Although considered to be a relatively common condition, the precise prevalence of telogen effluvium remains unknown. [9]

Incidence

  • The overall incidence of alopecia areata is approximately 20.2 per 100,000 person-years. [2]
  • About 50,000 per 100,000 Caucasian males have androgenetic alopecia by the time they are 50 years old. This number rises up to about 80,000 per 100,000 by the age of 70 years. [10]
  • The incidence cutaneous lupus erythematosus is about 4.2 per 100,000 individuals, with the incidence being higher in males. [11]

Age

  • Tinea capitis is more common among children and adolescents than in adults. [12]
  • The risk of androgenetic alopecia increases with age. Up to 80,000 per 100,000 Caucasian men over the age of 70 years have androgenetic alopecia compared to 50,000 per 100,000 in Caucasian men who are 50 years.
  • Although the link between age and risk of telogen effluvium is currently unclear, it has been observed that elderly women are more susceptible to telogen effluvium after sustaining severe trauma or bleeding, having a high fever, or going through psychological stress [13]. Studies have reported the incidence of telogen effluvium in children to be around 2.7% [14].

Gender

  • In telogen effluvium, women are at higher predisposition than men.
  • Alopecia areata can occur in adults and children and distribution is about equal between the sexes [1].
  • Traction alopecia is seen most commonly in females, majority of whom are of African-American descent. [8]
  • Cutaneous lupus erythematosus is more common in males than in females, with a ratio of about 59.4 per 100,000 versus 1.6 per 100,000. [11]

Race

  • Traction alopecia is seen most commonly in African-American females. This is likely as a result of certain hairstyles that are more predominantly made by African-Americans [8]
  • Caucasian males have the highest incidence of androgenetic alopecia. They are followed by Asian males, African-American males, and lastly, Native Americans and Eskimos. [10]
  • Tinea capitis has a higher incidence among darker races. [15]


References

  1. 1.0 1.1 1.2 1.3 1.4 Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM; et al. (2018). "Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis". J Am Acad Dermatol. 78 (1): 1–12. doi:10.1016/j.jaad.2017.04.1141. PMID 29241771.
  2. 2.0 2.1 2.2 2.3 Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ (1995). "Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989". Mayo Clin Proc. 70 (7): 628–33. doi:10.4065/70.7.628. PMID 7791384.
  3. Rinaldi F, Marzani B, Pinto D, Sorbellini E (2019). "Randomized controlled trial on a PRP-like cosmetic, biomimetic peptides based, for the treatment of alopecia areata". J Dermatolog Treat. 30 (6): 588–593. doi:10.1080/09546634.2018.1544405. PMID 30513014.
  4. Mirzoyev SA, Schrum AG, Davis MDP, Torgerson RR (2014). "Lifetime incidence risk of alopecia areata estimated at 2.1% by Rochester Epidemiology Project, 1990-2009". J Invest Dermatol. 134 (4): 1141–1142. doi:10.1038/jid.2013.464. PMC 3961558. PMID 24202232.
  5. Christenson GA, Pyle RL, Mitchell JE (1991). "Estimated lifetime prevalence of trichotillomania in college students". J Clin Psychiatry. 52 (10): 415–7. PMID 1938977.
  6. King RA, Zohar AH, Ratzoni G, Binder M, Kron S, Dycian A; et al. (1995). "An epidemiological study of trichotillomania in Israeli adolescents". J Am Acad Child Adolesc Psychiatry. 34 (9): 1212–5. doi:10.1097/00004583-199509000-00019. PMID 7559316.
  7. Duke DC, Keeley ML, Geffken GR, Storch EA (2010). "Trichotillomania: A current review". Clin Psychol Rev. 30 (2): 181–93. doi:10.1016/j.cpr.2009.10.008. PMID 19926375.
  8. 8.0 8.1 8.2 Aguado Lobo M, Jiménez-Reyes J (2018). dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29265342 "Traction alopecia" Check |url= value (help). Int J Dermatol. 57 (2): 231–232. doi:10.1111/ijd.13846. PMID 29265342.
  9. Sant'Anna Addor FA, Donato LC, Melo CSA (2018). "Comparative evaluation between two nutritional supplements in the improvement of telogen effluvium". Clin Cosmet Investig Dermatol. 11: 431–436. doi:10.2147/CCID.S173082. PMC 6136400. PMID 30237729.
  10. 10.0 10.1 Mahmoudi H, Salehi M, Moghadas S, Ghandi N, Teimourpour A, Daneshpazhooh M (2018) Dermoscopic Findings in 126 Patients with Alopecia Areata: A Cross-Sectional Study. Int J Trichology 10 (3):118-123. DOI:10.4103/ijt.ijt_102_17 PMID: 30034191
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