Medical history (history of the patient) represents an important component in the diagnosis of alopecia (hair loss). Family history
- Are there clustered family members in your family who have hair loss?
Social history
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- How long has the hair loss been present?
- Slow and increasing?
- Suddenly?
- Does the hair loss exist only on the head or does the entire body hair fall out?
- Is it circular hair loss or does the hair fall out diffusely?
- Do you have other symptoms such as dandruff or redness of the scalp?
- When, at what age, did you first notice hair loss?
- How do you care for your hair?
Vegetative anamnesis including nutritional anamnesis.
- Please tell us your body weight (in kg) and height (in cm).
- Have you lost weight?
- Do you eat a balanced diet?
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
- Do you use drugs? If yes, what drugs (amphetamines) and how often per day or per week?
- Woman: when did menopause begin?
Self history including medication history.
- Pre-existing conditions (autoimmune diseases; hormonal diseases).
- Operations
- Allergies
Medications that can cause hair loss; hair loss typically occurs 2 to 3 months after starting the medication
- ACE inhibitors (captopril, enalapril).
- Analgesics/antirheumatics – ibuprofen, naproxen, piroxicam.
- Anthelmintics (albendazole, mebendazole).
- Antiarrhythmic drugs – Amiodarone
- Antidepressants
- Lithium (e.g., quoilinonum)
- Selective serotonin reuptake inhibitors (SSRIs) – fluoxetine, sertraline.
- Tetracyclic antidepressants
- Tricyclic antidepressants (TCAs) – amitriptyline, desipramine, imipramine.
- Antiepileptic drugs – carbamazepine, gabapentin, valproate, valproic acid.
- Angiogenesis inhibitors (sorafenib, sunitinib).
- Anticoagulants
- Coumarin derivatives – indandiones, phenprocoumon (product names: Marcumar, Falithrom), warfarin.
- Heparin (enoxaparin)
- Low-molecular-weight heparins (NMH) (certoparin, dalteparin, enoxaparin, nadroparin, reviparin, tinzaparin).
- Synthetic. Heparin analogue (Fondaparinux).
- Antimalarials – e.g. chloroquine
- Antifungals
- Azoles (voriconazole)
- Triazole derivatives (fluconazole)
- Antipsychotics (neuroleptics) – haloperidol.
- Antiretroviral drugs – e.g., indinavir
- Beta-blockers – e.g., metoprolol, propranolol; also for topical beta-receptor blockers: pindolol.
- Biologicals (adalimumab)
- Coumarins
- Gout remedy – colchicine
- Guanethidine
- H2 blockers – e.g., ranitidine, cimetidine
- Heparin
- Hormones
- Anabolic steroids
- Androgens (testosterone, testosterone antate, testosterone undecanoate).
- Progestins
- Hormone antagonists
- Aldosterone antagonists (e.g., spironolactone).
- Aromatase inhibitors (anastrozole, testolactone) → alopecia androgenetica in women undergoing mammary carcinoma (breast cancer) therapy.
- Estrogen antagonists (antiestrogens) – tamoxifen → alopecia androgenetica in women under breast carcinoma therapy.
- Octreotide
- Prolactin antagonist (bromocriptine)
- Thyrostatic agents (carbimazole, propylthiouracil).
- Estrogens
- Immunosuppressants
- Azathioprine
- Ciclosporin (cyclosporin A)
- Interferons (Interferon-α)
- Immunotherapeutics (fingolimod).
- Lipid-lowering agents
- Fibrates
- HMG-CoA reductase inhibitors (statins) – atorvastatin, cerivastatin, fluvastatin, lovastatin, mevastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin.
- Nicotinic acid
- Mesalazine
- Metals
- Gold
- Arsenic
- Metal binder – D-penicillamine (chelating agent).
- Monoclonal antibodies – pertuzumab
- Proton pump inhibitors (PPI; acid blockers) – esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole.
- Uricosurics (benzbromarone, probenecid).
- Antivirals
- Vitamins and their derivatives
- Vitamin A
- Vitamin A derivatives: retinoids (acitretin, isotretinoin).
- Cytostatics
- Alkylants (busulfan* * , carmustine* , chlorambucil, cycophosphamide* * * , dacarbazine* , ifosfamide, melphalan* , procarbazine, thiotepa* ).
- Anthracyclines (adriamycin* * * , daunorubicin* * * , daunorubicin, epirubicin).
- Antimetabolites (cytarabine* , fluorouracil* , mercaptopurine* , methotrexate (MTX)* * ).
- Mitomycins (Mitomycin C* * )
- Platinum derivatives (carboplatin, cisplatin* , oxaliplatin).
- Purine analogues (thioguanine* )
- Taxanes (paclitaxel, taxoids* * * )
- Topoisomerase inhibitors (mitoxanthrones).
- Other cytostatic drugs (actinomycin* * , bleomycin* , camptothecin* * , capecitabine, cytarabine, estramustine, etoposide* * * , floxuridine* * , hexamethylmelamine* , Hydroxyurea* , Ifosfamide* * * , L-asparaginase* , Nitrogen mustard* * , Mitomycins, Streptozotocin* , Teniposide* * , Vincristine* * * , Vinblastine* * * , Vindesine* * * ).
* Mild alopecia* * Moderate alopecia* * * Strong alopecia.
X-rays
- Radiotherapy (radiotherapy, radiatio).
Environmental pollution – intoxications (poisonings).
- Air pollutants: particulate matter (PM10) and diesel exhaust (→ decrease in the concentration of the protein beta-catenin in hair follicles; beta-catenin is required for hair growth).