Evaluation of Hair Loss

A thorough evaluation including scalp and hair microscopic assessment, or more commonly known as the miniaturization study, should be part of an initial evaluation for every hair loss Patient.

Obtaining personal family history of baldness is critical in making the proper diagnosis. A detailed history should be taken that includes the time, speed and quality of hair loss and its association with other medical, physical or emotional factors.

Miniaturization study is a key step in hair loss evaluation to assess stablity of donor area and predict the progress of hair loss.

A history of medical problems is particularly useful in women with female pattern baldness because it helps discover any treatable disorder that may have caused or accelerated the process of hair loss.

The most common disorders are: Iron deficiency, thyroid disorders, autoimmune diseases such as lupus and hormonal imbalances, such as increased male hormone or altered estrogen or progesterone levels.

Some medications could cause hair loss in both men and women in which case a more detailed history of medication use would be obtained.

Miniaturization study or recording the hair caliber changes on a microscopic level is used to diagnose most common hair loss patterns. Microscopic evaluation is also used to predict future hair loss.

The initial evaluation includes measurements of donor quality and scalp laxity. Those two factors are key to patients who undergo hair transplant procedure.

How a person’s hair will appear after hair transplant surgery is very important. These characteristics include: thicker hair vs. thinner one, wavy vs. straight and minimum contrast of hair with the skin. Less contrast means less visibility of the scalp and less appearance of baldness.

An examination is important because it helps us to determine a person’s qualifications for hair transplantation and to estimate the number of grafts needed. The pattern of hair loss, especially whether it is focal or diffused, may help diagnose the type of baldness. Some of the less common types of hair loss such as alopecia areata present with very limited focal hair loss.