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Pressure-induced alopecias (PAs) are an infrequent group of scarring and nonscarring alopecias that occur after ischemic obstruction of capillaries that leads to circumscribed areas of hair loss. Initially described after prolonged surgeries or immobilization, type 1 PA occurs after sustained external pressure to the skin, mainly the scalp prominences. Alopecia induced by cosmetic procedures, referred in this review as type 2 PA, is reported with increased frequency in literature and predominantly emerges from pressure exerted by the volume of injectables. It is important to differentiate type 2 PA from vascular occlusion-induced alopecia because they represent distinct entities. Clinically, PA may present with erythema, swelling, and tenderness; however, alopecia might be the sole manifestation. Crusts and ulceration are associated with a worse outcome and a higher risk of scarring alopecia. Prompt diagnosis is paramount to prevent complications. Trichoscopy, although considered nonspecific, may provide relevant clues for an accurate diagnosis. Hair regrows in most cases, but prognosis depends on ischemia severity and timely treatment with reperfusion therapies or mobilization. Treatment of hair loss is usually not necessary because the disease in most cases is self-limited and reversible. The role of topical minoxidil and corticosteroids remains unknown. [ABSTRACT FROM AUTHOR]

This article discusses drug-induced hair loss, which can occur with many drugs including cytotoxic agents, biologics, and immunomodulating agents, among others. It outlines the diagnosis and management of drug-induced alopecia, with a focus on recently implicated drugs. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is associated with androgenetic alopecia (AGA), telogen effluvium (TE), and alopecia areata (AA). No studies have analyzed the aggregate data to date. Objective: We conducted a systematic review to characterize the types, incidence, timing, and clinical outcomes of COVID-19–associated alopecia. Methods: We searched PubMed/MEDLINE, Scopus, and Embase for articles published between November 2019 and August 2021 using the key words “alopecia” or “hair” and COVID-19–related search terms, identifying 41 original articles describing patients with alopecia and COVID-19. Results: The current review included 1826 patients with alopecia and COVID-19 (mean age, 54.5 years; 54.3% male). The most common types of alopecia identified were AGA (30.7%, 86.4% male), TE (19.8%, 19.3% male), and AA (7.8%, 40.0% male). AGA preceded COVID-19 symptoms. TE was usually newly triggered by COVID-19 (93.6%). AA usually occurred in patients with preexisting disease (95.1%). Limitations: Definitions of COVID-19 onset varied. Studies differed in methodology and were susceptible to reporting and sampling bias. Studies with large sample sizes may exert a disproportionate influence on data. Conclusion: AGA may be a risk factor for severe COVID-19, whereas TE presents as a sequela of COVID-19. AA generally occurs as a relapse in patients with preexisting alopecia.

The prevalence of hair loss has increased during COVID‐19. In this study, we review the current literature on incidence and characteristics of various types of COVID‐19‐related and COVID‐19‐vaccine‐ related hair loss including telogen effluvium, alopecia areata, friction alopecia and anagen effluvium. Regarding most of them, the more severe the infection, the more profound and prolonged the course of alopecia. However, the most important issue is reassuring the patients of the non‐serious nature of this complication, since psychological support is the most important factor in the earlier resolution of the condition. [ABSTRACT FROM AUTHOR]

Background: There is a time lag between hair follicle harvesting and implantation; during this time, hair follicles have ischemic injury. We need a holding media or a solution to minimize or neutralize ischemic injury. Aim and Objectives: The aim of this study was to evaluate plasma as a graft-holding solution in terms of its efficacy in hair growth and hair graft survival. Materials and Methods: A split-scalp study was carried out. The left side was designated as the control area (Group A), where graft implanted was kept in Ringer′s lactate (RL), and the right side behaved as the test area (Group B), which received grafts preserved in autologous plasma. The P value was calculated. Observations: MTT [3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide] staining for graft stored in RL at 12–72 h showed poor hair follicles cells survival, whereas graft kept in plasma showed viable cells even after 72h. The hair count and density in plasma group were significantly higher than the RL group. There was an improvement in hair thickness in both groups from 6 to 12 months. Conclusion: Autologous plasma is an easily available graft-holding solution. Platelets along with the plasma provide multiple growth factors promoting epithelialization, neovascularization, and action on hair follicle stem cells to improve growth. The fibrin coating around graft makes it sticky and prevents dehydration. The split-scalp controlled study certainly shows the advantages of using plasma over other extracellular graft-holding solutions.

Background There is a time lag between hair follicle harvesting and implantation, during this time hair follicles suffer ischemic injury. We need a holding medium or a solution to minimize or neutralize ischemic injury. Aims and Objective To evaluate plasma as a graft holding solution in terms of its efficacy in hair growth and hair graft survival. Method and Material A split scalp study was performed. The left side was designated as the control area (Group A) where grafts implanted were kept in Ringer’s lactate, and the right side behaved as the test area (Group B) and received grafts preserved in autologous plasma. The p-value was calculated. Observations MTT staining for grafts stored in Ringer’s lactate at 12 and 72 hours showed poor hair follicle cells’ survival while grafts kept in plasma showed viable cells even after 72 hours. The hair count and density in plasma group were significantly higher than those in the Ringer’s lactate group. There was an improvement in hair thickness in both groups from 6 months to 12 months. Conclusion Autologous plasma is an easily available graft holding solution. Platelets along with the plasma provide multiple growth factors promoting epithelialization, neovascularization, and action on hair follicle stem cells to improve growth. The fibrin coating around the graft makes it sticky and prevents dehydration. The split scalp controlled study certainly shows the advantages of using plasma over other extra cellular graft holding solutions.

Background: The use of non-scalp donor hair is considered in situations of a relative or absolute lack of head donor hair supply. Till now, very few published works are present on body hair transplant. None of them have compared scalp and non-scalp hair in terms of survival as well as characteristics. Objective: To compare the characteristics such as rate of anagen effluvium and survival rates of scalp, beard, and chest hair in hair restoration procedure of scalp. Materials and Methods: Three blocks of 1cm2 were marked on a non-frontal area. Thirty slits with a 0.9mm blade were made in each block. Single follicular unit was taken from scalp, beard, and chest area and was implanted simultaneously in each block, respectively. The areas were evaluated for any graft loss, anagen effluvium, and survival rate. Results: During initial period of 2 months, anagen effluvium in scalp (40%) and beard (30%) were significantly less than body (53.3%) hair with excellent survival rate of beard (95%), followed by scalp (89%) and then followed by chest hair (76%) at 1 year. Conclusion: Non-scalp hair can become an excellent source of donor area for hair restoration procedure.

Background: The diagnosis of cutaneous adversities in the cancer patient is especially difficult, given the complexity of their illness and combination protocols used for the treatment. The present study was undertaken to know the spectrum of cutaneous adversities in patients undergoing chemotherapy and the drug(s) most commonly associated with it. Materials and Methods: A total of 1000 patients with malignancies under chemotherapy in the oncology ward and outpatient department were screened in this observational study from January 2013 to February 2015. Relevant investigations for diagnosis of malignancies under chemotherapy and dermatological disorders were carried out. Results: Three hundred and eighty-four patients presented with cutaneous adversities of chemotherapy. The most common was anagen effluvium (78.6%), followed by xerosis (4.4%), thrombophlebitis (3.1%), generalised pruritus (2.9%), melanonychia (2.9%), hand-foot syndrome (2.6%), extravasation reactions (1.8%), flagellate dermatosis (1.3%), prurigo nodularis (0.8%), exfoliation (0.5%), ichthyosis (0.5%), papulopustular rash (0.3%), bullous photodermatitis (0.3%), and Sweet's syndrome (0.3%). Chemotherapeutic drugs were mostly given in combinations. Most common drugs to cause anagen effluvium were alkylating agents in combinations, hand-foot syndrome by taxanes (docetaxel), flagellate dermatoses by antitumour antibiotics (bleomycin), and exfoliation by antimetabolites (methotrexate). The limitation of this study was to imply a specific drug as the causation of the cutaneous adversities since the chemotherapy mostly consisted of combination protocols. Therefore, we have tried to associate the drug combination itself. Conclusion: Chemotherapeutic drugs produce a range of cutaneous adversities, certain specific adversities pertaining to drugs, and their combinations have been implicated which should be looked for and managed accordingly. Knowledge of the adverse effects of anticancer drugs will help reduce the psychological trauma and improve the quality of life.

Low-dose methotrexate (MTX) is the backbone of treatment for extensive psoriasis vulgaris not responding to topical therapy. Since its induction for the treatment of psoriasis in the 1970, its short- and long-term side effect profile has been extensively studied. Hair loss with MTX has been reported mostly with high-dose MTX used in chemotherapy. Here, we report a case of guttate psoriasis who presented with acute-onset anagen effluvium following the administration of only two doses of MTX 7.5 mg per week. [ABSTRACT FROM AUTHOR]

Background: There is a time lag between hair follicle harvesting and implantation; during this time, hair follicles have ischemic injury. We need a holding media or a solution to minimize or neutralize ischemic injury. Aim and Objectives: The aim of this study was to evaluate plasma as a graft-holding solution in terms of its efficacy in hair growth and hair graft survival. Materials and Methods: A split-scalp study was carried out. The left side was designated as the control area (Group A), where graft implanted was kept in Ringer's lactate (RL), and the right side behaved as the test area (Group B), which received grafts preserved in autologous plasma. The P value was calculated. Observations: MTT [3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide] staining for graft stored in RL at 12-72 h showed poor hair follicles cells survival, whereas graft kept in plasma showed viable cells even after 72 h. The hair count and density in plasma group were significantly higher than the RL group. There was an improvement in hair thickness in both groups from 6 to 12 months. Conclusion: Autologous plasma is an easily available graft-holding solution. Platelets along with the plasma provide multiple growth factors promoting epithelialization, neovascularization, and action on hair follicle stem cells to improve growth. The fibrin coating around graft makes it sticky and prevents dehydration. The split-scalp controlled study certainly shows the advantages of using plasma over other extracellular graft-holding solutions. [ABSTRACT FROM AUTHOR]

Since the beginning of the COVID-19 pandemic, dermatologists are increasingly often seeing cutaneous changes in patients who are positive or who have already recovered from the disease. What is particularly striking is the increasing number of patients who suffer from increased hair loss sometime after recovery from COVID-19. We present twenty cases of a post-COVID-19 infection with anagen effluvium treated with platelet-rich plasma (PRP). A total of three treatments were performed, one each month. After the second treatment, the patients noticed reduced hair loss and, after the third treatment, the condition had almost returned to normal. Due to the increasing number of cases of hair loss after COVID-19 infection, we have ascertained a connection between the two diseases. The treatment of our choice is safe and produces minimal side effects. [ABSTRACT FROM AUTHOR]

Background  There is a time lag between hair follicle harvesting and implantation, during this time hair follicles suffer ischemic injury. We need a holding medium or a solution to minimize or neutralize ischemic injury. Aims and Objective  To evaluate plasma as a graft holding solution in terms of its efficacy in hair growth and hair graft survival. Method and Material  A split scalp study was performed. The left side was designated as the control area (Group A) where grafts implanted were kept in Ringer's lactate, and the right side behaved as the test area (Group B) and received grafts preserved in autologous plasma. The p -value was calculated. Observations  MTT staining for grafts stored in Ringer's lactate at 12 and 72 hours showed poor hair follicle cells' survival while grafts kept in plasma showed viable cells even after 72 hours. The hair count and density in plasma group were significantly higher than those in the Ringer's lactate group. There was an improvement in hair thickness in both groups from 6 months to 12 months. Conclusion  Autologous plasma is an easily available graft holding solution. Platelets along with the plasma provide multiple growth factors promoting epithelialization, neovascularization, and action on hair follicle stem cells to improve growth. The fibrin coating around the graft makes it sticky and prevents dehydration. The split scalp controlled study certainly shows the advantages of using plasma over other extra cellular graft holding solutions. [ABSTRACT FROM AUTHOR]

Cytotoxic chemotherapies, molecularly targeted therapies, immunotherapies, radiotherapy, stem cell transplants, and endocrine therapies may lead to hair disorders, including alopecia, hirsutism, hypertrichosis, and pigmentary and textural hair changes. The mechanisms underlying these changes are varied and remain incompletely understood, hampering the development of preventive or therapeutic guidelines. The psychosocial impact of chemotherapy-induced alopecia has been well documented primarily in the oncology literature; however, the effect of other alterations, such as radiation-induced alopecia, hirsutism, and changes in hair color or texture on quality of life have not been described. This article reviews clinically significant therapy-related hair disorders in oncology patients, including the underlying pathophysiological mechanisms, severity grading scales, patient-reported quality of life questionnaires, management strategies, and future translational research opportunities. [ABSTRACT FROM AUTHOR]

Background: The use of non-scalp donor hair is considered in situations of a relative or absolute lack of head donor hair supply. Till now, very few published works are present on body hair transplant. None of them have compared scalp and non-scalp hair in terms of survival as well as characteristics. Objective: To compare the characteristics such as rate of anagen effluvium and survival rates of scalp, beard, and chest hair in hair restoration procedure of scalp. Materials and Methods: Three blocks of 1 cm2 were marked on a non-frontal area. Thirty slits with a 0.9 mm blade were made in each block. Single follicular unit was taken from scalp, beard, and chest area and was implanted simultaneously in each block, respectively. The areas were evaluated for any graft loss, anagen effluvium, and survival rate. Results: During initial period of 2 months, anagen effluvium in scalp (40%) and beard (30%) were significantly less than body (53.3%) hair with excellent survival rate of beard (95%), followed by scalp (89%) and then followed by chest hair (76%) at 1 year. Conclusion: Non-scalp hair can become an excellent source of donor area for hair restoration procedure. [ABSTRACT FROM AUTHOR]

Introduction: Radiation-induced alopecia (RIA) is a side effect resulting from cranial radiation therapy (RT) and it can be temporary or permanent. In cancer patients, RIA is a less frequent event than chemotherapy-induced alopecia, although the former is more likely to cause permanent hair loss. It is characterized initially by intense anagen effluvium caused by acute dose-dependent damage to the matrix cells of anagen follicles. Proton therapy (PT) is a specific type of RT used in the treatment of brain tumors, which sometimes can cause proton-induced alopecia (PIA), a rare subtype of RIA. Below, we report a case of a patient who presented PIA following PT treatment of a meningioma of the frontal region., Case Presentation: A 38-year-old female patient presented to our trichology outpatient clinic for widespread hair loss in the frontal region. Following a diagnosis of meningioma of the frontal region 3 years ago, adjuvant radiotherapy treatment of the frontal region with scanning beam PT (mean dose of 45 Gy) was performed. Two weeks after the end of treatment, the patient came to our attention with diffuse hair loss at the level of the PT-treated area. Trichoscopy showed flame hairs, broken hairs, black dots, and pigtail hairs. A diagnosis of PIA was established, and topical treatment with minoxidil 5% solution twice a day was initiated. At the follow-up visit after 4 months, the patient had total hair regrowth., Conclusion: PIA is a subtype of RIA still poorly studied in the literature. Hair loss is caused by aggression by radiations of the hair follicle in the anagen phase, leading to an interruption of the mitotic activity of the matrix cells. The cells of the follicular bulb are characterized by marked mitotic activity at this stage and are consequently more susceptible to cytotoxic damage. All this causes tightening of the proximal portion of the hair shaft, increasing its fragility and susceptibility to breakage., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 S. Karger AG, Basel.)

Abstract: Azathioprine (AZA)‐metabolizing enzyme gene polymorphism is strongly related to thiopurine‐induced leukocytopenia, which has not been well recognized in dermatological practice. We tried to see whether NUDT15 gene polymorphism can be the most susceptible genetic factor for AZA toxicity and the gene screening is beneficial to avoid the adverse events of AZA for the treatment of skin diseases. A retrospective study was carried out on 15 adult Japanese patients who were treated with AZA. Gene polymorphism of thiopurine‐metabolizing enzymes NUDT15 R139C, ITPA 94C>A, TPMT*2, TPMT*3B and TPMT*3C was analyzed. The single nucleotide polymorphisms were prospectively investigated in eight patients who were considered to have received AZA treatments. Two NUDT15 R139C homozygous patients developed agranulocytosis, severe thrombocytopenia and massive hair loss. The gene screening prior to AZA treatment identified one heterozygote of NUDT15 R139C and ITPA 94C>A, and three heterozygotes of ITPA 94C>A or TMPT*3C. Although this study was a retrospective single‐center case–control observational study that enrolled a small number of patients, NUDT15 R139C homozygosity is a genetic risk of thiopurine‐induced potentially fetal hematological abnormalities. To avoid serious adverse events, gene screening of thiopurine‐metabolizing enzymes, at least NUDT15 R139C, should be considered prior to administration in genetically predisposed populations, such as Japanese. We highlight that massive hair loss in the early period of the initiation of AZA would be a sign of impending severe myelotoxicity. [ABSTRACT FROM AUTHOR]

Endovascular interventional procedures are widely used for the treatment of intracranial vascular lesions. However, they sometimes produce reversible alopecia, known as radiation-induced temporary alopecia, depending on the radiation dose. Radiation-induced temporary alopecia manifested as rectangular alopecic patches without signs of inflammation, reflects damage to the keratinocytes in the hair matrix of anagen hair follicles, due to the sensitivity of these cells to radiation. The characteristics of radiation-induced temporary alopecia are similar to those of alopecia areata as follows: (1) clinical findings of well-defined alopecic patches and (2) dermoscopic findings of yellow dots, black dots, and short vellus hairs. The two conditions can be distinguished according to whether there is any history of endovascular interventional procedures, and by the shapes of the lesions and the inflammation status on histopathologic examination. A hair microscopic examination is a useful diagnostic tool in patients with hair loss disease, but the features of radiation-induced temporary alopecia have not been well described. Here, we report three cases of radiation-induced temporary alopecia preceded by endovascular procedures, including stent insertion and coil embolization. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of cutaneous adversities in the cancer patient is especially difficult, given the complexity of their illness and combination protocols used for the treatment. The present study was undertaken to know the spectrum of cutaneous adversities in patients undergoing chemotherapy and the drug(s) most commonly associated with it. Materials and Methods: A total of 1000 patients with malignancies under chemotherapy in the oncology ward and outpatient department were screened in this observational study from January 2013 to February 2015. Relevant investigations for diagnosis of malignancies under chemotherapy and dermatological disorders were carried out. Results: Three hundred and eighty-four patients presented with cutaneous adversities of chemotherapy. The most common was anagen effluvium (78.6%), followed by xerosis (4.4%), thrombophlebitis (3.1%), generalised pruritus (2.9%), melanonychia (2.9%), hand-foot syndrome (2.6%), extravasation reactions (1.8%), flagellate dermatosis (1.3%), prurigo nodularis (0.8%), exfoliation (0.5%), ichthyosis (0.5%), papulopustular rash (0.3%), bullous photodermatitis (0.3%), and Sweet's syndrome (0.3%). Chemotherapeutic drugs were mostly given in combinations. Most common drugs to cause anagen effluvium were alkylating agents in combinations, hand-foot syndrome by taxanes (docetaxel), flagellate dermatoses by antitumour antibiotics (bleomycin), and exfoliation by antimetabolites (methotrexate). The limitation of this study was to imply a specific drug as the causation of the cutaneous adversities since the chemotherapy mostly consisted of combination protocols. Therefore, we have tried to associate the drug combination itself. Conclusion: Chemotherapeutic drugs produce a range of cutaneous adversities, certain specific adversities pertaining to drugs, and their combinations have been implicated which should be looked for and managed accordingly. Knowledge of the adverse effects of anticancer drugs will help reduce the psychological trauma and improve the quality of life. [ABSTRACT FROM AUTHOR]

The diagnosis and treatment of medication-associated alopecia often challenges patients and physicians. While numerous studies on the topic exist, limited information on the strength and magnitude of these studies exists. We investigated the most commonly prescribed medications with high levels of evidence to support associations with alopecia. A list of most commonly prescribed medications was compiled using the "Top 100 Prescriptions, Sales" (Intercontinental Marketing Services) and "Top 200 Names Searched" (RxList.com). PubMed, Embase, and Web of Science were searched for "generic drug name" AND "alopecia" and "generic drug name" AND "hair loss." Two reviewers independently reviewed articles for drug, study type and level of evidence, and number of alopecia cases. A total of 192 unique drugs were investigated, with 110 yielding positive search results. Of these, 13 were associated with alopecia in studies with strong levels of evidence (adalimumab, infliximab, budesonide, interferon β-1α, tacrolimus, enoxaparin, zoster vaccine, lamotrigine, docetaxel, capecitabine, erlotinib, imatinib, and bortezomib). Only full-length articles available in the English language were included. The methodology used relied on lists of drugs based on their sales rather than number of prescriptions, which likely overrepresented expensive drugs. Few studies with high levels of evidence have been conducted on the topic of medication-associated alopecia. The mechanisms of hair loss must be further identified to provide effective management. [ABSTRACT FROM AUTHOR]

Background: The hair pull test lacks validation and has unclear pretest guidelines.Objective: We sought to quantify normal hair pull test values and elucidate the effect of pretest hair washing and brushing. The impact of hair texture and lifestyle was also examined.Methods: Participants (n = 181) completed a questionnaire recording demographics, medications, and hair health/history. A single hair pull test (scalp vertex) was performed.Results: The mean number of hairs removed per pull was 0.44 (SD 0.75). There was no significant difference in the mean number of hairs removed regardless of when participants washed (P = .20) or brushed (P = .25) their hair. Hair pull test values were similar between Caucasian-, Asian-, and Afro-textured hair. There was no significant difference in hair pull values between participants taking medications affecting hair loss and participants not taking these medications (P = .33). Tight hairstyles did not influence hair pull test values.Limitations: Participant hair washing and brushing could not be controlled during the study, but this information was documented and analyzed.Conclusion: Normal values for the hair pull test should be reduced to 2 hairs or fewer (97.2% of participants). The current 5-day restriction on pretest hair washing can be reduced and brushing be made permissible. [ABSTRACT FROM AUTHOR]

Anagen effluvium develops because of disturbances in the hair follicle cycle, leading to acute and severe hair loss in humans. The objective of this study was to establish a mouse model of anagen effluvium by 5-bromo-2′-deoxyuridine (BrdU) treatment, and evaluate the pathological changes and underlying mechanisms. We treated 9-10-day-old pups and 3-7-week-old C57 BL/6 mice with BrdU. After successfully inducing hair loss in the neonatal pups, microscopic, immunohistochemical and flow cytometry analyses were conducted. BrdU induced early onset alopecia in neonates and caused epidermal thickening and hair shaft breakage. BrdU appeared to incorporate the CD326-positive keratinocyte layer and induced p53-related apoptosis. Keratinocyte apoptosis caused immune cell infiltration in the dermal region; M2 macrophages and neutrophils were dominant. The BrdU-induced hair loss was dose-dependent, and alopecia was visible at a dose range of 25-200 μg/g bodyweight. The BrdU-induced anagen effluvium mouse model is novel and easily established by administrating four simple BrdU injections to pups; these mice showed synchronized onset of alopecia symptoms with little individual variation. Moreover, this model showed an alopecia phenotype similar to that of human anagen effluvium with acute, severe and widespread hair loss. [ABSTRACT FROM AUTHOR]

Anagen effluvium, the shedding of anagen hair, leads to diffuse non-scarring alopecia. We report two cases of anagen effluvium in the same family secondary to the ingestion of tubers of Gloriosa superba, which contains the antimitotic alkaloid colchicine. Both patients developed anagen effluvium and gastroenteritis 1-2 weeks after consuming the tubers. In addition, one of them had bicytopenia, pleural effusion, hematuria and altered liver function tests. Both were managed conservatively and counseled regarding the reversible nature of the hair loss. Follow-up at 3 months showed regrowth of hair in both the cases. [ABSTRACT FROM AUTHOR]

New COVID-19 skin manifestations continue to be described. We present a patient with COVID-19 related anagen effluvium. The patient was treated with and responded to low dose systemic steroids to treat an accompanying extensive COVID-19-related urticaria and maculopapular rash. [ABSTRACT FROM AUTHOR]

Background: Diffuse hair loss is a common complaint encountered by dermatologists in their daily clinical practice. Hair loss in women is a distressing condition. Various underlying factors individually or in combination contribute to the pathogenesis. Objectives: To determine causes of diffuse hair loss in women and to find the association between probable causes and relevant laboratory parameters, wherever applicable. Materials and Methods: One hundred and eighty women with diffuse hair loss were included in the study. Detailed history and clinical examination including hair pull test and hair microscopy were done in all study subjects. Specific laboratory investigations for determining iron deficiency anaemia, thyroid dysfunction and parasitic infestation were done. Results: Among 180 patients, 116 (64.44%) had telogen effluvium, 28 (15.55%) had CTE, 21 (11.66%) had FPHL and 1 (0.55%) had AE. Fourteen patients (7.77%) had more than one aetiological diagnosis of diffuse hair loss. TE was the commonest type of diffuse hair loss. Incidence of TE and FPHL were highest in the age group of 21-30 years, whereas CTE in 30-40 years. Psychological stress and iron deficiency anaemia were the most common underlying aetiological factors for TE, which is statistically significant (p