Diagnostics to hair loss

The recognition and treatment of male and female hair loss is a complex task which can often only be determined by the outcome of different specific diagnoses.
Male and female hair loss can be caused by many, often different, underlying syndromes or causes. The fact that around 80% of the patients can already be diagnosed on the basis of a thorough examination of case history (syndromes) and extensive clinical research proofs the importance of these examinations.

In the first place, it is required that the patient is always subjected to a thorough local examination in order to be able to set a diagnosis. The specialized doctor will evaluate whether it is a matter of baldness (alopecia) or a temporary form of male and female hair loss (effluvium) and if the scalp features any infections or other disorders.

The specialized physician thoroughly examines the scalp

During the consultation with the specialized doctor, a detailed discussion will take place on the basis of a medical questionnaire filled in by the patient. In this discussion, the patient can ask all questions he finds important, and the causes of the hair loss will be discussed thoroughly. It is often already possible at this stage to work out a concept of treatment. The patient will receive elaborate information about male and female hair loss during this conversation. The doctor will then take pictures which can be added to the patient's file. This makes it possible to check up on the development and effectiveness of the medication or the treatment, on the basis of comparing pictures.

This method of examination makes it possible to obtain information about the status of the hair roots. A study of the status of the hair roots takes place, which makes it possible to obtain information about the phases of hair growth and the deviating forms of the hair roots. An example is that in patients with advanced androgenetic alopecia only around 50% of the hair (instead of 80%) is in the growth phase. During a trichogram, around 50 hairs on at least two locations on the scalp are depilated by use of a clip, and subsequently, the hair roots that are to be studied are looked at under a microscope.

Depilation of the hairs by use of a clip

Microscopic examination

The phase of life of the hairs will be examined. The diagnosis is determined by the proportion of the number of hairs in the three different phases of life. If 35% or more of the hairs are in the resting phase, there is a potential problem

Hair count at the TrichoScan

A screen shot of a Trichoscan - diagnosis

At a Trichoscan or Microderm hair, a special microscope and special software is used to count the number of hairs in a certain area, to measure the thickness of the hair and evaluate it. This examination is a further development of the Trichogram. In it, the hairs are only shaved of at two small locations and are examined.

After two days, usually another examination takes place. This Trichoscan method is relatively laborious, but unlike classic Trichogram examination, it leads to very precise, reproducible and digitally documentable results. This examination is painless for the patients, and enables the specialist to evaluate the effectiveness of a therapy, even in the case of differing checks

Analysis of the hair roots at the TrichoScan

Blood test:

A blood test can lead to recognition of various physical diseases.

Hormonal status:

This test applies especially to women and will be determined at the beginning of the follicular phase or at the end of the monthly stop of the pill.

Analysis of hair and mineral material:

In contrast to a blood test, this test will explain possible problems based on the past months. In this way, it is possible under certain conditions to recognize intoxications of the body, such as cadmium or quicksilver intoxication. This analysis can not replace other test methods and is at this moment not yet telling. It is only possible to obtain possibly useful additional information in diagnostic coherence.

Blood samples to be examined

A biopsy of the scalp is only necessary in some cases, such as in the case that the diagnosis of a hair disease is dubious or unambiguous. In this case, a small strip of skin with a length of around 0,8mm to 1,0mm and a width of 3,0mm is removed with a scalpel, and subjected to histological research.

Close-up of the scalp before a biopsy