What tests does a trichologist do?

A trichologist employs various diagnostic tests to accurately determine the underlying causes of hair loss, scalp conditions, and hair shaft disorders. These specialists focus on understanding the health of the hair and scalp, often linking symptoms to internal health imbalances or external factors.

Common diagnostic tests and methods a trichologist might utilize include:

Initial Consultation and Assessment

The diagnostic process typically begins with a thorough consultation, where the trichologist will:

Take a Detailed Medical History: Inquire about your overall health, any existing medical conditions, medications, dietary habits, stress levels, and family history of hair loss.
Discuss Lifestyle Factors: Explore daily routines, hair care practices, and potential environmental exposures that might contribute to your condition.
Perform a Visual Examination: Carefully inspect your scalp for signs of inflammation, scaling, redness, or scarring, and assess your hair's density, texture, and overall condition.

Specialized Trichology Tests

Beyond the initial assessment, a trichologist may conduct or recommend more specific tests to pinpoint the cause:

Test Type	Purpose & What It Reveals
Hair Pull Test	Measures the number of hairs that easily come out when gently tugged. This helps assess the shedding rate and identify active hair loss.
Hair Strand Analysis	Involves examining individual hair strands under a microscope (trichoscopy). This can reveal abnormalities in hair shaft structure, signs of miniaturization (hairs becoming thinner), or specific types of breakage. It helps diagnose conditions like alopecia areata, telogen effluvium, or various hair shaft defects.
Scalp Examination	Using specialized magnifying devices, a trichologist thoroughly inspects the scalp for signs of inflammation, infection, follicular abnormalities, or scarring. This can aid in diagnosing conditions like seborrheic dermatitis, psoriasis, or specific forms of scarring alopecia.
Blood Tests	While not always performed directly by the trichologist, they will often refer you for crucial blood tests. These include: Full Blood Count (FBC): To check for anemia or other systemic issues that can affect hair growth. Hormonal Tests: Occasionally run to detect imbalances, especially levels of hormones like dihydrotestosterone (DHT). Elevated DHT levels are a primary cause of common types of hair loss, such as male pattern baldness and female pattern hair loss. Thyroid hormones and other endocrine markers might also be assessed. Nutritional Deficiency Tests: To identify deficiencies in essential vitamins and minerals like iron (ferritin), vitamin D, B12, and zinc, all of which play a vital role in hair health.
Scalp Biopsy (Rarely)	In more complex or ambiguous cases, a trichologist might recommend a scalp biopsy, which is typically performed by a dermatologist. This involves taking a small sample of scalp tissue for microscopic analysis to definitively diagnose inflammatory conditions or scarring alopecias.

These tests, combined with a comprehensive understanding of the patient's history, allow a trichologist to formulate an accurate diagnosis and develop a tailored treatment plan.