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Evaluation of Hair Loss

When evaluating a person with hair loss complaints we have two basic goals in mind. First is to find out the cause of his/her hair fall and whether it is reversible or not. The second goal is to assess how much that person will benefit from a hair transplant.
Evaluation for cause of Hair Loss is done by obtaining detailed clinical history including family history, any chronic disease, current medications etc. In case of family history the possibility of male pattern baldness is high. Such cases benefit from hair loss treatment medicines as well as hair transplant. Physical examination of the scalp to see presence or absence of dandruff, chronic folliculitis etc. is done next. If such conditions are present, their therapy also forms a part of hair loss treatment. Hair strength is evaluated by "Hair Pull Test" and hair root analysis is done in selected cases. Videomicroscopy of the affected scalp and phototrichogram of the affected region are done for assessment of hair density, hair caliber and scalp condition.

Lastly, some blood investigations may be requested to assess hormonal status of individual and to assess the body iron stores if required. In case, a hair transplant is being planned, pre-surgical investigations are also requested, Very rarely a scalp biopsy may be done if an auto-immune pathology like Alopecia areata or Lichen planus is suspected. In such cases hair loss treatment is only medical therapy and hair transplant is not generally advised.
Overall more than 95% of individuals visiting our clinic have androgenic alopecia where diagnosis is rather straightforward. Androgenic alopecia is characterised by patterned hair loss, slow progression and irreversible hair miniaturisation with sparing of hairs in safe zone. These people benefit most from hair transplantation. In such case evaluation becomes a part of long term hair loss treatment plan, wherein a combination of medicines and transplantation is used to maintain a full head of hair.

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