The right advice is the basis for successful treatment
We all know them, have been advised to try them or have actually tried them: tips, tricks and household remedies to help with hair loss. Sometimes it even works – they say faith moves mountains – but sometimes it doesn’t. So spare yourself the detours and get professional help right from the start. Consult your physician to help you determine the cause of your hair loss and treat it directly. To prepare optimally for a doctor’s visit, use the questionnaire here which you can complete in advance.
How do I treat my hair loss?
Specific drug therapies are available for the various forms of hair loss.
In diffuse hair loss, for example, hair growth can be stimulated and hair loss significantly reduced by supplying suitable nutrients. One effective treatment option are Pantogar® capsules. Pantogar® capsules anti-hair loss formula contains a specifically formulated active substance complex which stops hair loss and stimulates the growth of new hair. For a list of places where you can find Pantogar®, see here.
Special products are also available for hereditary or androgenetic hair loss.
However, particular consistency and patience are always required: because of the life cycle of a hair, a treatment should be carried out for at least 3 to 6 months.
How your doctor diagnoses hair loss
You have prepared well for your appointment with a medical specialist and are wondering how the doctor will proceed during your consultation? You would like to know what procedures they might use to find out the cause of your hair loss?
Depending on the degree of hair loss, your doctor may diagnose you using different procedures:
- Scalp inspection / hair parting
- Plucking or epilation test
- Scouring through the hair
- Hair rubbing test
- Blood test
- Trichogram
- TrichoScan
- Scalp biopsy
Scalp inspection / hair parting
The doctor will usually examine your hair under a bright lamp. They check the hair structure, scalp and hair density thoroughly.
Depending on the type of hair loss or scalp disorder, the skin of the entire body is checked and conspicuous areas are examined using an incident light microscope. Examination of body hair can also be necessary for many types of hair loss.
Image source: Textbook source: Textbook “Hair – Practice of Trichology” by Prof. Ralph M. Trüeb, Steinkopff Verlag, Darmstadt
Plucking or epilation test
The doctor reaches into the patient’s hair and tries to pull this out with a gentle tug. This test is performed on several parts of the scalp to determine how easily the hair detaches from the scalp. The severity of hair loss can be roughly determined by this procedure, but not the cause of the hair loss.
Note: This test only provides a rough estimate of the extent of hair loss. The doctor will then carry out further tests to determine hair loss more precisely.
Image source: Textbook source: Textbook “Hair – Practice of Trichology” by Prof. Ralph M. Trüeb, Steinkopff Verlag, Darmstadt
Scouring through the hair
This allows the doctor to detect an increase in loose “telogen hairs”, in other words hairs that are in the resting phase and fall out at the end of this phase (more information on the hair growth cycle).
With spread fingers, the doctor reaches into the patient’s hair against the direction of growth and, with closed fingers, slowly pulls in the direction of hair growth. If more than 5-10 hairs get stuck in the doctor’s fingers, this can be an indication of increased hair loss.
Hair rubbing test
The doctor takes some hairs between their fingers and rubs them. This enables the doctor to determine whether the hair is more brittle than normal and whether there may be damage to the hair structure.
If the hair rubbing test shows an increased brittleness, the doctor will carry out further examinations, as this test cannot determine the cause of hair loss either.
Image source: Textbook source: Textbook “Hair – Practice of Trichology” by Prof. Ralph M. Trüeb, Steinkopff Verlag, Darmstadt
Blood test
Medications, certain illnesses or deficiencies can be the cause of diffuse hair loss. The doctor therefore takes blood samples, for example to check thyroid or iron levels. Once the findings are available, such illnesses or deficiencies can be treated specifically.
MICROSCOPIC EXAMINATIONS
Microscopy can make the diagnosis of hair loss much more precise. Find out more about examination methods such as TrichoScan, trichogram, biopsy.
TrichoScan
The TrichoScan method is a modern, computer-assisted analysis method for determining hair density and hair root status. For the analysis, the hair is no longer removed from the scalp; rather, an affected area of the scalp measuring approx. 16-20 mm is shaved off in a place that can be easily concealed. The area is dyed with ink dye and an image is taken at 20x magnification using digital microscopic photography. The image is then automatically analysed by the software in the computer and the hair density is determined. If the status of the hair root is also to be determined, as with the trichogram, the hair stubbles are only dyed and photographed after three days.
Image source: Prof. Hoffmann
Hair in the growth phase grows back in the three days after shaving and before taking a photograph; hair in the resting or loss phase remains in the shaved length and does not grow back. The proportion of hair in the growth phase is analysed. Normally, about 80-90% of all hair is currently in the growth phase. An increased proportion of hair in the resting or loss phase can give further indications of the form of hair loss.
The advantage of this method is that no hair has to be plucked out. The hair can also be washed beforehand as usual. Another positive aspect is that the results can be archived on a computer. The doctor can monitor the course of the disease and the healing process with further future examinations and thus determine possible improvements.
Trichogram – light microscopic hair analysis
The trichogram is the light microscopic examination of the hair roots. The doctor removes a strand of around 50 hairs from the affected region of the scalp by pulling out the hair with a rubber-reinforced clamp. The same number of hairs is removed from another area of the scalp not affected by hair loss. Both tufts are then examined and analysed under the microscope.
Image source: Textbook “Hair – Practice of Trichology” by Prof. Ralph M. Trüeb, Steinkopff Verlag, Darmstadt
Assessment of the hair
The specialist doctor can see which phase of the growth cycle the plucked hair is currently in. They examine whether the hair is in balance between the growth, transition and resting phases of the hair cycle (more information on the growth cycle can be found in the hair lexicon). In addition, the doctor can assess whether the hair roots have changed pathologically, whether there is an increase in hair breakage or whether the surface structure of the hair has changed.
Image source: Textbook “Hair – Practice of Trichology” by Prof. Ralph M. Trüeb, Steinkopff Verlag, Darmstadt
This procedure is very painful for people who are sensitive to pain. In addition, the hair must not be washed for around one week before the trichogram, otherwise the results would be distorted. A trichogram should be performed by an experienced doctor. Today, photographic methods such as the TrichoScan provide more accurate results.
Scalp biopsy
Biopsy is the technical term for the removal and examination of tissue from a living organism. In the case of hair loss, the doctor removes a 4mm piece of the scalp, including the hair roots. The collection is of course carried out under local anaesthesia. The piece of scalp is then examined under the microscope. The number of active hair follicles is also determined. The biopsy can be particularly useful in cases of unexplained scalp diseases and scarring alopecia in order to obtain further information about the disease.
Image source: Textbook “Hair – Practice of Trichology” by Prof. Ralph M. Trüeb, Steinkopff Verlag, Darmstadt
