Differential Diagnosis for Tender Scalp with Dry and Brittle Hairs and Diffuse Hair Fall

• Single Most Likely Diagnosis
  • Androgenetic Alopecia: This condition is characterized by hair thinning, often due to hormonal influences, and can lead to dry, brittle hair and scalp tenderness. It's a common condition that affects both men and women.
• Other Likely Diagnoses
  • Telogen Effluvium: A condition that causes excessive hair shedding due to stress, hormonal changes, or other factors, leading to diffuse hair loss and potentially scalp tenderness.
  • Alopecia Areata: An autoimmune condition that leads to patchy hair loss, which can sometimes be accompanied by scalp tenderness and dry, brittle hair.
  • Seborrheic Dermatitis: A skin condition causing scaly patches, red skin, and stubborn dandruff, which can lead to scalp tenderness and contribute to hair dryness and brittleness.
• Do Not Miss Diagnoses
  • Thyroid Disorders: Both hypothyroidism and hyperthyroidism can cause hair loss, dryness, and brittleness, along with scalp tenderness. Missing these diagnoses could lead to significant morbidity if left untreated.
  • Autoimmune Disorders (e.g., Lupus): Systemic lupus erythematosus and other autoimmune diseases can cause hair loss and scalp symptoms, and are critical to diagnose due to their potential for severe systemic complications.
• Rare Diagnoses
  • Tinea Capitis (Ringworm of the Scalp): A fungal infection that can cause hair loss, scalp tenderness, and brittleness, though it's more common in children.
  • Lichen Planopilaris: An inflammatory condition that leads to hair loss, often accompanied by scalp tenderness and dryness, but is less common than other causes of hair loss.
  • Trichotillomania: A psychological disorder characterized by compulsive hair pulling, leading to hair loss, which might be accompanied by scalp tenderness due to the constant pulling.