Alopecia history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

History

A directed medical history should be obtained to ascertain if alopecia is the correct diagnosis.

• Age
  • Childhood: only 2 common diagnoses tinea capitis, alopecia areata
  • Adulthood: tinea capitis rare; all the rest possible
• Duration
  • <1 year: suggests telogen effluvium if diffuse loss
  • >1 year: suggests androgenetic alopecia if diffuse loss
  • Pattern of loss
  • Shedding: “lots of hair coming out,” may be due to hair breakage or loss by the root
  • Thinning: scalp more visible without noticeable hair fallout, suggests androgenetic alopecia
  • Family history: may be positive in androgenetic alopecia, alopecia areata
  • Grooming practices: can cause hair fragility/breakage
  • Chemical treatments (relaxers, perms, bleaching) most damaging; hair dye less so

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