How is it Diagnosed?
Alopecia, or hair loss, is diagnosed through clinical examination and a detailed medical
history. The physician evaluates the pattern, extent, and duration of hair loss and asks
about family history, recent illnesses, medications, or stress, which may contribute.
The type of alopecia—such as alopecia areata, androgenetic alopecia, or telogen
effluvium—is usually distinguished based on clinical features. Scalp examination helps
identify signs like broken hairs, exclamation point hairs, inflammation, or scarring.
A hair pull test may be performed to assess active hair shedding. The test involves
gently pulling a small section of hair to see how many strands come out. A trichoscopy
(dermatoscopic examination of the scalp) provides a magnified view of hair follicles and
shaft abnormalities.
For further clarification, a scalp biopsy may be done. A small piece of scalp tissue is
removed and examined microscopically to detect autoimmune activity, inflammation, or
scarring.
Blood tests are frequently ordered to rule out underlying causes such as thyroid
dysfunction (TSH), iron deficiency (serum ferritin), vitamin D or B12 deficiency, and
autoimmune disorders (ANA test).
Diagnosis is tailored based on the suspected type and cause of alopecia. Identifying
reversible factors early is crucial for effective management and prognosis.