Translate
Hair and Scalp Disorders
Hair and Scalp Disorder Management provides specialist dermatological assessment to accurately diagnose the cause of hair loss and implement evidence-based treatments to restore hair growth, prevent progression, and address the significant emotional impact of hair loss.
Overview
Hair loss causes profound psychological distress and social impact affecting self-esteem and mental health particularly in women. Accurate diagnosis is essential as the management of androgenetic alopecia, alopecia areata, scarring alopecias, and telogen effluvium are completely different. Trichoscopy -- dermoscopic examination of hair shafts and scalp -- significantly improves diagnostic accuracy in most presentations.
Types of Hair and Scalp Conditions
- Androgenetic Alopecia (male/female pattern -- most common cause)
- Alopecia Areata (autoimmune -- patchy, diffuse, or total loss)
- Alopecia Totalis and Universalis (complete scalp and body hair loss)
- Frontal Fibrosing Alopecia (scarring -- slowly advancing frontal recession)
- Lichen Planopilaris (scarring -- patchy follicular destruction)
- Telogen Effluvium (diffuse shedding from illness, deficiency, or stress)
- Trichotillomania (compulsive hair pulling causing irregular loss)
- Scalp Psoriasis and Seborrhoeic Dermatitis with hair thinning
Investigation of Hair Loss
- Trichoscopy (dermatoscopic scalp and hair shaft examination)
- Iron studies and ferritin (iron deficiency causing telogen effluvium)
- Thyroid function (hypothyroidism causing diffuse loss)
- Testosterone and DHEAS (androgenic alopecia and PCOS)
- ANA and complement (autoimmune conditions)
- Zinc and ferritin (nutritional deficiency)
- Scalp biopsy (for scarring alopecias and diagnostic uncertainty)
- Hair pull test (assessing telogen effluvium activity)
Hair Loss Symptoms Requiring Specialist Assessment
- Rapid diffuse shedding affecting more than 150 hairs per day
- Patchy loss progressing to multiple areas or complete involvement
- Recession of frontal hairline in a woman with scalp irritation
- Scalp scarring, redness, or follicular plugging with loss
- Hair loss in a young woman with irregular periods or acne
- Hair loss after systemic illness or significant nutritional change
- Abnormal hair shaft texture, fragility, or colour changes
- Scalp itching, burning, or pain accompanying hair loss
Key Benefits
Discover the advantages of choosing our hair and scalp disorders services.
Trichoscopy diagnosis guides specific treatment avoiding empirical therapy of the wrong diagnosis
Treating identified nutritional deficiencies provides objectively measurable hair cycling improvement
Minoxidil maintains hair density preventing the progression of androgenetic alopecia
Intralesional triamcinolone achieves regrowth in 60 to 70% of patchy alopecia areata patches
JAK inhibitors achieve complete or near-complete scalp hair regrowth in 30 to 40% of severe alopecia areata
Clinical Features
The technology, techniques and clinical approach behind our hair and scalp disorders.
Trichoscopy provides diagnostic accuracy superior to clinical examination for all alopecia types
Ferritin target above 70 mcg/L for optimal hair cycling
Scalp biopsy with horizontal and vertical sectioning for accurate scarring alopecia subtype diagnosis
Oral minoxidil provides systemic delivery to all follicles avoiding application challenges
JAK inhibitors are the first licensed treatments for severe alopecia areata
Preparation Instructions
Apply topical treatments consistently -- minoxidil must be used every day as discontinuation reverses any regrowth. Attend photographic monitoring appointments to objectively track response. Treat identified nutritional deficiencies -- ferritin must be above 70 mcg/L for optimal hair cycling. Contact your dermatologist for rapidly spreading patches, scalp pain or burning, or signs of scalp infection.
The Procedure
Step-by-step guide to what you can expect during your hair and scalp disorders procedure.
Trichoscopy Assessment
A dermatoscope applied to the scalp at 20 to 50x magnification examines follicular density hair shaft calibre miniaturisation pattern fibrosis and vascular architecture -- providing diagnostic accuracy superior to clinical examination alone.
Targeted Blood Tests
Ferritin thyroid function tests testosterone SHBG DHEAS B12 folate and zinc are measured -- addressing systemic causes of hair loss that improve with treatment before prescribing scalp therapies.
Scalp Biopsy When Indicated
For suspected scarring alopecia a 4mm punch biopsy from an active margin is sent for horizontal and vertical sectioning with direct immunofluorescence -- distinguishing different scarring types requiring different treatments.
Minoxidil Therapy Initiation
Topical minoxidil 5% solution or foam is initiated for androgenetic alopecia. Oral low-dose minoxidil is offered for patients unable to tolerate topical application or requiring more potent therapy.
Alopecia Areata Immunotherapy
Patchy alopecia areata is treated with intralesional triamcinolone injections every 4 to 6 weeks. Severe alopecia areata is assessed for JAK inhibitor therapy (baricitinib ritlecitinib) -- the first licensed systemic therapies for severe AA.
Scalp Condition Treatment
Seborrhoeic dermatitis and scalp psoriasis require specific scalp formulations. Treating scalp inflammation significantly reduces the associated hair thinning.
What to Expect
Your dermatologist performs a scalp and hair examination using trichoscopy. Blood tests exclude systemic causes. A scalp biopsy under local anaesthetic may be performed for scarring alopecias. Treatment -- topical or oral minoxidil, PRP, or systemic immunosuppression for alopecia areata -- is explained with realistic expectations about timeline and response.
Frequently Asked Questions
Common questions about hair and scalp disorders.
Related Services
Explore other services in our Dermatology department.
Psoriasis Management
Eczema and Atopic Dermatitis
Skin Lesion Assessment and Biopsy
Ready to Get Started?
Schedule your consultation today and take the first step towards better health.
