Hair Loss Consultation

Hair loss is a complex condition that encompasses various types and causes. It is not simply a single disease but rather a broad spectrum of conditions that affect the hair follicles.

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Types of Hair Loss

You can group conditions by inflammation and hair loss patterns, which may be widespread or patchy. Common types of hair loss include androgenetic alopecia, telogen effluvium, alopecia areata, traction alopecia, lichen planopilaris, and frontal fibrosing alopecia.

However, there are more conditions that may result in hair loss.

Diagnosing Hair Loss

To accurately diagnose and understand the underlying causes of hair loss, a comprehensive approach is necessary. At our clinic, we employ a variety of methods to establish the correct diagnosis. This includes:

  1. Conducting a thorough anamnesis (patient history)
  2. Assessing the patient’s family history and medical background
  3. Conducting relevant blood tests
  4. Performing a detailed clinical examination
  5. Employing trichoscopy (microscopic examination of the hair and scalp)
  6. Performing a biopsy (tissue sample analysis) if necessary.

By utilizing these comprehensive diagnostic methods, we can accurately identify the underlying cause of hair loss in most cases. This approach allows us to develop tailored treatment plans that address the specific needs and concerns of our patients. Finding the right diagnosis is vital for choosing the best treatment and avoiding unnecessary actions.

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How We Diagnose Hair Loss

Blood Tests for Hair Loss

While not necessary for all types of hair loss, blood work can be crucial in diagnosing certain forms of hair loss. It is particularly beneficial when determining the underlying cause of telogen effluvium, as it can significantly impact the treatment plan. If you had blood tests before your appointment, please bring the results with you. We use blood tests to diagnose hair loss and may need more tests based on the examination. We have negotiated a lower price for blood tests at a lab nearby. This means that you can get the tests you need without having to spend a lot of money.

Clinical Examination

Clinical examination is vital when diagnosing hair loss, checking for inflammation, scaling, thinning, and areas of patches of hair loss. We closely examine the hair shafts for thinning, breakage, twisting, and other abnormalities that can provide diagnostic insights. Additionally, we analyze the relevant skin and nails, as other skin or nail conditions can sometimes be associated with hair loss. We also perform a “pull test” by gently pulling out a small segment of hair for microscopic examination. This information contributes to an accurate diagnosis and facilitates the development of an appropriate treatment plan.

Trichoscopy

We incorporate trichoscopy in our examination of hair loss. Trichoscopy is a non-invasive way to examine hair and scalp using a special device called a dermatoscope. This tool assists in identifying and addressing issues with hair and scalp. It does so by providing a detailed view of the hair follicles and scalp structures. We use a digital trichoscopy system with artificial intelligence (FotoFinder). It saves photos on a secure server for progress monitoring, following HIPAA guidelines.

Scalp Biopsy

In challenging cases, doctors may perform a scalp biopsy to diagnose certain types of hair loss. This procedure is particularly essential for hair loss among African American patients, as their presentation can be more challenging. Scalp biopsy is a relatively simple procedure. A dermatologist numbs the area with medicine. Then, they take a small piece of skin. Finally, they send it to a lab for testing. In some cases, the doctor will take two samples for different sections. Small cuts are stitched up. Biopsy results typically take up to two weeks to be ready. Dr. Kazlouskaya, a board-certified dermatologist and dermatopathologist, evaluates scalp biopsies to establish an accurate diagnosis. You can choose between a televisit or a personal appointment for the biopsy follow-up. The cost of the follow-up is already included in the initial visit.

Patient History

During consultations, we discuss various factors related to hair loss, including:

Genetic factors

Family members often exhibit androgenetic alopecia, commonly known as male or female pattern baldness. Early intervention is key in preventing its progression.

Stress

Stress and lack of sleep can make hair loss worse. When we experience high levels of stress, our body releases hormones that disrupt the hair growth cycle. Finding healthy ways to manage stress, such as exercise, meditation, or therapy, can help prevent hair loss.

Diet

Lack of essential nutrients and protein can contribute to hair loss. Additionally, restrictive diets to fight body weight, such as keto or strict vegan diets may also lead to hair loss.

Metabolism

Recent studies suggest a connection between androgenetic hair loss and heart disease.

Chronic Conditions

Various chronic conditions can cause different types of hair loss, such as chronic telogen effluvium. A thorough medical examination with a primary care provider is essential to assess for any underlying chronic conditions.

Medications

Certain medications can cause hair loss. These medications include those used for high blood pressure, inflammation, infections, cancer, mental health, weight loss medications, and hormone replacement.

Hairstyling Practices

Tight hairstyles, like ponytails or braids, can put excessive tension on the hair follicles and cause traction alopecia. Heat styling tools, such as flat irons and curling irons, can damage the hair shaft and cause breakage. It is important to give your hair regular breaks from these practices and use heat-protectant products when styling.

Haircare

Maintaining a proper hair care routine is essential for preventing hair loss. Regularly washing and conditioning your hair with gentle products can keep the scalp clean and healthy. Avoiding harsh chemicals and excessive heat can also help maintain the integrity of your hair. Additionally, using a wide-toothed comb or a brush with soft bristles can minimize hair breakage.

Psoriasis of the scalp. Scaling and focal bleeding seen on dermoscopy.

Black dots and yellow dots, as well as miniaturized hair – signs of active alopecia areata.

Miniaturized hair and thin pigtail re-growing hair in alopecia areata.

Lichen planopilaris / Frontal fibrosing alopecia. Dermoscopy demonstrates inflammation around hair follicles.

Frequently Asked Questions

Many clinics offer hair loss treatments without providing a detailed hair loss consultation. However, due to the myriad reasons for hair loss and the challenge of identifying those factors, a thorough consultation is necessary. Without consulting properly, doctors may make a wrong diagnosis, which can result in ineffective treatment. We strongly believe that a consultation is essential for the success of hair loss treatment.

Accurately diagnosing the specific condition being treated is crucial to ensure the treatment’s potential effectiveness. Each hair loss condition can vary significantly in terms of treatment. While many types of hair loss may persist throughout one’s life, there are treatments designed for specific conditions. The efficacy of treatment depends on factors such as patient compliance, correct diagnosis, patient contraindications, and other individual factors.

Coverage for hair loss treatment depends on various factors. FDA-approved medical treatments can treat certain types of hair loss. Finasteride and minoxidil are FDA-approved for male pattern baldness, with Propecia often covered by insurance. Baricitinib and Ritlecitinib are two medications FDA-approved for alopecia areata. Other medications may require prior authorization from insurance companies. Insurance companies typically do not cover regenerative hair loss treatments such as PRP injections, laser treatment and microneedling. We can assist with insurance inquiries and provide the necessary documentation for coverage considerations.

Board-certified dermatologists are the most qualified specialists to address hair loss. They have special training to treat skin, nail, and hair conditions. They can diagnose and create effective treatment plans. Check if trichologists have medical degrees to prescribe medicines and give accurate diagnoses. Others may claim to be trichologists, but it’s important to verify their qualifications.

There is no one-size-fits-all “best” treatment for hair loss, as each case is unique. Before starting any long-term treatment, it is important to have a confirmed diagnosis. Our comprehensive consultations ensure that we recommend the most suitable and effective treatments based on individual needs.

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