Curriculum · ENT, Ophthalmology, and Dermatology
Female pattern hair loss
What it is
Hair loss is split first by whether it is focal or diffuse. Focal hair loss covers alopecia areata, female and male pattern hair loss, tinea capitis, traction alopecia, trichotillosis and the scarring alopecias. Diffuse hair loss covers telogen effluvium, alopecia totalis, drug-induced hair loss, iron deficiency anemia and hypothyroidism. Alopecia areata itself is a presumed autoimmune condition that causes localised, well demarcated patches of hair loss, and is also described as a chronic, relapsing, immune-mediated inflammatory disorder of the hair follicles that results in patchy hair loss.
Causes and risk
Recurrence of alopecia areata is frequent and is often precipitated by emotional distress. The history that separates the causes covers onset and duration, the pattern and which areas of the scalp are affected, whether there is shedding or thinning, associated symptoms such as scalp pain, acne, endocrine or thyroid disease, joint pain and photosensitivity, medical history and recent medication use, recent surgery, admission or emotional stress, family history, hair care practices, and dietary history. Alopecia areata is also listed in CVID, where it stands with necrotizing granuloma as the dermatological manifestation that comes alongside recurrent infections; the autoimmune phenomena of CVID are a row of their own, hemolytic anemia, thrombocytopenia, vitiligo and rheumatoid arthritis, and the malignancies are non-Hodgkin lymphomas of B-cell phenotype. In women with androgenic alopecia the note beside it is to check for PCOS, and alopecia areata itself may be linked to thyroid disease.