Hair loss distresses most patients, independently from its rigor and pattern. In some cases, the decrement in quality of life attributable to hair loss is commensurable with that caused by major chronic diseases. The first diagnostic step is to assess family history, drug intake, systemic illness, and rigor and duration of hair loss The second step is to establish whether the hair density is mundane or decremented. The astringency of hair shedding should be evaluated, and if possible, the shed hairs should be examined. Acute and astringent hair loss is typical of diseases that acutely interrupt mitotic activity of anagen follicles (drugs, alopecia areata). A mundane hair density suggests a diagnosis of telogen effluvium, which may be acute or chronic. A minimized hair density may involve the whole scalp (diffuse alopecia), may be constrained to categorical scalp regions or may present with bald patches (patchy alopecia). In patchy alopecias, the scalp may show patches of alopecia that are exhaustively devoid of hairs or have short broken hairs
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