Factors Associated with Premature Hair Graying in a Young Indian Population

Premature Graying of Hair: A Comprehensive Review and Recent Insights

Background

Hair symbolizes well-being and self-expression, with graying occurring naturally among different racial groups at varying ages. Premature graying has psychological and societal impacts, influencing self-esteem and quality of life. Gray hair usually advances gradually and is permanent, with occasional reports of natural repigmentation. Premature graying of hair (PMGH) results from a complex interplay of genetic, environmental, and cellular factors.

Materials and Methods

Studies exploring links between gray hair and conditions such as osteopenia, hearing loss, smoking, obesity, dyslipidemia, and cardiovascular disease have yielded mixed results. Despite continuous research into the causes of gray hair, effective, evidence-based treatments are lacking and still need to be improved.

Conclusion

Herein, we reviewed the causes, mechanisms, risk factors, psychosocial effects, and emerging therapies for PMGH.

Cardiovascular risk markers in premature canities

Background An elevated cardiovascular risk has been demonstrated in middle-aged individuals with onset of hair greying before the age of 30 years. Increased serum levels of pro-inflammatory cytokines, interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), indicate an ongoing state of chronic inflammation that is correlated with cardiovascular risk but have not been studied earlier in patients with early onset of hair greying. Aim/Objective To study various cardiovascular risk markers including pro-inflammatory cytokines interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) in patients with premature canities. Methods This was a hospital-based case-control study of 40 patients with premature canities (age between 19 and 25 years; >5 grey hair) and an equal number of age and gender-matched healthy controls. The blood pressure, pulse rate and body mass index were recorded, and investigations including fasting blood sugar, serum insulin, fasting lipid profile, high sensitivity c-reactive protein (hs-CRP), IL-6 and TNF-α were performed. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated for all the participants. Results The mean blood pressure, fasting blood sugar, serum insulin, hs-CRP and HOMA-IR were all significantly elevated in patients with premature canities and the serum HDL levels were significantly lower. A greater number of patients with premature canities had significantly elevated IL-6 as compared with the controls. Limitations The sample size was small. A subjective scale was used for grading the severity of premature canities. Trichoscopic evaluation of severity of greying or modified phototrichogram could not be used in this study. Conclusion Abnormalities in cardiovascular risk markers were found in patients with premature canities. Screening and counselling of patients with premature greying of hair is recommended in order to prevent future cardiovascular disease.

Expression of Melanocortin-1 Receptor and Serum Melanin in Canities at Young Male students

BACKGROUND: Molecular genetics suggest that hair pigmentation is related to the melanocortin-1 receptor gene. It is a G protein-coupled receptor, which is activated by a number of peptides to stimulate melanogenesis. Melanocortin-1 receptor gene mutation tends to produce functional variability in premature hair graying (PHG) or canities. AIM: Therefore, the objective of this study was to determine melanocortin-1 receptor expression and asses serum melanin in college students canities at Universitas Sumatera Utara. METHODS: This study was a cross-sectional design. We recruited 80 subjects equally divided into normal (control) and premature hair graying groups. The sample included males, aged 25 years who had gray hair and had no history of pigmentary disorders of the skin. Expression of melanocortin-1 receptor was detected with conventional PCR and serum melanin was measured with Elisa using Elisa kit melanin for human. RESULTS: The results showed that the Mean ± SD graying age was 20.28 ± 1.99 years with an age range of 19–24 years and the average age in the control group was 21.25 ± 2.02 years with an age range of 18–24 years. Melanocortin-1 receptor gene expression was shown in the control and PHG groups. Serum melanin levels were decreased significantly (p = 0.0001) in the gray-haired group was 9.27 ± 1.62 μg/dl and the control group was 10.72 ± 1.78 μg/dl. CONCLUSION: Melanocortin-1 receptor gene plays a role in hair graying at young age and there serum melanin levels were low significantly.

Analysis of Zinc and Copper Serum Levels in Premature Hair Graying at Young Age

BACKGROUND: Premature canities or premature hair graying is a terminology for early hair graying at an unusual age, with unclear etiology. The pathogenesis of graying is multifactorial such as genetic, environmental, and nutritional factors. The risk factor of premature graying is a deficiency of micronutrient serum such as zinc, copper, and selenium. AIM: The aim of the present study was to examine the role of zinc and copper serum concentrations in premature hair graying as well as the relationship between them. MATERIALS AND METHODS: This study was a cross-sectional recruited 40 consecutive respondents suffering from premature graying and healthy controls, male sex and aged <25 years. The serum samples were collected to detect zinc and copper with atomic absorption spectrophotometry. RESULTS: The mean age of cases was 20.28 ± 1.99 years and controls were 21.25 ± 2.02. Zinc serum concentration was significantly lower in premature hair graying compared with controls (0.48 ± 0.19 vs. 1.92 ± 0.68 ug/dL, p = 0.001) while copper serum concentration was not significantly lower in premature hair gray compared with controls (0.08 ± 0.03 vs. 0.09 ± 0.18 ug/dL, p = 0.706). CONCLUSION: A low zinc serum level may contribute to premature hair graying of college students at Universitas Sumatera Utara.

A clinical study of premature canities and its association with hemoglobin, ferritin and calcium levels

Background and Objectives:

Greying of hair is a regular feature of chronological aging that occurs in all regions and races. Premature canities is defined as minimum of five grey hairs in a person less than 20 years in Whites, 25 years in Asians, and 30 years in Africans. Premature canities is a common yet incompletely understood dermatological entity. This study aims at finding any association between premature hair greying (PHG) and parameters like hemoglobin (Hb), ferritin and calcium levels as well as its clinical profile.

Methodology:

This was a hospital-based cross-sectional analytical study conducted in the Department of Dermatology and Venereology, Trivandrum over one and half years. The study population consisted of 40 cases and 40 controls. Severity assessment, calculation of body mass index, and estimation of hemoglobin, serum ferritin, calcium, Random blood sugar, Anti Thyroid Peroxidase antibody, T3, T4, and TSH were done.

Results:

The mean age of the 40 patients was 17.14 years and most patients had onset of greying between 16 and 20 years. The male to female ratio was 1.2:1. A positive family history with a paternal predominance was noted. Vertex was the most common site of onset (42.5%), diffuse pattern was the most common clinical pattern (47.5%) and 60% had involvement of mild grade. Fourteen patients (35%) had abnormal investigations reports, in terms of low ferritin levels in 7 (17.5%), low calcium in 4 (10%) and a low Hb levels in 3 (7.5%) patients. Six (15%) patients had raised Anti TPO values. The association of PHG with low ferritin and raised anti-TPO levels were statistically significant.

Conclusion:

Low serum ferritin and raised Anti TPO levels may have a role in premature hair greying.

A Community Based Study to Estimate Prevalence and Determine Correlates of Premature Graying of Hair among Young Adults in Srinagar, Uttarakhand, India

Background

There are several ways by which aging is identified, of which graying of hair is perhaps the most common way. Nowadays, graying of hairs, which was expected to occur after 40s, can be easily observed among younger age group, even before 20s. The present study aims to estimate the prevalence of graying of hairs and its correlates among young adults in Srinagar, Uttarakhand, India.

Methodology

A community-based cross-sectional study was conducted among 384 young adults between 15 and 30-year age group in the urban area of Srinagar tehsil of Pauri district. Graying of hair was assessed on the basis of the number of white hairs on examination of scalp.

Results

The prevalence of premature graying of hairs (PMGHs) was found to be 27.3%. Binary logistic regression analysis showed that a paternal history of PMGH, history of smoking, maternal history of PMGH, sunlight exposure, and body mass index were significant predictors of PMGH.

Limitations

The factors found associated could be better determined through a follow-up study which could not be done in the current study. The present study was carried in a tehsil of one district of Uttarakhand therefore has limited external validity.

Conclusion

The present study highlights the importance of maintaining a healthy lifestyle as well as adequate exposure to sunlight in preventing PMGH.

Epidemiological and biochemical factors (serum ferritin and vitamin D) associated with premature hair graying in Egyptian population

BACKGROUND

The etiology of premature hair graying (PHG) remains incompletely understood with limited treatment options, although has profound impacts on patient's quality of life.

AIMS

To assess demographic and clinical profiles of Egyptian PHG patients and explore association of various epidemiological risk factors and serum vitamin D and ferritin levels with PHG.

PATIENTS AND METHODS

Three hundred PHG patients and equal number of controls, aged <30 years, were included. Assessment of epidemiological and clinical characteristics, biometric data and stress perception using perceived stress scale (PSS-10) was done, with measurement of serum vitamin D and ferritin levels for all subjects. PHG was graded into mild, moderate, and severe if <10, 10-100, and >100 gray hairs, respectively. Statistical significance for various compared parameters was done employing suitable tests, with P-value ≤ .05 considered significant.

RESULTS

Results reported significant positive relation of PHG with family history, sedentary life style, and stress (P = .001, .029, and .001, respectively), while no significant relation with smoking, body mass index, or frequent hair dyes use (>3 per year) (P = .425, .5, and .65, respectively). No significant difference was found in mean vitamin D between patients and controls (23.79 ± 13.01 ng/mL vs 24.85 ± 13.19 ng/mL, P = .701), while low serum ferritin (<20 ng/mL) was significantly associated with PHG (14.7 % patients vs 2.7% controls, P = .017).

CONCLUSION

PHG in Egyptian population is significantly associated with positive family history, stress, sedentary life style, and low serum ferritin level, while role of vitamin D deficiency should be further evaluated.

Premature graying of hair: Risk factors, co-morbid conditions, pharmacotherapy and reversal-A systematic review and meta-analysis

Premature graying of hair (PGH) being a very common entity for which pharmacotherapy and reversibility are not properly addressed. Therefore, this systematic review was conducted to address these issues. For this relevant study were selected from various databases including PubMed, EMBASE, OVID, Web of science, Scopus, and Google Scholar till January 20, 2019. Studies which reported risk factors, co-morbid conditions associated with PGH, its pharmacotherapy and reversal were included in the study. Although many risk factors are reported in literature, smoking, vitamin deficiency (B12, folic acid, and B7), mineral deficiency (low serum calcium and serum ferritin) are found to be associated with PGH. Other important risk factors are family history of PGH, obesity, high B.P, lack of exercise, drugs, genetic syndromes, dyslipidemia, thyroid disorders, hyperuricemia, and alteration in liver function. PGH is found to be an important marker of CAD, more so in case of smoker. Among different pharmacotherapeutic management options, low grade recommendation (2A) is given to calcium pantothenate, PABA, calcium pantothenate + PABA combination. Anu-tailam is the only herbal agent evaluated in clinical research settings. Finally, treating the accompanying pathologies led to the reversal of the disease in many cases.

A Study of Association of Premature Graying of Hair and Osteopenia in North Indian Population

Context:

Hair graying is one of the signs of human aging and is caused by a progressive loss of pigmentation from growing hair shafts. Studies have shown a correlation of early hair graying with osteopenia, indicating that premature graying could serve as an early marker of osteopenia.

Aim:

To compare the degree of osteopenia in individuals with premature graying of hair (PGH) compared to ordinary individuals.

Settings and Design:

We conducted an observational, case–control study among 132 healthy individuals between 18 and 30 years of age.

Subjects and Methods:

Detailed history and examination of PGH was taken. Bone mineral density (BMD) was assessed using Furuno CM-200 ultrasound bone densitometer.

Statistical Analysis:

SPSS 21 software was used, and the data were summarized in the form of mean ± standard deviation for quantitative values and percentages for qualitative values. Chi–square test, Student's t-test, analysis of variance, and other appropriate tests were applied for comparison, and P < 0.05 was considered statistically significant.

Results:

PGH was present in 82 (62.1%) cases, whereas osteopenia was present in 56 (42.4%) cases. The mean age of onset of graying of hair among the cases was 20.62 ± 3.74 years. A higher age group of 25–30 years (P = 0.016) and family history of PGH (P < 0.001) were significant risk factors for PGH. The mean BMD of the case group was 0.76 ± 1.00 and the control group was 0.68 ± 1.11, but the difference was not statistically significant (P = 0.649).

Conclusion:

The study concluded that there is no significant association between osteopenia and PGH.

Therapeutics of premature hair graying: A long journey ahead

Premature graying of hair has major psychosocial and socioeconomic repercussion, as it is considered as a sign of hastily progressing old age, ill health and often leads to loss of self-esteem. Hair is said to gray prematurely when it happens before the age of 20 years in Caucasians, 25 years in Asians, and 30 years in Africans. The hair color chiefly depends on melanin pigment, and fabrication of this pigment takes place in melanosomes through the process of melanogenesis. This complex biochemical pathway (melanogenesis) is further dependent on tyrosinase which acts as fuel.The normal human scalp is subjected to various factors categorized as intrinsic and extrinsic leading to graying of hair. Intrinsic factors comprise of variants responsible for changes at genetic level while extrinsic factors include air pollution, ultraviolet radiation, smoking, and nutrition. It has been proposed that direct or indirect effect of all these factors results in the generation of reactive oxygen species (ROS), thus leading to further damage. Though research has expanded in last few years in terms of microscopic, biochemical (hormonal, enzymatic), and molecular changes happening within hair follicle/shaft, still the exact mechanism leading to premature graying of hair is not well understood. Probable solutions toward this quandary are diet, herbal remedies, and temporary hair colorants. Ironically, the latter one being the most common has various side effects such as allergic reactions, inflammation, and hair loss. The aim of this paper was to review the manifestation and probable future interventions in preventing premature hair graying.

Serum levels of lead and selenium in patients with premature graying of the hair

BACKGROUND

The exact etiology of premature hair graying (PHG) remains unknown; however, oxidative stress is shown to be involved. Selenium, as an antioxidant, is widely known for its antiaging potentials. Moreover, PGH is more prevalent among addicts and because Lead is a common impurity found in illegal drug.

AIMS

We evaluated the serum levels of lead and selenium in patients with PHG and compared it with a control group.

PATIENTS/METHODS

In this cross-sectional study, 60 patients referred to Dermatology Clinic of Imam-Reza Hospital of Mashhad, Iran in 2015 were evaluated in two groups with and without PHG. Demographic information and disease characteristics, skin phenotype, and family history of PHG were recorded. Furthermore, 5 mL of brachial blood was drawn for measuring selenium and lead levels.

RESULTS

The mean patients' age was 28.1 ± 4.8 years. Age, sex, occupation, and skin phenotype in individuals with and without PHG were not significantly different (P > .05) but family history of PHG was significantly higher in the patients with PHG (P = .001). Similarly, the number of white hairs was significantly higher (P < .001), and the age of onset of hair graying was significantly lower in patients with PHG (P < .001). Serum levels of selenium and lead were not significantly different between two groups (P < .05). However, the serum levels of lead in the patients with PHG were slightly higher.

CONCLUSIONS

The results of this study showed that there was no significant difference in lead and selenium serum levels in patients with and without PHG.

Relationship between Trace Elements and Premature Hair Graying

Context:

Hair is said to gray prematurely when a minimum of five gray hairs occurs before the age of 20 in fair skinned, 25 in Asians, and 30 in Africans. It may be genetically associated with autoimmune syndromes or certain environmental factors.

Aims:

The aim of this study was to evaluate the serum level of iron, copper, and calcium and to assess their role in premature hair graying.

Subjects and Methods:

This study was carried out on 60 patients with premature hair graying (PHG) and 30 age- and sex-matched healthy individuals served as a control group. The severity of PHG was assessed by the hair whitening scoring system. Serum iron, copper, and calcium concentrations were measured using Beckman Coulter instrument and spectrophotometric method.

Results:

There was a reduction in serum levels of iron, copper, and calcium in patients with PHG in comparison with controls. There was a statistically negative significant correlation between the severity of PHG and serum iron and calcium levels. There was a negative nonsignificant correlation between body mass index and serum iron, copper, and calcium levels.

Conclusions:

Serum iron, copper, and calcium levels were reduced in association with PHG and correlated with its severity. Premature graying may be an indicator that hair is not getting enough nutrients and minerals, and supplementation with these trace elements might reverse and is expected to prevent progression of canities; however, further studies are needed to find the underlying mechanism of this relationship.

Three Streams for the Mechanism of Hair Graying

Hair graying is an obvious sign of human aging. Although graying has been investigated extensively, the mechanism remains unclear. Here, we reviewed previous studies on the mechanism of graying and seek to offer some new insights. The traditional view is that hair graying is caused by exhaustion of the pigmentary potential of the melanocytes of hair bulbs. Melanocyte dysfunction may be attributable to the effects of toxic reactive oxygen species on melanocyte nuclei and mitochondria. A recent study suggests that bulge melanocyte stem cells (MSCs) are the key cells in play. Graying may be caused by defective MSC self-maintenance, not by any deficiency in bulbar melanocytes. Our previous study suggested that graying may be principally attributable to active hair growth. Active hair growth may produce oxidative or genotoxic stress in hair bulge. These internal stress may cause eventually depletion of MSC in the hair follicles. Taken together, hair graying may be caused by MSC depletion by genotoxic stress in the hair bulge. Hair graying may also be sometimes caused by dysfunction of the melanocytes by oxidative stress in the hair bulb. In addition, hair graying may be attributable to MSC depletion by active hair growth.

Association of Epidemiological and Biochemical Factors with Premature Graying of Hair: A Case-Control Study

Background:

Premature hair graying (PHG) is often a matter of great concern for patients as it is viewed as a sign of increasing age, debility, decreasing vigor, and may lead to low self-esteem and psychological morbidity. Its etiopathogenesis is not completely understood but genetic, and various acquired factors have been implicated. The present study was undertaken to evaluate various epidemiological and biochemical variables associated with PHG.

Materials and Methods:

A cross-sectional case–control study was conducted at a tertiary care hospital in North India for 1 year which comprised 120 patients and equal number of controls. Various epidemiological variables were recorded and compared to controls. Serum ferritin, serum calcium, serum Vitamin D, serum Vitamin B12, lipid profile, thyroid profile, and fasting blood sugar were measured and compared among cases and controls.

Results:

Significantly higher proportion of cases had atopic diathesis, sedentary lifestyle, family history, history of smoking, and higher perceived stress values as compared to controls. Hair oiling seemed to protect against premature graying. Significantly, lower levels of serum calcium, ferritin, Vitamin B12, high-density lipoprotein-cholesterol, and high low-density lipoprotein-cholesterol were observed among cases.

Conclusion:

In the light of the present study, further studies with larger sample size are required to establish the definite etiological significance of these variables and formulate various preventive and therapeutic targets to prevent and treat PHG.

Premature Graying of Hair: Review with Updates

Premature graying of hair (PGH) is defined as graying of hair before the age of 20 years in Caucasians and before 30 years in African American population. It can severely affect the self-esteem of an individual. The exact etiopathogenesis remains unknown, although it has been associated with premature aging disorders, atopy, and autoimmune diseases. Patients, who present with PGH, should be assessed for syndromes and metabolism diseases. Hair dyes remain the main modality of the treatment for cosmetic concerns after nutritional supplementation.