Diagnosis of Hair Loss in Men
Typical androgenetic alopecia or male patterned baldness in men is generally diagnosed based on the appearance and patterned distribution of the hair loss, along with a comprehensive medical history, including details about the prevalence of hair loss in the family. It is usually straightforward by noticing the presence of miniaturized hair in the areas of thinning. Miniaturization is a progressive decrease in the hair shaft’s length and diameter that takes place in response to androgens.
An experienced and skilled dermatologist or hair transplant surgeon must examine the scalp under magnification preferably using a device called as a “video densitometer” to ascertain the level of miniaturization of the hair follicles. This device magnifies a little portion of the scalp where the hair has been clipped to about 1mm in length. Through the densitometer, dermatologists assesses if the scalp is normal, have healthy terminal hairs, full thickness in follicular units, with hair shafts of static diameter or if it exhibits a scalp with decreased hair shafts sized due to miniaturization, a feature of androgenetic alopecia. This evaluation is quite substantial for advising upon the appropriate course of treatment.
Hairs may be in inconsistent and changing states of miniaturization, but if the follicles are continually revealed to the DHT hormone, there are pretty much chances that they will at a time stop producing hairs and the follicles will eventually disappear.
The diagnosis of androgenetic alopecia is reinforced by the family history of hair loss, however a positive history is not always recognized, and the unavailability of other medical causes of alopecia. In patients of older age (40-60 years), their personal history of travelling through the different Norwood stages is strongly indicative of male pattern alopecia.
Diagnosing Diffuse Hair Loss
Because of the reason that there is thinning all over the scalp rather than limited to few particular areas as depicted by one of the Norwood patterns, diagnosis of diffuse hair loss becomes literally difficult. However, the appearance of miniaturization in the regions of thinning automatically guarantees the diagnosis of androgenetic alopecia.
If the diagnosis of diffuse hair loss is still in ambiguity after using magnifying densitometry, a few other medical afflictions known to cause diffuse hair loss must be figured out, including anemia, PCOD, prostate problems and thyroid disease. Some drugs concentrated medications or taken for acute depression or high blood pressure can also cause hair loss, as can anabolic steroids. When a non-androgenetic cause for diffuse hair loss is detected, the following laboratory tests are often beneficial to identify the cause:
- complete blood count
- Blood chemistries
- serum iron
- Thyroid functions
- lupus and syphilis tests
When the diagnosis of androgenetic alopecia is doubtful yet, additional diagnostic details can be gathered from a microscopic evaluation of the hair shaft and bulb, hair-pull test, scalp biopsy, scraping and culture for fungus. A dermatologist consultation is highly advised whenever the cause of hair loss is uncertain.