Saç Dökülmesi Şikayetiyle Başvuran Kadınlarda Non-Skatrisyel Alopesi: Klinik Özellikler ve Etkileyen Faktörler

Year 2026, Volume: 7 Issue: 1, 50 - 60, 31.01.2026

Gamze Tas Aygar , Muhammed Salih Karagöz , Hanife Karataş , Erkin Berkay Yılmaz , Pelin Kartal

https://doi.org/10.47482/acmr.1664241

Abstract

Amaç: Bu çalışmanın amacı, saç dökülmesi şikayetiyle dermatoloji polikliniğine başvuran kadın hastalarda skar bırakmayan (non-skarlı) alopesi tiplerinin özelliklerini ve bunları etkileyen faktörleri değerlendirmektir.

Yöntem: Saç dökülmesi olan toplam 213 kadın hasta çalışmaya dahil edildi. Saç dökülme süresi ortalama 25,3 ± 32,2 aydı. Klinik değerlendirme sonucunda telogen effluvium (TE), traksiyon alopesi (TA) ve androjenetik alopesi (AGA) tanıları konuldu. Hastalarda tiroid fonksiyonları (TSH, T4), vitamin ve mineral düzeyleri (D vitamini, B12, folat), demir eksikliği belirteçleri (ferritin) ve hematolojik parametreler (hemoglobin) incelendi. Ayrıca saç bağlama alışkanlıkları, başörtüsü kullanımı ve dermoskopik bulgular da kaydedildi.

Bulgular: TE, %75,6 oranıyla en yaygın alopesi türüydü. Ferritin düzeyleri, TE varlığı ile anlamlı şekilde ilişkili bulundu. TA, hastaların %41,8’inde saptandı. Başörtüsü kullananlarda TA gelişme riski daha yüksek bulunmakla birlikte (p <0,05), en güçlü risk faktörü saçı sıkı topuz veya at kuyruğu şeklinde bağlamaktı (olasılık oranı [OR]: 26,65). Saçını bağlamayanlarda TA oranı anlamlı şekilde daha düşüktü ve TA şiddetini etkileyen en önemli faktör başörtüsü kullanım süresiydi. Yirmi yıl veya daha uzun süre başörtüsü kullanan hastalarda, foliküler açıklığın kaybı ve perifoliküler eritem gibi dermoskopik bulguların daha yaygın olduğu gözlendi. Bu durum, uzun süreli mekanik stresin saç folikülleri ve çevre dokuda yapısal hasar ve inflamasyona yol açabileceğini düşündürmektedir. AGA prevalansı %31,4’tü ve sıklığı yaşla birlikte artmaktaydı. Hastaların çoğunda aile öyküsü mevcuttu. Dermoskopik olarak, AGA anlamlı şekilde saç kalınlığı farklılığı, vellus tüyleri ve sarı nokta pozitifliği ile ilişkilendirildi.

Sonuç: Skar bırakmayan alopesi durumlarını değerlendirirken, yaşam tarzı ve kültürel faktörlerin yanı sıra klinik ve dermoskopik bulgular da dikkate alınmalıdır.

Keywords

saç dökülmesi , telogen effluvium , traksiyonel alopesi , androgenetik alopesi , dermoskopi

Non-Scarring Alopecia in Women Presenting with Hair Loss: Clinical Features and Influencing Factors

Abstract

Background: This study aimed to evaluate the characteristics of non-scarring alopecia and the influencing factors in female patients presenting with hair loss.
Methods: A total of 213 female patients were included. Clinical diagnoses of telogen effluvium (TE), traction alopecia (TA), and androgenetic alopecia (AGA) were established. Laboratory evaluations included thyroid function (TSH, T4), vitamin and mineral levels (vitamin D, B12, folate), ferritin, and hemoglobin. Hair styling habits, headscarf use, and dermoscopic findings were also assessed.
Results: TE was the most prevalent type, observed in 75.6% of patients, with ferritin levels significantly associated with its presence. TA was identified in 41.8%, and its risk was significantly higher in individuals wearing headscarves (p<0.05), especially among those styling hair in tight buns or ponytails (OR: 26.65). TA severity correlated with the duration of headscarf use; individuals with ≥20 years of use demonstrated increased perifollicular erythema and loss of follicular openings, suggestive of chronic mechanical stress. AGA was detected in 31.4% of patients and was more common with advancing age. Most AGA patients had a positive family history. Dermoscopic features significantly associated with AGA included hair diameter variation, vellus hairs, and yellow dots.
Conclusion: In the assessment of non-scarring alopecia, both clinical and dermoscopic findings should be interpreted in light of individual lifestyle and cultural practices, which may play a contributory role in disease development and severity.

Keywords

hair loss , dermoscopy , telogen effluvium , traction alopecia , androgenetic alopecia

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