Symptoms

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I. Alopecia areata

  • Onset is usually sudden and the course of the disease is slow and may vary from person to person
  • Presence of round or oval, circumscribed patches of baldness (usually centimeter or two in diameter) with no signs of inflammation, scarring or degeneration
  • Affected skin is shiny and slightly thin and hair pores are visible
  • Small hairĀ  (2-3 mm) maybe seen in the form of exclamation mark at the margins.
  • Usually resolves on its own but in some cases the hair may not grow back.

II. Traction alopecia

  • Hair line on forehead is irregular and receding
  • Skin surrounding the stumps of hair is slightly red (erythema)
  • Treatment consists of avoiding traction

III. Alopecia steatoides

  • Dandruff like scaling from the scalp with moderate itching
  • Slow and progressive loss of hair from vertex (i.e. on top of the head) and temples
  • Presence of short, poorly formed hair

IV. Idiopathic premature alopecia (Masculine alopecia)

  • Onset is gradual (slow)
  • The hair loss is symmetrical
  • Starts with a receding hair margin and with widening of the forehead. Later on other areas of the scalp may also be affected.
  • Lustreless, thinned out hair

V. Androgenic alopecia in women

  • Increased spacing between hair or general thinning of hair overall.
  • Mild to moderate hair loss at the crown (i.e. on top of the head) or the hairline

VI. Senile alopecia

Symmetrical thinning or loss of hair

  • Vertex (i.e. on top of the head), frontal area of head and even the back of the scalp (occiput) may be involved
  • Degenerative changes that take place with old age can be seen in the skin

VII. Primary cicatrical alopecia

  • Onset is gradual (slow)
  • Characterized by ill-defined, round or oval areas of hair loss
  • Skin appears white, shining, shriveled or scarred with no sign of inflammation
  • Cicatrical (scarred) alopecia patches appear like footprints in the snow across the scalp.
  • INVESTIGATION
  • Clinical examination of the hair and scalp are usually enough to identify the nature of the problem.
  • Other tests may include:
    • microscopic examination of the hair
    • skin biopsy: especially if skin changes are present