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Practical management of hair loss.
Can Fam Physician. 2000 Jul; 46:1469-77.CF

Abstract

OBJECTIVE

To describe an organized diagnostic approach for both nonscarring and scarring alopecias to help family physicians establish an accurate in-office diagnosis. To explain when ancillary laboratory workup is necessary to confirm the diagnosis.

QUALITY OF EVIDENCE

Current diagnostic and therapeutic interventions for hair loss are based on randomized controlled studies, uncontrolled studies, and case series. MEDLINE was searched from January 1966 to December 1998 with the MeSH words alopecia, hair, and alopecia areata. Articles were selected on the basis of experimental design, with priority given to the most current large multicentre controlled studies. Overall global evidence for therapeutic intervention for hair loss is quite strong.

MAIN MESSAGE

The most common forms of nonscarring alopecias are androgenic alopecia, telogen effluvium, and alopecia areata. Other disorders include trichotillomania, traction alopecia, tinea capitis, and hair shaft abnormalities. Scarring alopecia is caused by trauma, infections, discoid lupus erythematosus, or lichen planus. Key to establishing an accurate diagnosis is a detailed history, including medication use, systemic illnesses, endocrine dysfunction, hair-care practices, and family history. All hair-bearing sites should be examined. A 4-mm punch biopsy of the scalp is useful, particularly to diagnose scarring alopecias. Once a diagnosis has been established, specific therapy can be initiated.

CONCLUSIONS

Diagnosis and management of hair loss is an interesting challenge for family physicians. An organized approach to recognizing characteristic differential features of hair loss disorders is key to diagnosis and management.

Links

PMC Free PDF

Authors+Show Affiliations

Shapiro J
Division of Dermatology, University of British Columbia (UBC), Vancouver. shapiro@interchange.ubc.ca
Wiseman M
No affiliation info available
Lui H
No affiliation info available

MeSH

AdultAlopeciaAlopecia AreataChildCicatrixDecision TreesFemaleHumansMalePhysical ExaminationTinea CapitisTrichotillomania

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

10925761

Citation

Shapiro, J, et al. "Practical Management of Hair Loss." Canadian Family Physician Medecin De Famille Canadien, vol. 46, 2000, pp. 1469-77.
Shapiro J, Wiseman M, Lui H. Practical management of hair loss. Can Fam Physician. 2000;46:1469-77.
Shapiro, J., Wiseman, M., & Lui, H. (2000). Practical management of hair loss. Canadian Family Physician Medecin De Famille Canadien, 46, 1469-77.
Shapiro J, Wiseman M, Lui H. Practical Management of Hair Loss. Can Fam Physician. 2000;46:1469-77. PubMed PMID: 10925761.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Practical management of hair loss. AU - Shapiro,J, AU - Wiseman,M, AU - Lui,H, PY - 2000/8/5/pubmed PY - 2000/8/19/medline PY - 2000/8/5/entrez SP - 1469 EP - 77 JF - Canadian family physician Medecin de famille canadien JO - Can Fam Physician VL - 46 N2 - OBJECTIVE: To describe an organized diagnostic approach for both nonscarring and scarring alopecias to help family physicians establish an accurate in-office diagnosis. To explain when ancillary laboratory workup is necessary to confirm the diagnosis. QUALITY OF EVIDENCE: Current diagnostic and therapeutic interventions for hair loss are based on randomized controlled studies, uncontrolled studies, and case series. MEDLINE was searched from January 1966 to December 1998 with the MeSH words alopecia, hair, and alopecia areata. Articles were selected on the basis of experimental design, with priority given to the most current large multicentre controlled studies. Overall global evidence for therapeutic intervention for hair loss is quite strong. MAIN MESSAGE: The most common forms of nonscarring alopecias are androgenic alopecia, telogen effluvium, and alopecia areata. Other disorders include trichotillomania, traction alopecia, tinea capitis, and hair shaft abnormalities. Scarring alopecia is caused by trauma, infections, discoid lupus erythematosus, or lichen planus. Key to establishing an accurate diagnosis is a detailed history, including medication use, systemic illnesses, endocrine dysfunction, hair-care practices, and family history. All hair-bearing sites should be examined. A 4-mm punch biopsy of the scalp is useful, particularly to diagnose scarring alopecias. Once a diagnosis has been established, specific therapy can be initiated. CONCLUSIONS: Diagnosis and management of hair loss is an interesting challenge for family physicians. An organized approach to recognizing characteristic differential features of hair loss disorders is key to diagnosis and management. SN - 0008-350X UR - https://www.unboundmedicine.com/medline/citation/10925761/Practical_management_of_hair_loss_ DB - PRIME DP - Unbound Medicine ER -