Hair loss, in most cases, can be diagnosed based on complete medical history, family history and physical examination. Your doctor will observe the pattern and rate of hair loss, appearance of nearby strands of hair and accompanying symptoms before making the diagnosis and recommending tests and treatment.
Medical examination and history: Your doctor may ask questions such as:
Male-pattern baldness is easily identified on physical examination as it follows a certain pattern. It starts with the receding of hairline in the late twenties or thirties, and may gradually progress to thinning of the hair on the crown and temples. A horseshoe shape of hair remains around the back and sides of the head.
In females, hair loss because of female pattern baldness usually becomes noticeable after menopause. In women, the hairline at the forehead is not affected. They usually have broadening of a part of their scalp and some women may lose hair from the top of their head.
In hair loss due to alopecia areata, there are no obvious symptoms other than patches of baldness measuring about an inch (2.6 centimeters) across. In fact, your partner or hairdresser may notice the patch before you discover it. The skin appears normal and healthy.
If your hair loss is not related to age associated thinning, your primary care physician may refer you for tests or to a dermatologist.
Blood tests: Blood tests may be done to determine if some other medical condition that you have is the cause of hair loss. Some of the tests that may be done include tests for thyroid disease, diabetes or lupus.
Biopsies and samples: Tests that may be done rarely include
Hair pull test and microscopic examination of plucked hair: During a pull test, some hair as a bunch is gently pulled to see how many come out. This helps to know the stage of shedding process. Examination of scraping of sample from plucked hair or scalp can help to diagnose whether an infection is causing hair loss or not. In difficult to diagnose cases, punch biopsy of scalp is done. In this test, a circular tool is used to remove a small section of your skin's deeper layers. This is examined under a microscope for abnormality.