Trichotillomania associated with a 25-hydroxy vitamin D deficiency: A case report

Abstract

Vitamin D deficiency has been correlated with non-scarring alopecia including alopecia areata or female pattern hair loss. It was theorized that hair loss secondary to vitamin D deficiency in patients susceptible to trichotillomania may exacerbate this obsessive-compulsive disorder. Though vitamin D deficiency is common, especially among patients suffering from neuropsychiatric disorders, its correlation with trichotillomania is not well reported. Two female patients suffering from trichotillomania defined by noticeable hair loss on the scalp through the Massachusetts General Hospital Hair Pulling Scale were treated to promote hair growth. Treatment included dietary supplementation with vitamin D3 1000 IU every day. It was found that in both patients treated with vitamin D3, marked improvements occurred over the span of 3 to 4 months. These included a reduction in obsessive compulsive disorder related hair loss as measured using the Massachusetts General Hospital Hair Pulling Scale, which correlated to their serum 25-hydroxyvitamin D levels. Experimental and clinical evidence is available to explain the underlying physiology and its probable relationship to trichotillomania's pathophysiology.

Decreased vitamin D levels in obsessive-compulsive disorder patients

“…38 Finally, a correlation between vitamin D and trichotillomania, an OCD-related disorder, was highlighted in 2 women who improved after a treatment with vitamin D supplementation. 46 In our sample, no differences in vitamin D levels were noted between men and women, or between medicated or unmedicated patients, or among patients with different comorbidities. We only observed that patients (13) taking SGAs showed higher vitamin D values than patients (4) taking FGAs.…”

“…Another recent study revealed that patients with PANDAS showed a reduced level of vitamin D in comparison with healthy control subjects, independently from the seasons 38 . Finally, a correlation between vitamin D and trichotillomania, an OCD-related disorder, was highlighted in 2 women who improved after a treatment with vitamin D supplementation 46 …”

Role of vitamin D in hair loss: A short review

“…Vitamin D also improves hair growth by complex molecular pathways regulating the interaction between dermal papillary cells and surrounding epithelial stem cells. 29 To conclude, vitamin D supplementation along with psychopharmacological management may help to decrease the urge to pull hair and improve hair growth in TTM.…”

“…Vitamin D in a daily dose of 1000 IU for 3–5 months, reduced the urge to pull in TTM. Vitamin D also improves hair growth by complex molecular pathways regulating the interaction between dermal papillary cells and surrounding epithelial stem cells 29 …”

“…TTM is characterized by compulsive hair pulling and may be associated with other psychiatric conditions such as depression, body dysmorphic, and personality disorders. Vitamin and mineral supplementation, specifically vitamin D, improves the overall nutritional status and is linked with preventing many psychobehavioral paradigms 29. VDRs are present in the neuronal and glial cells within the central nervous system.…”