Is more hair always better? A single biopsy specimen is preferred for the evaluation of alopecia

Hair loss is both a common chief complaint by patients and a clinical challenge for physicians, especially general practitioners, yet few dermatological problems yield as much patient satisfaction when resolved as hair loss. The diagnosis is often attributed to androgen-related hair loss, while other causes, some of which are life-threatening but treatable, are overlooked. We searched for relevant literature on hair loss and supported these findings with our clinical experience to identify seven major systemic etiologies of hair loss, ranging from infectious agents to consumption of unsafe supplements. Many causes are only described in the literature through case studies, though some original articles and meta-analyses are available. Careful history taking, proper examination techniques, and judicious use of laboratory tests are essential to reach at the correct diagnosis in a cost-effective manner when performing patient work-up. Such methodical evaluation of hair loss can result in the appropriate treatment plan and provide significant patient satisfaction. Key messages Hair loss is a common chief complaint and a difficult challenge for both general practitioners and dermatology consultants. We identified seven major categories of systemic hair loss etiology and present a framework for their clinical evaluation. A methodical approach to hair loss can result in the appropriate treatment plan and provide significant patient satisfaction.

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Systemic causes of hair loss

Lin

Garibyan

Kimball

et al. 2016

Annals of Medicine

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A New Subtype of Lichen Planopilaris Affecting Vellus Hairs and Clinically Mimicking Androgenetic Alopecia

Abbasi¹,

Kamyab‐Hesari

Rabbani

et al. 2016

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Diagnostic value of horizontal versus vertical sections for scarring and non-scarring alopecia: a systematic review and meta-analysis

Du¹,

Li²,

Wang³

et al. 2016

European Journal of Dermatology

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Is more hair always better? A single biopsy specimen is preferred for the evaluation of alopecia

Cited by 3 publications

References 2 publications

Systemic causes of hair loss

Systemic causes of hair loss

A New Subtype of Lichen Planopilaris Affecting Vellus Hairs and Clinically Mimicking Androgenetic Alopecia

Diagnostic value of horizontal versus vertical sections for scarring and non-scarring alopecia: a systematic review and meta-analysis

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