Diagnostics

Some forms of hair loss, such as circular hair loss and hereditary hormone-induced hair loss, can often be recognized by a glance diagnosis. In case of diffuse hair loss or unclear diagnosis, the hair, scalp and blood are examined more closely. Laboratory tests can easily detect chronic inflammation, thyroid gland dysfunction, anemia, iron deficiency or hormone irregularities.

The exact anamnesis, especially regarding medication, other chronic diseases, family history and menopause in women are equally important. By means of the plucking test (epilation test), the doctor can determine how severe the hair loss is. To do this, the doctor pulls lightly on a small tuft of hair to see how easily it can be removed from the scalp.

The hair roots can be examined more closely with the help of a trichogram. This involves microscopic examination of the different growth phases of some hairs. To create a trichogram, 20-50 hairs are torn out of the patient in the direction of growth.

The phase of the hair cycle can then be determined under the microscope. Since each hair goes through different phases, the proportion of hairs in each phase can be estimated. For healthy hair, more than 80% of the hair should be in the growth phase and less than 20% in the rejection phase.

The remaining 1-3% are usually in the transition phase. The plucking of the hairs is essential for the examination, since previously fallen hairs were obviously in the rejection phase, and thus no statement can be made about the vital hairs of the scalp. With the help of a TrichoScan, further parameters of the hair can be determined.

This is a special computer software, which uses digital photography to make a statement about the hair density per square centimeter, the hair diameter and the growth speed of the hair over time. This allows not only to assess the current hair loss in its intensity, but also allows a follow-up examination to evaluate the success of the therapy. With this examination method, the hair does not have to be pulled out, but small areas have to be shaved off in one or two places on the scalp.

After three days, the growing hairs are dyed and then photographed in high magnification. Based on the speed of growth, a special software calculates the proportion of individual hairs in the growth phases. If the clinical image is no longer sufficient to make a diagnosis, small tissue samples (biopsies) must be taken.

The tissue samples are taken deep enough that the entire hair follicle is visible under the microscope. The diagnostic procedure should be individually tailored to the specific anamnesis and indicative findings. For this purpose, an examination of hair growth and hair loss on the entire body is performed.

After diagnosis and analysis of the findings, an individual treatment concept should be developed. The elimination of the causative factors, such asB. the replacement of the triggering drugs or harmful substances may be followed by spontaneous recovery.

It can also help to try out measures that stimulate or accelerate hair growth. The androgen that is crucial for the development of androgenetic hair loss is dehydrotestosterone (DHT). It is metabolised from testosterone by two enzymes.

Therapeutic starting point is the hormonal follicle interaction. Selective enzyme inhibitors lead to a reduction of DHT (5-alpha-reductase inhibitor, finasteride, trade name: Propecia®). However, finasteride must not be used in women, as there is a risk of damage to the unborn male child in case of pregnancy!

An alternative is a local therapy with a 2- or 5% minoxidil solution. Applying it increases local blood circulation and stimulates hair growth. In women, the use of oral contraceptives (“pill”) can also have an effect.

For permanent scalp hair reconstruction, state-of-the-art surgical techniques achieve excellent aesthetic results. Hair restoration can be achieved by hair transplantation and plastic surgery reconstruction options. Homeopathic medicines can also have a positive effect on hair loss.

Here, the cause of the hair loss is taken into account. More about homeopathy and hair loss can be found in the topic: Homeopathy for hair loss. Hair loss is a widespread problem in the population and primarily affects men.

There are basically three different types of hair loss: Hormonally-inherited hair loss (alopecia androgenetica), circular hair loss (alopecia areata), and diffuse hair loss (alopecia diffusa). The causes of these forms of hair loss have not yet been fully explained, making treatment difficult in some cases. The diagnosis is made by closely observing the pattern of hair loss, taking a medical history of other underlying diseases and medication, as well as blood tests and other specific tests.

With the help of these diagnostic possibilities, the hair cycle and hair follicles can be examined in detail and thus possibly lead to a diagnosis. In many cases, the therapy consists of a lifelong medication intake. The form of hormone-induced hair loss is relatively easy to treat, because the exact cause and thus a therapeutic starting point has been found.

The therapy of diffuse hair loss consists of the treatment of the triggering underlying disease. Circular hair loss, on the other hand, is relatively difficult to treat because the exact cause has not yet been found. Basically, the therapy often takes a long time, and especially in the context of hormone-induced hair loss must be taken for life. Depending on the different causes and types of hair loss, the prognosis is very different.