Hair loss disorders (alopecias)

This article focuses on hair loss disorders (alopecias). Hair loss can be broadly classified into scarring and non-scarring. Taking a tailored clinical history and performing a detailed examination helps guide the physician to the diagnosis. A scalp biopsy can be indicated, particularly when scarring hair loss is suspected. The aim of treatment is to prevent or slow further hair loss and promote hair regrowth where possible. Hair loss can be a cause of significant emotional and psychological distress, and it is important for this aspect of alopecia to be recognized and acknowledged. However, as treatment options can be limited, it is important to be realistic about what can be achieved therapeutically. The recent approval by the UK National Institute for Health and Care Excellence and Scottish Medicines Consortium of the Janus kinase inhibitor ritlecitinib for severe alopecia areata in patients aged ≥12 years represents a major therapeutic advance in the treatment of this difficult to manage condition.