Diagnosis of Hair Loss


Diagnosis of Hair Loss

Has the amount of hair in your brush or on the shower floor increased? Is your hairline thinning or receding? If so, it’s time to take action and uncover the cause of your hair loss. In this blog post, we’ll explore some of the most common reasons for thinning hair and help you determine what steps to take next.

Understand Your Family History

Understanding your family history is an integral part of diagnosing hair loss. Hereditary hair loss means hair loss in families, most often found in men and women. Women are also more likely to lose hair if they have a family history of hair loss. For example, a positive record on the mother’s side may be significant for female pattern hair loss (FPHL) development. Your doctor will ask about your medical and family history, including if any relatives experienced hair loss and at what age, as well as other factors such as age, significant weight loss, certain medical conditions, and more. A detailed history of hair loss can help to determine the cause and ultimately guide the treatment plan.

Physical Exam

In the physical exam, your doctor will also look for signs of hair loss. They may perform a pull test, which involves gently pulling several dozen hairs to check for excessive shedding. They may also look at your nails to check for signs of disorders like alopecia areata, which can cause nail changes. Your doctor may take a scalp sample under the microscope or do a blood test to check hormone levels such as DHEA, testosterone, androstenedione, prolactin, follicular stimulating hormone, and luteinizing hormone. Finally, they will examine the areas where hair has been lost for any signs of scarring or scaling that could indicate a particular type of alopecia.

Check Your Nails

In addition to looking at the scalp, checking your nails for signs of hair loss is essential. Between 10 and 20 per cent of people with alopecia areata have nail changes, such as dry and brittle nails. If you have alopecia areata, your doctor may be able to identify it by looking at the extent of your hair loss and a few hairs from the bald spots. It is crucial to consider additional hair loss factors, such as vitamin deficits, illnesses, and hormonal shifts. A physical examination and blood tests may discover the underlying cause of hair loss. Reviewing your family’s history of hair loss is crucial to determining whether there is a genetic component to your condition.

Blood Test

Blood testing is a crucial component of determining the root of hair loss. A complete blood count (CBC) will give your doctor an overall picture of your health and help determine if any underlying medical conditions could contribute to your hair loss. Iron, haemoglobin, and ferritin levels can also be tested to check for anaemia, which can lead to hair loss. The DHT male hair loss test is a complete hair testing solution that fits DHT levels in the scalp. Suppose a doctor suspects the hair loss may be due to an underlying medical condition. In that case, they may also request additional tests to rule out autoimmune diseases such as lupus or rheumatoid arthritis. The results of these tests can provide valuable information to help your doctor accurately diagnose the cause of your hair loss and recommend the best treatment plan for you.

Scalp Biopsy

A scalp biopsy may be recommended to help diagnose the cause of hair loss. It is a quick and simple procedure where a small skin sample is removed from the scalp for testing and examination. The biopsy can help identify underlying medical conditions and diagnose some causes of thinning hair that may not be visible. It can also be used to exclude telogen effluvium or early scarring alopecia in cases where the pattern of AGA is not typical. A scalp biopsy can even help to identify fungal agents or any signs of autoimmune disease. To inspect the hair roots, your doctor may also scrape samples from the skin or remove a few hairs from the scalp. You can better understand what is causing your hair loss and go over potential treatment choices with your doctor by learning about your family history, conducting a physical exam, checking your nails, getting a blood test, and getting a scalp biopsy.

Hair Pull

Hair pull is a diagnostic test used to assess the severity of hair loss. It involves the doctor gently pulling a small amount of hair (around 100 strands) to determine if excessive shedding has occurred. The test helps diagnose conditions such as telogen effluvium or diffuse alopecia areata, which can cause a positive hair pull test result. To understand why a pull test is practical for diagnosing hair loss, it’s essential to know how your hair grows and can be affected by various conditions. If more than three hairs come out when the doctor pulls the small amount of hair, you are likely experiencing some degree of hair loss. Hair pull can be used with other diagnostic tools, such as a scalp biopsy, blood tests, and physical examination, to provide a more comprehensive understanding of the cause and severity of hair loss. Understanding your family history and looking for signs of autoimmune disease can also be important in diagnosing hair loss. Working with your dermatologist to discuss possible causes and treatment options can help you determine the best approach to restoring your healthy head of hair.

Examination of Areas Where Hair Has Been Lost

Examining areas where hair has been lost is essential to diagnosing the cause. Your dermatologist may use a dermoscopy tool to analyze the scalp, look for signs of scarring or another skin disease, and even determine if there is excessive hair loss. Focal hair loss can be further broken down into scarring and non-scarring causes, which a dermatologist will evaluate. Additionally, your doctor may take a small sample of skin or hair from the scalp for further examination. A biopsy may also be done if the diagnosis is unclear after examination and other tests. By looking at the degree of hair loss, examining hairs, and discussing possible causes and treatment options with you, your doctor can accurately diagnose alopecia areata. Treatments such as creams, topical medications, light therapy, or injections may be recommended depending on the severity of your condition.

Detailed History of Hair Loss

Obtaining a detailed history from patients with hair loss is essential, as it may provide clues to the underlying cause. This should include questions about family history and when and how the hair loss began. Ask about any associated symptoms, such as itching or burning, and if there have been any changes in the nails. Blood tests may be ordered to check for underlying medical conditions, and a scalp biopsy may be performed to rule out certain forms of alopecia. The pull test and examination of areas where hair has been lost can also help to evaluate diffuse scalp hair loss. Understanding the basic principles of hair biology, potential causes of hair loss and awareness of autoimmune diseases are essential in diagnosing. With this information, NYU Langone dermatologists can discuss possible causes and treatment options with the patient.

Look for Signs of Autoimmune Disease

When diagnosing hair loss, looking for signs of autoimmune disease is essential, as this can be a significant cause. When the body’s immune system mistakenly attacks healthy cells, an autoimmune disorder as alopecia areata develops, resulting in patchy hair loss on the scalp. To identify an underlying medical disease that may be the root of your hair loss, your doctor may advise a blood test or scalp biopsy. Also, it’s crucial to check places where hair has fallen out for indications of an autoimmune condition. Talk to your doctor if you have a family history of autoimmune disorders like thyroid illness, psoriasis, or vitiligo. These problems can raise your risk of developing alopecia areata. Your doctor can identify any underlying causes of your hair loss and go over potential treatments with you after a comprehensive examination and complete history.

Discuss Possible Causes and Treatment Options

Your doctor will discuss possible causes and treatment options for your hair loss depending on the results of your physical exam, family history and blood tests. If your doctor thinks an underlying medical problem could cause your hair loss, he or she can suggest a blood test or a scalp biopsy. Minoxidil can be used to treat androgenetic alopecia, which can be clinically identified. Platelet-Rich Plasma (PRP) is injected into the scalp to encourage hair growth once alopecia areata is determined by the characteristic patches of hair loss. Treatment and preventative strategies may help maintain a healthy head of hair. Hair loss may be temporary or permanent or brought on by illness, stress, or heredity. Your doctor can recommend the finest therapies for your condition.



Hair loss can be caused by various factors, from genetic predisposition to medical conditions. Proper diagnosis is essential in determining the cause and best treatment option. A thorough medical history, physical exam, blood tests, scalp biopsy, hair pull test, and examination of areas where hair has been lost can all help to diagnose the condition and develop a treatment plan. Understanding your family history can also provide insight into potential causes. In some cases, autoimmune diseases may cause hair loss and should be discussed with your doctor. Hair loss can be managed and prevented with the correct diagnosis and treatment plan.

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