Diagnosis and Treatment of Nonscarring Hair Loss in Primary Care in 2021

In 2021, the initial step in diagnosing hair loss (alopecia) was to distinguish between nonscarring and scarring alopecia. This review focused on nonscarring alopecia, the most common type of hair loss seen in primary care. Scarring alopecia, which permanently destroys follicular structures, was identified by symptoms such as itching, pain, redness, scaling, crust, and obliteration of follicular pore markings, resulting in an unusually smooth skin appearance. These patients might have needed a scalp biopsy for diagnosis and referral for specialized care. Once hair loss was classified as nonscarring, the next step was to identify the distribution of loss on the scalp as patterned, diffuse, or focal. The diagnosis and management of the most prevalent nonscarring disorders in each of these categories were discussed.