Diagnosis of alopecia in women should be done with sensitivity towards most women's concern for their age and depends on careful examination of the scalp for signs of inflammation, scarring and scalping and a careful patient history because many of the causes for hair loss have no unique characteristics or laboratory findings. Fungal and bacterial infections can be diagnosed by culture of the respective organism. Seborrhea and psoriasis can be confirmed by associated findings on other parts of the body. Disorders of the endocrine system like hirsutism and acne can be diagnosed by laboratory tests and alopecia areata, an uncommon form of baldness, leaves a typical patch of baldness and can be confirmed by a scalp biopsy. Hair loss secondary to systemic diseases such as cancer and lupus should be part of the diagnosis of the underlying disease.
Androgenetic alopecia is caused by testosterone and a genetic predisposition for baldness.
Its exact mechanism has yet to be established and it is difficult to distinguish it from age-related baldness. Although most cases of alopecia resolve spontaneously, some patients require drug treatment of their specific conditions. Fungicidal and bactericidal preparations, medicated shampoos, cortisone creams and a variety of systemic medications are effective in treating specific causes of baldness. Thyroid hormone therapy is controversial as is the effect of massages.