Alopecia: the diagnosis

Ask the right questions

Diagnosing alopecia first requires that the doctor asks the patient many questions about medical history, medication, and family history.

In case of female alopecia, the dermatologist is interested in:

  • the regularity of menstrual cycles,
  • signs that suggest an excess of male hormones (oily skin, acne, excessive hair),
  • signs of thyroid dysfunction (chills or feeling hot, depression or excessive nervousness).

A detailed interrogation on the cosmetic habits is also necessary.

Traction test

The test of traction is part of the examinations performed by the dermatologist. It consists in drawing a lock of about thirty hairs to know how much are detached. Normally, only 1 or 2 hair will snap. A means of assessing whether the fall is excessive, without prejudging the cause. If the alopecia is visible to the naked eye, the examination will be, initially, visual.

Male androgenic alopecia is easily recognizable when there are gills and / or alopecia of the tonsure, and the diagnosis is therefore easy to make. In a third of cases, however, it presents as diffuse alopecia, as is generally seen in female androgenetic alopecia.

Other tests and exams

To refine the diagnosis, an examination of the skull can also be performed using a trichoscope or a videotrichoscope that can visualize the presence of thin hair rods and different diameters in case of androgenetic alopecia.

Photographic snapshots are taken from several angles to see the transformations and compare before and after treatment. A line is drawn in the middle of the hair to see the loss and regrowth, if any.

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