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Last updated: September 25, 2025View editorial policy

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Differential Diagnosis for Hair Loss on the Lower Legs

  • Single most likely diagnosis
    • Alopecia areata: This is an autoimmune condition that can cause patchy hair loss on any part of the body, including the lower legs. It's a common condition and can be triggered by stress, genetics, or other factors.
  • Other Likely diagnoses
    • Tinea barbae or Tinea corporis: Fungal infections can cause hair loss, especially if they infect the hair follicles. These conditions are more common in warm, moist environments and can be treated with antifungal medications.
    • Pseudofolliculitis barbae: This condition is caused by ingrown hairs and can lead to hair loss, especially in areas where the hair is curly or coarse.
    • Folliculitis: An inflammation of the hair follicles, often caused by bacterial or fungal infections, can lead to hair loss on the affected areas.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Peripheral artery disease (PAD): While not directly causing hair loss, PAD can lead to poor circulation, which might result in hair loss on the lower legs due to reduced blood flow. Missing this diagnosis could lead to severe complications, including gangrene or amputation.
    • Diabetes: Uncontrolled diabetes can lead to peripheral neuropathy and poor circulation, both of which can contribute to hair loss on the lower legs. Early detection and management of diabetes are crucial to prevent long-term complications.
  • Rare diagnoses
    • Sarcoidosis: A rare autoimmune disease that can cause hair loss, among other symptoms, due to the formation of granulomas in various parts of the body, including the skin.
    • Lichen planopilaris: A rare inflammatory condition that can cause hair loss, especially on the scalp, but can also affect other parts of the body, including the lower legs.
    • Discoid lupus erythematosus: A chronic skin condition characterized by inflammation and scarring, which can lead to hair loss on the affected areas, including the lower legs.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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