Overview
Alopecia areata is an autoimmune non-scarring hair follicle disease characterized by patches of significant hair loss. While androgenic alopecia is a chronic follicular disorder characterized by progressive hair loss with a patterned distribution.
Alopecia may be abrupt or gradual in onset.
Severity of Alopecia Tool (SALT) is commonly used in assessing the severity of alopecia based on the area of scalp hair loss.
Early intervention, when thinning is first noticed hairs are incompletely miniaturized, optimizes treatment.
For further information regarding the management of Alopecia, please refer to Disease Algorithm for the Treatment Guideline.
Frequently Asked Questions
https://tradepress-cms.mims.com/disease/alopecia/management?subsection=pharmacological-therapyWhat are common causes of alopecia?
Alopecia may be non-scarring or scarring. Common non-scarring causes include androgenetic alopecia, telogen effluvium, alopecia areata, traction alopecia, and drug-related hair loss. Scarring alopecia is less common but important because follicular destruction may cause permanent loss. Clinical pattern, duration, associated symptoms, medications, and systemic features help narrow the diagnosis. Clarification: distinguishing scarring from non-scarring alopecia is a key early step because urgency and reversibility differ. Read more
How should alopecia be initially assessed?
Initial assessment should define the pattern, extent, and time course of hair loss, and identify scalp symptoms, triggers, comorbidities, grooming practices, and recent illness or medication exposure. Examination should assess scalp inflammation, erythema, scaling, follicular openings, and distribution of loss. Hair pull testing and inspection of eyebrows, eyelashes, nails, and body hair can add diagnostic value. Clarification: a focused history and scalp examination often establish the likely diagnosis before investigations are ordered. Read more
When are investigations needed for alopecia?
Investigations are guided by clinical suspicion rather than performed routinely for every patient. Laboratory tests may be considered when diffuse shedding, nutritional deficiency, endocrine disease, autoimmune disease, or systemic illness is suspected. Dermoscopy can support diagnosis by showing characteristic findings in alopecia areata, androgenetic alopecia, and scarring disorders. Scalp biopsy is useful when the diagnosis is uncertain or scarring alopecia is suspected. Clarification: biopsy should be considered early when permanent follicular loss is a concern. Read more
What treatments are used for alopecia?
Treatment depends on the alopecia subtype and whether hair loss is scarring. Common options include topical minoxidil for pattern hair loss, intralesional or topical corticosteroids for alopecia areata, and management of underlying triggers in telogen effluvium. Scarring alopecias may require anti-inflammatory therapy to limit irreversible follicular damage. Supportive measures such as camouflage, gentle hair care, and counseling are also important. Clarification: therapy aims either to stimulate regrowth or to halt ongoing follicular injury, depending on the cause. Read more
How should patients with alopecia be followed?
Follow-up should monitor response, adherence, adverse effects, and disease progression. Photographic documentation and repeat examination of density, shedding, and scalp inflammation help assess treatment benefit over time. Follow-up interval varies by diagnosis and treatment used, but earlier review is appropriate for active scarring alopecia or medication-related adverse effects. Clarification: lack of visible regrowth after a short interval does not always indicate treatment failure because hair cycling delays response. Read more
