Trichoscopy in self-inflicted hair loss: A valuable diagnostic tool for differential diagnosis


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Psychodermatology addresses the interplay between psychological factors and skin disorders. Stress and psychological events can have a significant impact on the course of dermatological conditions, often leading to profound psychological distress and secondary psychiatric disorders.

Among the branches of Psychodermatology, Psychotrichology is the most common and prevalent one.

Psychotrichological disorders cover a range of compulsive skin-picking syndromes, with self-inflicted hair loss being the most common subtype. This group of disorders involve deliberate and repetitive picking, scratching, and rubbing of hair and scalp, resulting in noticeable skin lesions. While formally classified as a mental health disorder, it is predominantly diagnosed by dermatologists due to the visible nature of the symptoms.

The most common among these disorders is Trichotillomania, characterized by the compulsive pulling out of one’s hair, leading to hair loss. Less common variants include Trichoteiromania (compulsive hair rubbing), Trichotemnomania (compulsive hair cutting or shaving), and Trichophagia (eating pulled-out hair, potentially causing digestive issues).

Differential diagnosis in dermatology can be complicated, thus requiring the use of trichoscopy as a valuable diagnostic tool. Trichoscopy reveals distinct features in each condition, facilitating accurate differentiation.

Since this subspecialty of Dermatology is relatively new, a holistic approach that addresses both psychological and dermatological needs is essential for these patients’ care.