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Hair pigmentation is regulated by melanogenesis within the follicle and modulated by various factors, including melanocyte-stimulating hormone (MSH), adrenocorticotropic hormone (ACTH), endothelin-1, prostaglandins, leukotrienes, fibroblast growth factors, nitric oxide, catecholamines, as well as essential vitamins and minerals

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Pruritis was also found in a number of patients, and severity varied along with thyroid state in five out of the 108 cases (4.63%)

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Furthermore, transcriptomics performed from TMX2 deleted PR 20 and GR 20 expressing neurons revealed upregulation of pro-survival unfolded protein response (UPR) pathway genes and downregulation of calcium-binding and apoptotic genes