Diffuse hair loss

13: Diffuse hair loss


Hair loss is frequently very distressing to patients. Hair loss is divided into scarring hair loss and nonscarring hair loss. This chapter discusses conditions that can cause diffuse hair loss. These include androgenetic alopecia, lichen planopilaris, telogen effluvium, and alopecia areata.

Key terms:

androgenetic alopecia

alopecia universalis

alopecia totalis

lichen planopilaris

telogen effluvium

Androgenetic alopecia

Clinical features

Androgenetic alopecia (AGA; also known as “female-pattern hair loss” and “male-pattern baldness”) is the most common type of hair loss in both men and women. It is caused by androgen-mediated effects on hair follicles, which result in miniaturization of hairs, decreased hair count, and observable hair thinning in a male-patterned scalp distribution.

Differential diagnosis

The differential for AGA is broad and includes telogen effluvium (TE), lichen planopilaris (LPP), traction alopecia, central centrifugal cicatricial alopecia (CCCA), and alopecia areata. Importantly, multiple types of hair loss can coexist in the same individual, making accurate diagnosis difficult in some cases.


AGA is typically a clinical diagnosis; however, in some cases, additional work-up is required to distinguish it from mimickers.

Initial steps in management

Management of AGA is different in men than it is in women. Regardless, early, aggressive management is recommended because maintenance of hair is much easier to achieve than hair regrowth.

In men

In women

Jul 22, 2021 | Posted by in Dermatology | Comments Off on Diffuse hair loss
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