**7. Diagnosis**

In the presence of hair loss, the key step is taking a thorough history of the patient. In addition, the affected areas of the scalp should be examined to determine the presence or absence of follicular orifices. It helps to distinguish the scarring and nonscarring alopecia [23]. In the presence of follicular orifices, nonscarring alopecia can be suspected, although further history findings are useful to unveil the main cause [14].

The diagnosis of TE is usually based on the patient's history, physical examination findings, and hair pull test results (**Table 2**) [10]. The recognition of diffuse, noninflammatory, nonscarring hair loss should raise the clinical suspicion for TE, when it occurs acutely and is preceded by a physiological or psychological stressor, in particular. In the majority of cases, scalp biopsy is not required [10].


**Table 2.** Diagnosis of telogen effluvium [10].
