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

Symptoms

Hair loss usually develops gradually and may be patchy or all over (diffuse). You lose roughly 100 hairs from your head every day. The average scalp contains about 100,000 hairs.