Hair Loss

Diagnosis of Hair Loss

Before diagnosing hair loss, your doctor will likely perform a physical exam and review your diet, hair care routine, and medical and family history. Additional tests may be used to determine the cause, including:

• Blood test: Helps identify medical conditions that may contribute to hair loss.

• Pull test: Your doctor gently pulls several dozen hairs to assess how many come out, helping to determine the stage of shedding.

• Scalp biopsy: Samples of scalp skin or a few plucked hairs are examined under a microscope to identify infections or other causes of hair loss.

• Light microscopy: Hairs trimmed at the base are examined to uncover possible disorders of the hair shaft.

Early diagnosis can help determine whether hair loss is temporary, reversible, or requires ongoing management.

Treatment of Hair Loss

Effective treatments are available for some types of hair loss. Depending on the cause, hair may regrow naturally, or treatments may slow further loss and promote regrowth.

Medications

• Treat underlying conditions: If hair loss is caused by a disease or certain medications, addressing the condition or pausing the medication may help.

• Minoxidil (Rogaine): Available over-the-counter in liquid, foam, and shampoo forms. Applied once daily for women and twice daily for men, it may regrow hair or slow hair loss over at least six months. Continuous use is necessary to maintain results. Possible side effects include scalp irritation and unwanted hair growth on nearby skin.

• Finasteride (Propecia): Prescription pill for men that can slow hair loss and promote regrowth. Effects may take a few months to notice, and ongoing use is required. Rare side effects include reduced libido and sexual function. Women who are pregnant or may become pregnant should avoid contact with broken or crushed tablets.

• Other medications: Options include spironolactone and oral dutasteride for specific cases.

Hair Transplant Surgery

Hair transplant surgery can restore hair in bald areas, especially on the top of the head. A dermatologist or cosmetic surgeon removes hair from areas with healthy growth and transplants it to bald spots.

• Methods include micrografts, minigrafts, or larger strips of hair-bearing skin.

• The procedure is typically outpatient, with sedation provided for comfort.

• Possible risks include bleeding, bruising, swelling, and infection.

• Multiple procedures may be needed, and hereditary hair loss may continue despite surgery.

• Surgical hair restoration is generally not covered by insurance.

Laser Therapy

The FDA has approved low-level laser devices for hereditary hair loss in men and women. Studies show potential improvements in hair density, but more research is needed to confirm long-term effects.