Evaluating Medical and Family History

Written by Dr. Griffin

Perhaps the strongest association of hair loss is genetics. Looking into the patient’s family history on either side can lead to conclusions about the cause of the condition, and can thereby greatly assist in the diagnosis of pattern hair loss in both sexes. Physiological conditions, whether hereditary or not, have a direct impact on the development of hair loss. It is important to tell Dr. Griffin of all past medical conditions and associated medications, including over the counter meds that you have taken. Certain illnesses are directly linked with hair loss.

Real Patient Before & After Photos

before and  12 months after procedure - photos of real patient

12 Months
Post Procedure

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Physical Examination

There are a few physical examinations that Dr. Griffin can conduct in order to help in the diagnosis of your hair loss. Such tests include:

Scalp and Hair Shaft Exam
It is important to assess the health of the scalp, as scarring, redness, and scaling are signs of particular hair loss disorders. Any unusual signs or an otherwise unhealthy scalp can help point Dr. Griffin to the cause of hair loss. The appearance of the hair shaft can point to possible hair breakage conditions.

Tug Test/Pull Test
In this test, a section of hair is gently “pulled,” and the amount of hair that subsequently falls as a result is evaluated. If hairs come out easily, the presence of a hair loss disease is validated. The hair that falls out as a result can then be further analyzed more directly under a microscope.

Thyroid Assessment
Thyroid disease is a medical condition which may be associated with hair loss. Low thyroid (hypothyroidism) can cause thinning and also the loss of eyebrows. Hyperthyroidism caused by various diseases may be associated with alopecia areata.

Hair Density
For a more visible interpretation of the health of the hair, Dr. Griffin may use a densitometer to assess changes in hair density. Also, it can be beneficial to compare the density of the hair on the top of the scalp with hair on the sides and back of the scalp.

Real Patient Before & After Photos

before and  9 months after procedure - photos of real patient

9 Months
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Diagnostic Procedures

Lab tests may be helpful in understanding the cause of a patient’s hair loss. Moreover, Dr. Griffin may advise a scalp biopsy to assess the pathology of the scalp disease in question. The biopsy is 4 mm (about the size of a pencil eraser), and is performed in the office with local anesthesia.

Hair Loss Grading Scale

The two most referenced grading scales for hair loss include the “Norwood” scale for men and the “Ludwig” scale for women.

Norwood grading scale - left side view and top view, imagesFig 1. As seen in this image, the Norwood grading scale for men ranges from 1, which shows no sign of hair loss, to 7, which is the most severe form of balding. In the most dramatic form of pattern hair loss, the scalp is nearly completely bald and is lined by hair on the sides and back of the scalp.