How is hair loss diagnosed?

If a blood analysis shows high levels of male hormones (androgens), a hormonal cause for hair loss may be present, in which case additional…

The Importance of Diagnosing Hair Loss – A Cautionary Tale

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How is hair loss diagnosed? – 2022

If a blood analysis shows high levels of male hormones (androgens), a hormonal cause for hair loss may be present, in which case additional hormone tests are performed. If we suspect an underlying illness as the cause of the loss of hair, other examinations like blood pressure measurement, ECG or ultrasound tests are carried out to find out whether there is an illness affecting the body’s organs or muscles.

A detailed discussion between the patient and the doctor is essential for each diagnosis. The first questions are about previous illnesses, hormonal changes or possible stress factors.

A plucking test in front of the mirror at home can provide initial information. If individual hairs together with the hair root can be pulled out of the scalp with a gentle pull, this usually means there is pathological hair loss.

The first step in diagnosing hair loss is to perform a thorough physical examination of the scalp in order to rule out possible underlying conditions, such as thyroid disease, lupus erythematosus, or seborrheic dermatitis. A blood test may also be ordered if you are experiencing symptoms that could indicate an underlying medical condition.

The second step in diagnosing hair loss is to document your hair loss over time. Your physician will look at your medical history and ask questions about your family’s pattern of baldness and hair thinning. Photographs taken over a period of time can help your physician determine if you are losing more than the typical amount of hair for someone of your age and ethnicity. This documentation system is used to confirm the presence and extent of your thinning and/or balding areas over time.

Your physician will also take note of how much hair you have lost from each part of your body and whether the pattern is sudden or gradual in onset. Sudden onset may indicate certain types.

When we lose hair every day, we don’t give it a second thought. But when those hairs start to pile up on the drain of your sink, you may be thinking that it’s time to go see a doctor. And this is the right decision—when hair loss occurs in greater quantities than normal, it can be due to hormonal changes, genetics, stress or illness.

But how do you know if your hair loss is abnormal? One way is to test for it in front of the mirror at home. In most cases, normal hair loss will pull out with a gentle tug—the hair root comes out with the hair strand. If individual hairs come out without the root, then this is an indication of pathological hair loss.

Another technique is to pluck 10–15 hairs from different areas of your scalp: if three or more are lost without roots, you should consult a dermatologist for further examination.

When you wake up in the morning, you expect your hair to be there, flat against your head, where it’s supposed to be. But what if there’s a hole where your hair should be? What if you start pulling out handfuls of hair from that spot? Or what if you feel a tingling sensation at the back of your scalp? These symptoms could all indicate that you’re experiencing some sort of pathological hair loss, which means that you need to consult a dermatologist as soon as possible.

Three conditions are responsible for almost all cases of pathological hair loss: alopecia areata, telogen effluvium and anagen effluvium. A dermatologist will first talk with you about your health history and the changes in your diet and stress level before they assess whether one of these three conditions is causing your hair loss. To determine which condition is responsible for your situation, a blood test is usually performed to rule out other possible problems. Prior to this blood test, the skin on your scalp will be examined under magnification. The skin can show several signs of alopecia areata: for example, an area with missing or broken hairs that is surrounded by inflammation can be observed.

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