How Dermatologists Diagnose Hair Loss

Hair loss can be distressing, confusing, and difficult to understand—especially when the cause isn’t obvious. Whether you’re noticing gradual thinning or sudden shedding, seeing a dermatologist is one of the most important steps you can take. Dermatologists are specially trained to diagnose and treat hair and scalp conditions, helping patients identify the root cause of hair loss and determine the most effective treatment plan.

At Integrated Dermatology of Fairfax, our board-certified dermatologists help patients throughout Fairfax, Virginia and Northern Virginia understand why hair loss is happening and what can be done about it.

Why Seeing a Dermatologist for Hair Loss Matters

Hair loss is not a one-size-fits-all condition. It can be caused by genetics, medical conditions, hormonal changes, stress, medications, or underlying scalp disorders. Self-diagnosing or relying on over-the-counter products may delay proper treatment and allow hair loss to progress.

A dermatologist is uniquely qualified to:

• Identify the specific type of hair loss

• Rule out underlying medical conditions

• Recommend evidence-based treatments

• Monitor progress and adjust treatment plans

Early diagnosis often leads to better outcomes.

Step 1: A Detailed Medical and Hair Loss History

The diagnostic process begins with a thorough conversation about your health and hair concerns. Your dermatologist will ask questions such as:

• When did the hair loss begin?

• Is it gradual or sudden?

• Is there a family history of hair loss?

• Have you experienced recent stress, illness, pregnancy, or weight changes?

• Are you taking any medications or supplements?

This information helps narrow down possible causes such as androgenetic alopecia, telogen effluvium, alopecia areata, or hair loss related to medical conditions.

Step 2: Scalp and Hair Examination

A physical examination of the scalp and hair is a critical part of diagnosing hair loss. During this exam, your dermatologist will look for:

• Patterns of hair thinning or recession

• Signs of inflammation, redness, or scaling

• Broken hairs or scarring

• Differences in hair shaft thickness

Certain hair loss patterns can strongly suggest specific diagnoses, such as male or female pattern hair loss.

Step 3: Pull Test and Hair Density Evaluation

Dermatologists may perform a hair pull test, gently tugging on small sections of hair to assess how much shedding is occurring. Excessive shedding may indicate conditions like telogen effluvium.

They may also evaluate overall hair density and compare different areas of the scalp to determine whether hair follicles are shrinking or becoming inactive.

Step 4: Dermoscopy (Trichoscopy)

Many dermatologists use a specialized handheld tool called a dermoscope to examine the scalp at high magnification. This allows them to see:

• Hair follicle openings

• Miniaturized hairs

• Scalp inflammation

• Signs of scarring or autoimmune conditions

Dermoscopy provides valuable clues without the need for invasive testing.

Step 5: Lab Work When Necessary

In some cases, hair loss may be linked to underlying health issues. Your dermatologist may recommend blood tests to evaluate:

• Thyroid function

• Iron levels

• Vitamin deficiencies

• Hormonal imbalances

• Autoimmune markers

Identifying and treating these conditions can be essential for stopping or reversing hair loss.

Step 6: Scalp Biopsy (When Indicated)

If the cause of hair loss remains unclear or scarring alopecia is suspected, a scalp biopsy may be performed. This involves removing a small sample of scalp tissue for laboratory analysis.

While not needed for every patient, a biopsy can provide definitive answers and guide treatment decisions.

Common Types of Hair Loss Dermatologists Diagnose

Some of the most common hair loss conditions include:

• Androgenetic alopecia (male and female pattern hair loss)

• Alopecia areata

• Telogen effluvium

• Traction alopecia

• Scarring alopecias

• Hair loss due to scalp psoriasis or dermatitis

Accurate diagnosis is essential, as each condition requires a different treatment approach.

What Happens After Diagnosis?

Once a diagnosis is made, your dermatologist will create a personalized treatment plan. This may include:

• Topical or oral medications

• In-office treatments

• Lifestyle or hair care modifications

• Ongoing monitoring to track progress

Hair loss treatment is most effective when started early, which is why timely evaluation is so important.

Schedule a Hair Loss Consultation in Fairfax, Virginia

If you’re experiencing hair thinning or hair loss, expert care is available close to home. Integrated Dermatology of Fairfax provides comprehensive hair loss evaluation and treatment for patients in Fairfax, Virginia and surrounding areas.