Differential Diagnosis for Female Central Alopecia
Single most likely diagnosis
- Female Pattern Hair Loss (FPHL): This is the most common cause of hair loss in women, characterized by a gradual thinning of hair over the central scalp. The age of the patient and the duration of symptoms support this diagnosis.
Other Likely diagnoses
- Traction Alopecia: This condition is caused by prolonged tension on the hair follicles, often due to hairstyles such as tight braids, ponytails, or buns. It's a common cause of hair loss, especially in women.
- Alopecia Areata: An autoimmune condition that can cause patchy hair loss, including central alopecia. Although less common than FPHL, it's still a possible diagnosis.
- Telogen Effluvium: A condition characterized by excessive hair shedding, often triggered by stress, hormonal changes, or medical conditions. It can cause central alopecia, especially in older women.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Hypothyroidism: Hair loss can be a symptom of hypothyroidism, and untreated hypothyroidism can lead to serious health complications. Although less common, it's essential to rule out this condition.
- Lupus: Systemic lupus erythematosus (SLE) can cause hair loss, including central alopecia. Missing this diagnosis could lead to delayed treatment and increased morbidity.
Rare diagnoses
- Frontal Fibrosing Alopecia: A rare condition characterized by scarring hair loss, often affecting the frontal and central scalp.
- Central Centrifugal Cicatricial Alopecia (CCCA): A rare condition that causes scarring hair loss, often starting in the central scalp and progressing outward.
- Lichen Planopilaris: A rare autoimmune condition that can cause scarring hair loss, including central alopecia.