Women presenting with diffuse hair loss is a common challenging problem encountered by the dermatologists. The most common cause is telogen effluvium which is often triggered by endocrine, nutritional or autoimmune etiologies. However, in chronic telogen effluvium (CTE) wherein the hair loss lasts for more than 6 months, the precipitant is often not identified and it is often a routine practice to supplement these patients with biotin and micronutrients like zinc, copper, iron and selenium. The rationale of supplementation is based on the observation that alopecia is one of many consequences associated with biotin, copper and zinc deficiencies. However till date there are no evidences to support deficiency of biotin or these micronutrients and there are no clinical trials to demonstrate their supplementation to be effective in hair loss (CTE).  This is also the case with iron deficiency, which is often believed to be a cause of hair loss (CTE) , wherein the literature reports are inconsistent regarding role of iron supplementation. Some nutritional supplements are, however, approved as drugs not requiring prescriptions and not reimbursable by health care insurers. In addition, it has also been reported that excessive intakes of nutritional supplements may actually cause hair loss and are not recommended in the absence of a proven deficiency.

Hence, we propose to study the levels of biotin and copper in serum and hair of women with chronic telogen effluvium in comparison to those without hair loss. If a deficiency of biotin and copper is observed in those with hair loss, we would like to estimate the cut off levels at which hair loss occurs.