The first finding of alopecia kind usually begins with the establishment of alopecia as either a scarring (cicatricial) alopecia or alopecia nonscarring. Nonscarring alopecia tend to have preserved follicular ostia. No clinically apparent inflammation is noted most of the presentations, but histological inflammation may be present. The most common nonscarring alopecia include alopecia areata and telogen effluvium.
Scarring alopecia have loss of follicular ostia or atrophy. Clinical inflammation is often, but not always present. Histological inflammation are present. Ultimately, histological confirmation is the best method to confirm the presence of fibrosis / scarring process hair follicles.
Many types of alopecia are biphasic. For example, androgenic alopecia ultimately resulting in loss of ostia, and therefore may be represented as a scarring alopecia.