The Truth About Hair Loss

Questions To Ask Your Doctor About Baldness

Is the baldness caused by a medical disorder rather that the regrowth process stopping?

If baldness runs in the family, will the male family members evidently start going bald?

Will certain kinds of medicine cause hair loss?

Do you recommend hair replacement?

Is this procedure successful?

Do you recommend using Rogaine or Propecia?

Tests and diagnosis

A complete medical history, family history and physical examination can help in a diagnosis. The pattern and rate of hair loss, the appearance of nearby hairs (for example, if hairs are broken off), and accompanying symptoms are considered when making the diagnosis.

Tests may be necessary if the cause isn't apparent after the examination. These include:

  • Pull test. Several dozen hairs are gently pulled to see how many come out. This helps determine the stage of the shedding process and can help diagnose or rule out telogen effluvium.
  • Skin scrapings. Samples taken from the skin or from a few hairs plucked from the scalp can help verify whether an infection is causing hair loss.
  • Punch biopsy. When a diagnosis is difficult to confirm, especially in the case of

alopecia areata or scarring alopecia, your doctor may perform a punch biopsy. During this test, the doctor uses a circular tool to remove a small section of your skin's deeper layers.

• Screening tests for related diseases. Your doctor may perform tests to determine if you have a medical condition that causes hair loss, such as thyroid disease, diabetes or lupus. Your doctor may also ask questions about the types of medications you're taking. Sometimes hair loss is a side effect of certain drugs, such as those that treat gout, arthritis, depression, heart problems and high blood pressure.

Preparing for your appointment

You're likely to start by first seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a dermatologist. Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restricting your diet.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, as well as any vitamins or supplements, that you're taking.
  • Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor.Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For hair loss, some basic questions to ask your doctor


  • What is likely causing my symptoms or condition?
  • Are there other possible causes for my symptoms or condition?
  • What kinds of tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • What are the alternatives to the primary approach that you're suggesting?
  • I have these other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • Should I see a specialist? What will that cost, and will my insurance cover seeinga specialist?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Are there any brochures or other printed material that I can take home with me?

What Web sites do you recommend?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • When did you first begin experiencing hair loss?
  • Has your hair loss been continuous or occasional?
  • Have you had a similar problem in the past?
  • Has anyone in your immediate family experienced alopecia?
  • What, if anything, seems to improve your hair loss?
  • What, if anything, appears to worsen your hair loss?

Coping and support

Chances are that the greatest challenge of losing your hair is coping with the change in your appearance. You may be frustrated or upset by other people's reactions or after trying various treatments with little success. If you're having difficulty coping with baldness caused by heredity, a medical condition or medical treatments, you may find some of the following suggestions helpful:

  • Learn about the cause of your baldness and treatment options. Be wary of alternative treatments that have no proven track record or may cause dangerous or unpleasant side effects.
  • Educate those near to you. Your family and friends can be more sympathetic ifthey understand the cause of your baldness or your concerns about your looks. You may also learn that they are less concerned about changes in your appearance than you are.
  • Consider joining a support group. While support groups aren't for everyone, they can be sources of information and comfort. Talking with people who experience the same challenges or medical conditions and learning how they cope can be reassuring.

Hair Loss: Procedures to Avoid

Be aware that many physicians in this country and abroad perform outdated and even dangerous hair restoration techniques.

One reason is economics. To perform state-of-the art follicular unit hair transplantation, a physician or group has to revamp the infrastructure of their practice. They have to hire and train a full-time staff of technicians, purchase binocular stereomicroscopes, and most likely expand the size of their facilities.

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