Ready to learn the underlying cause of your hair loss? Here are the four ways a doctor will diagnose

By Deepa C. Lingam, MD

When a patient comes in for hair loss, they’ve typically noticed more hair shedding, discovered random patches of hair loss, or even just realized a change in texture or the amount of hair they have.

Regardless of what brought them in, there’s usually a valid reason, and it’s my job to help them determine what may be contributing to their loss.

Four ways your dermatologist may diagnose what’s causing your hair loss

The two most common forms of hair loss that we see at our practice are androgenetic alopecia, also known as male or female pattern hair loss in which heredity plays a major role, and telogen effluvium, a more diffused-type shedding of the hair that typically occurs after the body goes through something traumatic.

There are various causes for these different forms of hair loss, and as a dermatologist, here are some steps I may take to ensure we get an accurate diagnosis.

1.  Take a close look at your history

When evaluating a patient for hair loss, a lot of our work focuses on getting a very detailed history, and we ask a range of questions in order to gather this information.

Clinical history:  When did the loss start? Did it develop gradually or occur all of a sudden?

Medical history: Do you have any current medical problems or diseases? Have you had bariatric surgery?

Family history: Do you have a family history of early onset hair loss in parents or grandparents?  Does thyroid disease, anemia, or anything like that run in your family?

Since hair grooming practices can also play a role, we’re also going to ask how often you’re getting your hair colored or chemically treated, which can contribute to hair damage over time.  

2. Perform a thorough physical exam

We’ll also take a look at the scalp to see where the loss is occurring and check for any random patches of hair loss or significant thinning.

In female pattern hair loss, we first start to see significant thinning on the top of the scalp, so the crown of the scalp starts to show, and we typically don’t see as much of the recession of the hairline like you would see in male patients. In the later stages, we do eventually see a whitening of the scalp on the hair parting.

For women coming in at those early stages, it can be really hard to diagnosis them with androgenic alopecia because you don’t see the “part whitening.” That’s when the history would be very helpful, as well as taking a biopsy since we can see miniaturization of the hair follicles underneath the microscope, which points towards pattern hair loss.

For pattern hair loss in the male patient, we typically see a receding hairline in the temple region of the scalp, as well as significant thinning in the vertex, or the top back part of the scalp.

3. Identify recent life stressors

In order to diagnosis telogen effluvium, again we would get a good clinical history and ask a range of questions to see if the body has recently been under a lot of physical stress.

• Since postpartum hair loss is very common in women, we need to know if you’ve recently had a baby.
• Some medications can cause hair shedding so be sure to tell your dermatologist about any new medications you’ve started.
• General anesthesia can put the body under enough stress that it can cause hair shedding so also inform your doctor of any recent surgeries.

4. Check lab work

Since nutrition can play a role in hair health, it’s also possible that the patient isn’t absorbing all the nutrients they need as a result of disease or even weight loss surgery. By performing lab work, we can check for thyroid disease, anemia, and any deficiencies in iron, vitamin D, zinc, or other nutrients.

Following your hair trends over time provides clues as to which treatment is best for you long-term

Sometimes getting a diagnosis can be difficult, especially in the very early stages of loss, so along with going through these methods of diagnosis, we’ll also want to follow your hair loss, take pictures of your scalp and have you follow-up on a regular basis to see if the loss continues.

This way, we can track your progress, give you reassurance, and through proper treatment, help you stabilize that hair loss once and for all.

Contact Center of Surgical Dermatology in Westerville, OH To Determine the Cause of Your Hair Loss
Center of Surgical Dermatology is the largest medical and surgical skin treatment and wellness facility in Central Ohio. Since 2007, our board-certified Dermatologists, fellowship-trained Mohs surgeons, and caring professional staff have provided patients with the treatment they can trust in an environment second to none. Learn more about our state-of-the-art Dermatology Center before booking your appointment today.