You’ve decided it’s time to consider hair restoration. While you’re excited to get the process going, you might be wondering what will happen at that first exam.
Before recommending the best hair restoration procedure for you, your doctor will examine your scalp to determine the cause of your hair loss. Most people seeking hair restoration in the U.S. are among the 80 million men and women who have male and female pattern hair loss, a condition that is simple to diagnose and easy to treat.
If the exam shows your hair loss comes from anything other than male or female pattern baldness, the doctor will seek out the cause through various tests. In some cases, you may have an underlying condition that needs to be treated before you can begin hair restoration. Here are some of the tests you can expect your doctor to perform at your first visit if you hair loss is not due to pattern baldness.
Doctors use a hair pull on nearly every patient who complains of unexplained hair loss. It helps them determine if there are any abnormalities in your hair growth cycle. During the hair pull, about 25 to 50 hairs are taken from your scalp during a series of gentle hair pulls. Normally, with each hair pull, only a few will come out. However, when more than a few come out at a time, there is a possibility of abnormal hair growth cycling. Once the hairs are removed, the ends may be examined under a microscope to determine the condition of the hair shaft and the bulb (the end of the hair shaft extracted from the hair follicle).
There are two variations of the hair pull – the phototrichogram and the hair window:
Phototrichogram— During this procedure, hairs are clipped or shaved from an area of the scalp. Photos then will be taken over a period of 3 to 5 days to determine the pattern as the hair grows back.
Hair window— During the hair window, hairs are once again clipped or shaved in an area of the scalp. This time, the hair growth is evaluated for the next 3 to 30 days.
Abnormalities in hair growth cycling are not common, but they can occur at any age. When there is an abnormality in hair growth cycling, common causes can be a thyroid hormone imbalance, nutritional deficiencies, side effects of certain drugs, anemia and other systemic illnesses or psychological stress.
While this is not a common procedure, a doctor may perform a biopsy of your scalp if additional information is needed to evaluate hair loss inside of the hair follicle. Biopsies are not common for most patients being evaluated for hair loss and hair restoration.
Hair Shaft Evaluation
If doctors do suspect a hair shaft abnormality or infection, they will look under a microscope at the hairs removed during your hair pull. Hair shaft abnormalities, and fungal, bacterial or viral infections can be responsible for hair loss associated with hair breakage, hair shedding and hair that is unruly.
A hair specialist physician will order a hair analysis only to determine the reason for a hair shaft abnormality. The test has no value for the diagnosis of systemic disease or nutritional status, despite what some non-physician "hair analysis specialists" might say.
Hair analysis is a laboratory test done if a hair shaft abnormality needs to be looked at further for:
-Altered hair-protein profile from an inherited abnormality
-Drug ingestion or heavy mental contamination.
Fortunately, most people seeking hair restoration in the U.S. are among the 80 million men and women who have male and female pattern hair loss, a condition simple to diagnose and easy to treat.
Extensive diagnostic work-ups for these easily recognized conditions are usually not necessary. There are other causes of hair loss, however, and it is essential that the cause of hair loss be evaluated before hair restoration is undertaken. Contact one of our ISHRS physicians by using our Hair Restoration Doctor Search.