Diagnosis and Evaluation of Hair Loss

Experiencing hair loss can be concerning, but an accurate diagnosis is essential for determining the underlying cause and developing an effective treatment plan. In this article, we will explore the process of diagnosing hair loss, including the evaluation methods used by healthcare professionals. By understanding the diagnostic process, readers will gain insight into the various factors considered and the importance of seeking professional guidance.

  1. Medical History: The first step in diagnosing hair loss involves taking a detailed medical history. This includes discussing the onset, duration, and pattern of hair loss, as well as any associated symptoms or medical conditions. Information about family history, medications, recent life events, and lifestyle factors is also important, as these can contribute to hair loss.
  2. Physical Examination: A thorough physical examination of the scalp and hair is conducted to assess the extent and characteristics of hair loss. The healthcare professional examines the scalp for signs of inflammation, scaling, redness, or scarring. They may also evaluate the density, texture, and overall health of the remaining hair.
  3. Pull Test: A pull test involves gently tugging on a group of hairs to determine the number of easily shed hairs. This test helps assess the stage of the hair growth cycle and the presence of excessive shedding, which may indicate certain types of hair loss.
  4. Scalp Biopsy: In some cases, a scalp biopsy may be necessary to obtain a tissue sample for further examination. A small piece of the scalp is removed under local anesthesia and sent to a laboratory for microscopic evaluation. This can help identify any underlying scalp conditions, inflammation, or scarring that may be contributing to hair loss.
  5. Blood Tests: Blood tests may be ordered to evaluate for specific medical conditions that can cause hair loss. These tests may check for levels of hormones, iron, thyroid function, vitamin D, and other relevant markers to identify any hormonal imbalances, nutritional deficiencies, or underlying systemic diseases.
  6. Trichoscopy: Trichoscopy is a non-invasive diagnostic technique that uses a specialized handheld device with magnification and light to examine the scalp and hair follicles in detail. It helps identify specific hair and scalp characteristics, such as hair shaft thickness, follicular openings, presence of miniaturized hairs, and signs of inflammation or scarring.
  7. Phototrichogram: A phototrichogram involves taking high-resolution photographs of the scalp and hair to analyze hair density and thickness. This method provides quantitative data on hair growth, shedding, and regrowth rates, helping to monitor the progress of hair loss and response to treatment over time.
  8. Hormonal Evaluation: In cases where hormonal imbalances are suspected, hormone evaluation may be performed. This involves measuring hormone levels, such as testosterone, dihydrotestosterone (DHT), estrogen, progesterone, and thyroid hormones, to assess their impact on hair follicles and overall hair health.
  9. Consultation with Specialists: In complex cases or when a specific underlying condition is suspected, a referral to a dermatologist or trichologist may be recommended. These specialists have expertise in diagnosing and treating hair loss and can provide further insights and treatment options.


Diagnosing hair loss involves a comprehensive evaluation process that includes taking a medical history, performing a physical examination, conducting specialized tests, and considering various factors that contribute to hair loss. Seeking professional advice is crucial for an accurate diagnosis and personalized treatment plan. By understanding the diagnostic process, individuals can make informed decisions and take proactive steps towards managing and treating their hair loss effectively.

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