The real or perceived symptom of increased hair loss can be psychologically devastating for female patients. This article is intended as a brief review of the most common causes of adult female alopecia and a thorough introduction to the evaluation of this complaint in the primary-care setting. Bear in mind that many women who experience hair loss will still require referral to a dermatology practice.
Hair follicles constantly cycle through three phases: (1) anagen—the growth phase; (2) catagen—the phase transitioning between growth and resting; and (3) telogen—the resting phase. It is normal to lose as many as 100 hairs per day.
Women who present with excessive hair loss must undergo a detailed and extensive history and thorough examination of the hair, with the clinician paying special attention to the pattern of loss and how easily the hair pulls out. The clinician also must order blood tests and examine the scalp. In some cases, pathologic analysis of a scalp biopsy may be necessary.