Imposters of Androgenetic Alopecia

August 2013 in “ Facial Plastic Surgery Clinics of North America ”

Nicole E. Rogers

androgenetic alopecia cicatricial alopecias lichen planopilaris frontal fibrosing alopecia pseudopelade of Brocq folliculitis decalvans central centrifugal cicatricial alopecia perifollicular erythema shiny alopecia yellow dots pruritis burning exclamation mark hairs polarized light scalp biopsy AGA LPP FFA CCCA

TLDR Recognize and treat hair loss conditions that mimic androgenetic alopecia by identifying warning signs and using proper tools.

This article discusses the importance of recognizing hair loss conditions that can be mistaken for androgenetic alopecia (AGA), including cicatricial alopecias such as lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), pseudopelade of Brocq, folliculitis decalvans, and central centrifugal cicatricial alopecia (CCCA). The document provides information on the clinical presentation, histology, and treatment options for each of these conditions. The article emphasizes the importance of recognizing warning signs such as perifollicular erythema, shiny alopecia, yellow dots, unexplained pruritis and burning, and exclamation mark hairs to identify AGA imposters. The use of polarized light with magnification can ease the recognition of these signs. Physicians who are not comfortable looking for these features may consider routinely performing a scalp biopsy to rule out such imposters of androgenetic alopecia definitively.

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