Scalp Biopsy and Diagnosis of Common Hair Loss Problems

Alopecia can be either scarring or non-scarring. Non-scarring alopecias tend to have preserved follicular ostia, with no clinically visible inflammation in most presentations, although histologic inflammation may be present. The common types of non-scarring alopecias are androgenic alopecia, telogen effluvium, alopecia areata, trichotillomania and traction alopecia. Scarring alopecias, also known as cicatricial alopecia, refers to a collec‐ tion of hair loss disorders that have loss of follicular ostia, or atrophy, with permanent and irreversible destruction of hair follicles and their replacement with scar tissue. The histologic confirmation is the best method to confirm the presence of a fibrosing/scarring process with loss of hair follicles.