Sunday, July 14, 2024
Hair lossTests To Diagnose Alopecia

Tests To Diagnose Alopecia

Although alopecia areata does not cause any physical disabilities, it can negatively impact a person’s overall well-being.  Many individuals find that their hair regrows on its own without the need for any therapy.  Those with less severe instances may not even need treatment. Some individuals with severe cases decide not to have the treatment and instead look into goods that mask hair loss, like hairpieces or wigs.  Other people with extreme cases decide to get therapy.

The hair loss pattern characteristic of alopecia areata might also be caused by other medical disorders.  Your doctor may perform the following tests to assess whether or not an underlying medical condition causes the hair loss:

Scalp Biopsy

An assessment of alopecia can be made with or confirmed using a scalp biopsy.  A scalp biopsy is regarded as the required treatment in all instances of scarring alopecia. When there is no documented clinical history, it can be challenging to interpret the histological findings of basic scarring alopecias, especially when the biopsy sample is insufficient. In their non-scarring forms, these disorders are not particularly difficult to identify.  However, in some instances, a biopsy of the scalp may be necessary for:

  • Lack of clear triggers: Such a test is necessary for extreme hair loss, such as in some forms of alopecia areata, which does not manifest as a demarcated bald region, but rather as severe hair loss.
  • A sudden loss of hair: The test is needful for conditions that manifest themselves suddenly.

Blood Test

Blood tests can provide a significant quantity of information that is often vital to the potential assessment in managing baldness and thinning hair.  In most cases, having fasted for 12 hours before blood draws is preferable, and the best time to do this is early in the morning, preferably before 11 a.m.

Pull Test

A doctor can perform a simple procedure known as the hair pull test to assess the degree and persistence of hair loss.  The pull test approach has a high degree of interexaminer variability; nonetheless, every examiner can standardize this process and compare this appropriate standard evaluation in the patient.

It is required that the patient refrains from washing their hair for five days to get at least some level of standardization among participants.  This test will allow for similar results and quantification. From the base of the hair, roughly fifty to sixty hairs are gathered together and held between the thumb, index finger, and middle finger.  In this technique, the hair is gently but firmly yanked away from the scalp while the fingers glide over the hair strand.

After that, the number of hairs that are removed is counted, and then, based on the assessment, sometimes loose anagen hair is also checked under the microscope. It is considered a positive pull examination and indicates that active hair shedding occurs if more than 10% of the gripped hairs, equal to six hairs, are pulled out from the scalp.  When fewer than six hairs come out easily with pulling, this is regarded as normal physiologic shedding.

Wash Test

Blood Test

This test is a method for measuring hair loss that does not involve cutting or other intrusive procedures.  It involves counting and identifying the hairs that are rinsed out.  This test involves counting the number of terminal and vellus telogen hairs rinsed away.

After refraining from bathing their hair for five days, patients then wash and rinse the hair in a basin containing a gauze-covered hole used to collect the fallen hairs.  These hairs are gathered and analyzed further for hair count and other purposes after being examined thoroughly. The hair wash process has several drawbacks, including the following:

  • The procedure can cause breakage of the hair, which therefore results in a double count of the broken hairs;
  • Individuals with very short hair or hair that is curly are ineligible for treatment with this approach
  • The procedure can take a significant amount of time. I t necessary to perform a microscopic examination of the counted hairs to arrive at an accurate diagnosis.  This examination should focus on the hair cycle phases, shaft anomalies, and the distal tip’s morphologic look.

Hair Weighing

The weighing of hair can be an effective method for evaluating and analyzing the effect of medications or cosmetic compounds that have been systematically or topically applied in clinical research. A clearly defined rectangular location measured using a plastic template is shortened by one millimeter, highlighted, and then permanently marked by two miniature tattoos placed on non-adjacent sides of the square.

Carefully gathered hairs are hand-clipped short under magnification after an initial treatment-free period, depending on the anticipated efficacy of hair growth promotion. The ensuing treatment phase allows the hairs the same amount of time to grow before trimming and collecting them, as was done during the screening period.  At the end of the research project, the hairs gathered across all the sampling periods were cleaned, then weighed one at a time by an expert technician in the reverse chronological sequence in which the doctor collected them.


The trichogram is an effective instrument for distinguishing between the many kinds of hair loss.  After the patient has gone five days without washing their hair, rubber-armed forceps are used to pluck between 60 and 80 hairs from the scalp. The hair bulbs are placed in an embedding liquid, enabling microscopic examination so that the doctor can evaluate the results in the most accurate manner possible.

Scalp Biopsy

The scalp biopsy, which is often carried out with a cylindrical punch measuring 4 millimeters in diameter, is an essential instrument for diagnosing cicatricial alopecia and certain forms of non-cicatricial alopecia.  It is essential to determine the appropriate site for the biopsy, which varies depending on the condition.


The many types of alopecia each require a unique approach to therapy.  Conditions that cause temporary hair loss can be treated, but those that cause permanent hair loss cannot be reversed.  The provision of the appropriate treatment for the hair will be dependent on the understanding of the cause; hence, testing is required.


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