Common causes of hair loss – clinical manifestations, trichoscopy and therapy
January 2021
in “Journal of the European Academy of Dermatology and Venereology”
TLDR The document concludes that understanding and treating hair loss requires recognizing its various types and using appropriate diagnostic tools and treatments.
The document from January 8, 2021, provides a comprehensive review of hair loss disorders, their clinical signs, diagnostic methods, and treatment options. It categorizes hair loss into non-cicatricial (non-scarring) and cicatricial (scarring) alopecia, with non-cicatricial being more common. Androgenetic alopecia (AGA) is highlighted as the most prevalent form, affecting a significant portion of both men and women, with treatments like minoxidil and finasteride available. Other conditions such as Telogen effluvium (TE), Anagen effluvium, and Alopecia areata (AA) are discussed, with AA having a prevalence of about 0.2% and lacking clearly defined treatments. The document also covers rarer disorders like Keratosis follicularis spinulosa decalvans (KFSD), Folliculitis decalvans (FD), Dissecting cellulitis (DC), and Erosive pustular dermatitis of the scalp (EPDS), detailing their treatments which range from antibiotics to corticosteroids. Diagnostic tools like trichoscopy and scalp biopsy are emphasized for accurate diagnosis, and the importance of prompt and appropriate treatment for a better prognosis is underlined. The review aims to guide dermatologists in the management of these conditions and acknowledges patient consent for case publication.
View this study on onlinelibrary.wiley.com →
Cited in this study
research Preliminary results of the use of scalp microneedling in different types of alopecia
Scalp microneedling may improve hair density and thickness for various alopecia types.
research Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial
Oral minoxidil and topical minoxidil 5% both effectively improve female-pattern hair loss with safe side effects.
research Italian Guidelines in diagnosis and treatment of alopecia areata
The Italian guidelines offer advice for diagnosing and treating alopecia areata based on expert opinion and limited clinical trial evidence.
research Alopecia Areata Incognita and Diffuse Alopecia Areata: Clinical, Trichoscopic, Histopathological, and Therapeutic Features of a 5-Year Study
The study concluded that AAI and DAA are forms of the same disease, with different symptoms in men and women, and that corticosteroid treatment is effective.
research <p>Erosive pustular dermatosis of the scalp: challenges and solutions</p>
Early treatment of EPDS can improve outcomes and reduce recurrence risk.
research <p>Telogen effluvium: a comprehensive review</p>
The document concludes that Telogen Effluvium is a hair loss disorder that can be assessed with the modified wash test and may be treated with clobetasol foam, with patient management being important.
research Erosive pustular dermatosis of the scalp – an Australian perspective: Insights to aid clinical practice
The article suggests a treatment plan for a stubborn scalp condition common in elderly Australians to help improve their lives.
research Trichoscopy features of trichotillomania
Trichotillomania shows specific signs like black dots and uneven hair lengths but lacks certain features of alopecia areata.
research Platelet‐rich plasma on female androgenetic alopecia: Tested on 10 patients
PRP injections increase hair density and diameter in female androgenetic alopecia patients.
research Frontal fibrosing alopecia: a case series of 65 patients seen in a single Italian centre
The study concluded that severity of Frontal fibrosing alopecia is not linked to how long someone has it, can start before menopause, and eyebrow loss may be an early sign.
research Case series of oral minoxidil for androgenetic and traction alopecia: Tolerability & the five C’s of oral therapy
Oral minoxidil helps hair growth, is cost-effective, and mostly well-tolerated.
research Dissecting folliculitis (dissecting cellulitis) of the scalp: a 66‐patient case series and proposal of classification
Researchers found that dissecting folliculitis of the scalp is linked to obesity, severity increases with duration and number of nodules, and early treatment is important to prevent scarring.
research Monitoring chemotherapy‐induced alopecia with trichoscopy
Chemotherapy caused hair loss with specific patterns, but most patients had hair regrowth after treatment, while some had lasting hair loss.
research Drug Treatment for Androgenetic Alopecia: First Italian Questionnaire Survey on What Dermatologists Think about Finasteride
Finasteride is considered the best treatment for hair loss, despite side effects.
research Alopecia areata
Alopecia areata is an autoimmune condition causing hair loss, influenced by genetics, stress, and diet, and may be prevented by a high soy oil diet.
research Advances in Hair Restoration
New techniques improve hair restoration success.
research Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone
Low-dose oral minoxidil and spironolactone combo effectively reduces hair loss and improves hair density in women.
research Sexual side effects of 5-α-reductase inhibitors finasteride and dutasteride: A comprehensive review
research Hair Transplantation Controversies
Hair transplants look natural, but the best method is debated, and PRP shows promise for hair regrowth.
research Treatment of chronic telogen effluvium with oral minoxidil: A retrospective study
Oral minoxidil effectively reduces hair shedding in women with CTE, with no major side effects.
research Erosive pustular dermatosis of the scalp: Clinical, trichoscopic, and histopathologic features of 20 cases
The conclusion is that high-potency steroids or tacrolimus are effective treatments for erosive pustular dermatosis of the scalp.
research Platelet-Rich Plasma in Combination With 5% Minoxidil Topical Solution and 1 mg Oral Finasteride for the Treatment of Androgenetic Alopecia: A Randomized Placebo-Controlled, Double-Blind, Half-Head Study
Combining platelet-rich plasma with 5% minoxidil solution improves hair regrowth in androgenetic alopecia patients.
research Chemotherapy‐induced alopecia management: Clinical experience and practical advice
The conclusion is to use scalp cooling, gentle hair care, and treatments like minoxidil for managing hair loss from chemotherapy, and stresses the need for more research and collaboration in this area.
research Low-level laser therapy as a treatment for androgenetic alopecia
Low-level laser therapy may improve hair regrowth and thickness for androgenetic alopecia, but more research is needed.
research Effects of a novel finasteride 0.25% topical solution on scalp and serum dihydrotestosterone in healthy men with androgenetic alopecia
The 0.25% finasteride solution, when applied once a day, effectively reduces scalp DHT, potentially minimizing sexual side-effects linked to a systemic DHT reduction.
research A novel finasteride 0.25% topical solution for androgenetic alopecia: pharmacokinetics and effects on plasma androgen levels in healthy male volunteers
New finasteride solution effectively reduces baldness-causing hormone, potentially with fewer side effects.
research Efficacy of interventions for prevention of chemotherapy‐induced alopecia: A systematic review and meta‐analysis
research Minoxidil 5% Solution for Topical Treatment of Loose Anagen Hair Syndrome
Minoxidil 5% solution significantly improved hair density in a girl with loose anagen hair syndrome over 28 months, with no side effects.
research Dissecting cellulitis (Perifolliculitis Capitis Abscedens et Suffodiens): a comprehensive review focusing on new treatments and findings of the last decade with commentary comparing the therapies and causes of dissecting cellulitis to hidradenitis suppura
New treatments for Dissecting cellulitis show promise, but more research is needed to understand the disease and establish a standard treatment plan.
research A randomized double-blind placebo-controlled pilot study to assess the efficacy of a 24-week topical treatment by latanoprost 0.1% on hair growth and pigmentation in healthy volunteers with androgenetic alopecia
Latanoprost 0.1% may effectively treat hair loss.
research Minoxidil Use in Dermatology, Side Effects and Recent Patents
Minoxidil treats hair loss, promotes growth, has side effects, and has recent patents.
research Trichoscopy update 2011
Trichoscopy is a useful tool for diagnosing different hair and scalp diseases by their unique visual features.
research Treatment of alopecia areata: “What is new on the horizon?”
New treatments for alopecia areata may target specific immune cells and pathways involved in hair loss.
research Prospective Cohort Study on the Effects and Tolerability of Flutamide in Patients with Female Pattern Hair Loss
Flutamide effectively treats female pattern hair loss with low doses showing good liver tolerance.
research Efficacy, safety, and tolerability of dutasteride 0.5 mg once daily in male patients with male pattern hair loss: A randomized, double-blind, placebo-controlled, phase III study
Dutasteride 0.5 mg daily improves hair growth safely in men with hair loss.
research Loose anagen hair syndrome
Loose Anagen Syndrome is a hair condition where hairs can be easily pulled out, mainly affecting young girls, and may improve on its own or with treatment.
research Trichodynia is a distinguishing symptom of telogen effluvium
Scalp pain is a common symptom in people with active hair loss from telogen effluvium.
research Diffuse hair loss in an adult female: Approach to diagnosis and management
To manage hair loss in adult women, find the cause and treat it accordingly.
research Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia
research Dermoscopy in female androgenic alopecia: Method standardization and diagnostic criteria
Trichoscopy can diagnose female hair loss with high accuracy by looking for specific patterns in hair and scalp appearance.
research Folliculitis decalvans
Folliculitis decalvans is a rare scalp condition causing scarring hair loss, treated with long-term antibiotics and other medications, but it often comes back and is hard to manage.
research Cicatricial alopecia: classification and histopathology
Early detection and histopathology are crucial to prevent permanent hair loss in cicatricial alopecia.
research Lichen planopilaris
Lichen planopilaris is a chronic, scarring hair loss condition with no definitive cure, requiring accurate diagnosis and treatment to manage symptoms.
research Frontiers in the (Neuro-)endocrine Controls of Hair Growth
Hair growth and health are influenced by stress and hormones.
research Hair Loss Pattern due to Chemotherapy-Induced Anagen Effluvium: A Cross-Sectional Observation
Chemotherapy often causes patterned hair loss, with some scalp areas more resistant to hair loss than others.
research Treatment of female pattern hair loss with oral antiandrogens
Oral antiandrogens effectively treat female hair loss, with better results in higher hair loss grades.
research Treatment of hyperandrogenic alopecia in women
Flutamide may slightly improve hair loss in women, but finasteride does not work.
research Nutritional factors and hair loss
Low iron and L-lysine levels can cause hair loss in women, and increasing these nutrients can reduce hair shedding.
research Effects of minoxidil 2% vs. cyproterone acetate treatment on female androgenetic alopecia: a controlled, 12-month randomized trial
Minoxidil works better for female hair loss, but cyproterone reduces scalp oiliness and causes menstrual issues.
research Fortnightly review: Male pattern androgenetic alopecia
Hair loss in men is common, treatable, but not curable.
research Male pattern hair loss: current understanding
Genetics and hormones cause hair loss; finasteride treats it safely.
research Beneficial effect of spironolactone on androgenic alopecia
Spironolactone may help reduce hair loss in androgenic alopecia.
research Topical finasteride in the treatment of androgenic alopecia. Preliminary evaluations after a 16-month therapy course
Topical finasteride helps regrow hair and reduce balding without side effects.
research Oral spironolactone therapy for female patients with acne, hirsutism or androgenic alopecia
Spironolactone is effective for treating acne, hirsutism, and androgenic alopecia in women with few side effects.
Related
research Alopecia areata: A multifactorial autoimmune condition
Alopecia areata is an autoimmune disease causing patchy hair loss, often with other autoimmune disorders, but its exact causes are unknown.
research Linear alopecia areata
research Treating of resistant cases of alopecia universalis
Combining platelet-rich plasma therapy with prostaglandin-F eye drops can significantly regrow hair in alopecia universalis.