"Textbook" Presentations of Hair Loss

Typical and “Textbook” Presentations of Hair Loss

Every hair loss condition has its “typical” presentation. This is the way one might expect the hair loss condition to look like when one flips open a textbook. Not surprising, typical presentations are sometimes also called “textbook” presentations. One might also refer to it as the expected presentation or regular, normal, standard or classic presentation. ​​​​​​​​

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The fascinating thing about hair loss is not every patient with hair loss walks into the office with a “typical” presentation. Understanding the various “atypical” presentations is the next step in clinical skill development after one feels they have a solid grasp of the typical presentations. It’s the appreciation of the “atypical” forms of hair loss that allows one to diagnose male balding with loss of hair in the back of the scalp, or frontal fibrosing alopecia with only loss of the leg and arm hair or folliculitis decalvans with only beard involvement or alopecia areata with only nail changes or discoid lupus with mild blepharitis of the eyelid margins.​​​​​​​​
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One must always remain humble to the incredible number of atypical forms that aren’t fully covered in the textbooks.