If the patient has or had…Consider…
Systemic/chronic illness (e.g., autoimmune disorder, cancer)Alopecia areata, cicatricial alopecia, telogen effluvium
Infection (systemic or local)Cicatricial alopecia, telogen effluvium, tinea capitis
Medication exposure (especially chemotherapy) or serious illness within previous three to four monthsTelogen effluvium
Psychiatric disorder (e.g., psychosis, anxiety, obsessive compulsive disorder)Trichotillomania
Physical stress (e.g., surgery, pregnancy, malnutrition) or life-threatening psychologic stressTelogen effluvium
Tight braids or “pulled-back” hairstyleTraction alopecia
Signs and symptoms of hormonal abnormalities
Hirsutism, amenorrhea, infertilityAndrogenetic alopecia (women)
Hypothyroidism, other endocrinopathiesAlopecia areata, telogen effluvium