Zinc deficiency associated with hypothyroidism: an overlooked cause of severe alopecia

Abstract

Hypothyroidism is a common and well recognized cause of diffuse hair loss. Zinc and other trace elements such as copper and selenium are required for the synthesis of thyroid hormones, and deficiency of these can result in hypothyroidism. Conversely, thyroid hormones are essential for the absorption of zinc, and hence hypothyroidism can result in acquired zinc deficiency. The hair loss attributed to hypothyroidism may not improve with thyroxine unless zinc supplements are added, as demonstrated in our case.

Keywords: Alopecia; hypothyroidism; zinc deficiency.

Figure 1

Diffuse alopecia of the scalp

Figure 2

Annular, erythematous, and scaly patches over the nape of neck

Figure 3

Scaling of the face with loss of eyebrows and eyelashes

Figure 4

Complete alteration of the appearance following thyroxine and zinc supplementation

Figure 5

Subsidence of the skin lesions and regrowth of hair following zinc supplementation