What Hair Trichology Test Your Specialist Will Perform

Are you wondering what hair trichology test your specialist will perform to find out the root cause of your increasing hair fall and damage? Hair health is important, as hair is the most noticeable part of your body.

Trichologists perform certain tests to identify whether the hair and scalp are healthy or not. These diagnostic tests help them decide the best treatment for your hair.

The upcoming topics will cover when to see a trichologist and the procedures they perform. It will also reveal the costs of trichologists and an interesting difference between a dermatologist and a trichologist. 

What is Trichology?

Trichology derived from the Greek word “Trikhos”, which means “hair”. It primarily deals with hair and scalp health, focusing on the causes, diagnosis, and treatment of hair problems. It is a scientific study that covers both the medical and cosmetic aspects of hair health. 

Trichology may seem new to you, but it is a 100-year-old specialized field focused on hair and scalp health, often working in conjunction with dermatology.

What Is a Trichologist?

A trichologist is a hair health expert who diagnoses and manages problems related to hair and scalp. They study different hair types and perform scalp tests for hair loss to identify abnormalities, and the factors that cause them.

Trichologists assess issues like hair breakage, dandruff, and scalp psoriasis, based on which, they develop personalised hair treatment plans. These plans cover everything from lifestyle factors, including diet and stress management, to products and hair restoration methods you need. To sum up, a trichologist takes care of your hair throughout your journey.

What Does A Trichologist Do?

Trichologists get training in assessing hair and scalp conditions for various diseases. These include different types of hair loss, including:

• Androgenetic Alopecia
• Alopecia Areata
• Telogen Effluvium

They also diagnose specific scalp disorders, such as: 

• Seborrheic dermatitis
• Psoriasis
• Dandruff
• Fungal infections

Changes in hair feel, brittleness, drying, and hair breakage are also examined to identify their root cause. Moreover, Trichotillomania (disorder of hair pulling) can also be cured with the guidance of hair and scalp specialists.

When To See A Trichologist?

If you’re noticing changes in your hair and scalp health, then you must visit a trichologist. The problems that need to be quickly recognized with hair trichology are:

• Hair loss like extreme hair shedding, thinning, light hair volume, and baldness.
• Scalp itching, inflammation, or dandruff.
• Hair texture changes like curl or wavy pattern, or frizzy, dry hair.
• Hair breakage, brittleness, and split ends.
• Excessive body hair growth.

What Hair Trichology Tests Does A Trichologist Perform?

Trichologists conduct various scalp tests to identify hair loss. Some of these tests are just physical examinations of certain hair conditions, while others are diagnostic tests performed when a physical test suggests a specific disease. 

Moreover, your hair and scalp specialist also asks questions about your habits and diet to see if they’re a cause of a hair condition.

Physical Examination of Hair Scalp

Physical examination of hair and scalp includes both non-invasive and semi-invasive procedures like inspection, palpation, hair-pulling test, and trichoscopy.

1. Visual Inspection & Palpation

Visual Inspection involves observing and examining any changes in hair texture or color. During inspection, your trichologist will look for any sign of hair disease or scalp conditions like inflammation, redness, or injury.

On the other hand, palpation is done with the help of hands and fingers to feel changes in hair texture or thickness, if any. Tenderness or lesions in your scalp can also be observed with palpation.

2. Hair Pull Test

Hair pulling is a non-invasive scalp test for hair loss, used to examine the hair strength or severity of hair loss. A small portion of hair (up to 60 hair strands) is selected and is pulled with hands gently to notice if there is excessive hair fall. 

Hair shedding more than 10% (indicating excessive hair fall) will show that the test results are positive, suggesting a potential hair loss condition. However, further diagnosis is required to determine the type of hair loss.

3. Trichoscopy

Physical examination of hair and scalp is often performed with the use of an instrument, like a dermatoscope. Your hair specialist will use this device to closely examine the causes of hair loss, invisible to the naked eye. 

Hair follicles, shafts, and scalp skin are assessed to help diagnose and differentiate between the types of alopecia. It is a better alternative to scalp biopsy. Trichoscopy can also analyze the patterns of blood vessels and pigmentation in the scalp.

Diagnostic Tests

Physical assessment reveals visual changes, but not the internal changes, that are sometimes the root causes of hair loss. If physical examinations identify any scalp problems, still diagnostic tests are necessary to choose the right treatment. 

Following are a few hair trichology tests your specialist will perform: 

1. Blood Tests for Hair Loss

Blood tests determine the percentage of nutrients and hormones in the blood. A small amount of blood (venous) is drawn from your arm and analysed in labs. These analyses determine the amount of red blood cells (RBCs), white blood cells (WBCs), and platelets. 

Iron content in the blood reveals if you’re suffering from iron-deficiency anemia or not, as it is also a cause of hair loss. The blood test reports typically can be tested within a week.

2. Scalp Biopsy

Scalp biopsy is an invasive method in which a small portion of skin from your scalp is taken and observed under a microscope for hair loss. It reveals the different types and reasons of scarring alopecia.

3. Trichogram

Trichogram involves taking a hair sample and its examination with a microscope. This reveals the stage of your hair growth cycle. The hair cycle has different phases of growth: 

• Anagen: The hair growth phase.
• Catagen: Slow hair and re-grow during this phase.
• Telogen: Phase in which new hair doesn’t grow and hair is shed.

Any disruptions like the slow growth of new hair during anagen phase will help determine the type of hair loss.

4. Hormone Trichology

This area studies hormones and their direct impact on hair problems. The change in the level of any hormone can stimulate hair and scalp-related problems.

For example, dihydrotestosterone (DHT) disturbs the complete hair cycle, leading to excess hair falling. It shrinks the hair follicles, resulting in weak and thin hair. Estrogen, however, is a hormone that reverses the action of DHT and prolongs the anagen phase of hair cycle.

5. Cuticle & Cortex Imaging

These techniques use high-quality, detailed images of hair cuticle and cortex, respectively, to determine hair health. The process involves capturing several high-resolution and high-magnification pictures of hair fiber at different points from one hair sample. 

These pictures are then analysed to determine the hair or scalp disease.

If the hair damage is due to heat, harsh brushing, and coloring procedures, it can be directly determined by cuticle imaging test. These tests also help find out the reasons for hair breakage, hair shaft abnormalities, or weakness.

6. Hair Porosity Test

Hair porosity is a measurement of moisture your hair can absorb and retain. This moisture content is determined by hair anatomy, i.e., the outer layer and cuticle. Hair cuticles are either spaced loosely or tightly, based on which hair porosity test is performed.

Hair porosity can be tested in two different ways:

1. Float Test: It involves taking a clean hair strand and dissolving it in water to see if it sinks or floats over the water surface.
2. Absorption Test: This test involves washing a small part of your hair and then spraying it with water to know how much moisture it absorbs.

Based on these tests, there are three different types of hair. This will help you to choose the right hair care products and routine to keep your hair healthy and manageable.

Porosity Type	Cuticle Structure	Moisture Absorption & Retention	Characteristics
High	Widely spaced cuticles	Easily absorbs, but also quickly evaporates	Prone to dryness and frizz
Low	Tightly packed cuticles	Difficult to absorb and difficult to escape	Can resist moisture, but also retains it well once absorbed
Medium	Loosely packed cuticles	Easily absorbed and can be retained efficiently	Easy to manage and maintain moisture balance

7. Densitometry

This hair assessment measures hair density of hair using a densitometer, a portable instrument having a magnifying glass on it. It assesses hair follicle shrinkage and overall hair density to diagnose hair loss conditions. 

• A small area of the scalp, usually 1 cm² (10mm x 10mm), is selected. 
• The hairs that are entered into the calibrated opening, which is about 10mm², are then counted to find their density. 
• This procedure is repeated on different scalp locations to determine the uniformity in hair minaturisation. This indicates androgenetic alopecia or other forms of hair loss.

8. Sebum Analysis

Oil that sometimes appears from the roots clogs the hair follicles and results in hair loss. Sebum analysis is the method of assessing oily content in your hair. A trichologist will conduct a sebum analysis test of your hair in different ways: 

• Sebum-tape: Using a specific tape to collect the oil from the scalp.
• Sebumeter: A device with a sensor that measures the oily content in the scalp.
• Image Analysis: Imaging techniques can also be used to find the sebum levels in your hair.

9. Fungal Culture

Sometimes, a fungal infection such as tinea capitis on the scalp contributes to hair loss. It results in symptoms like redness, inflammation, and itching. The fungal cultivation is examined with an analysis, in which your trichologist will collect a hair sample from close to your scalp. It is then stored in a container to prevent moisture and contamination. 

The hair sample is tested in the laboratory for fungal growth. If the sample allows reaction with the fungus, then the test is positive, indicating fungal infection. The hair trichology expert will recommend anti-fungal treatments to stimulate hair regrowth.

Medical History & Lifestyle Assessment

The scalp tests for hair loss are incomplete without a consultation that includes all questions about the hair problem and lifestyle. 

Sometimes, if there is no other apparent cause of hair loss, the consultation might reveal something like inheritance or a medication that helps the trichologist to understand the cause of hair loss.

1. Medical History

Your hair and scalp health specialist will ask you about your medical history. The questions that must be asked in your consultation will be about:

• A recent disease or illness you had suffered from (including onset, duration, progression, aggravating and relieving factors).
• Hair loss signs in the family to see if it is inherited.
• Hair loss pattern.
• If you’re a patient of thyroid, diabetes, or blood pressure.
• Any hormonal changes you’ve recently noticed.
• If you’re taking any medications for some time.

2. Diet & Lifestyle

A nutritious and balanced diet is essential for healthy hair and scalp. Deficiency of vitamin C, D, biotin, and iron in your diet can also be a factor behind hair loss.

3. How stressed are you?

Your emotional well-being plays a positive role in your hair health. Your hair specialist will ask if you are stressed, and how much. This will help them identify the disease and design a treatment plan that best fits you.

4. Hair Care 

A trichologist will ask about your hair care routine, like the shampoos, oils, or serums that you’re applying, and the times when you repeat it. Moreover, tight hair styling and excessive heat can also damage and cause hair breakage.

What Should I Expect During A Trichology Exam?

The hair trichology exam is a step-by-step procedure carried out during your visit to the trichologist. Here is a brief introduction to these phases:

1. Initial Consultation

First of all, you will have a detailed discussion with your trichologist, who will ask you about when the disease started and how it progressed. 

If you feel any factors that are contributing to your hair loss condition, you must share them with your trichologist. There will also be a discussion about your medication history and habits.

2. Physical Observation

In the second phase, the trichologist will physically examine the hair loss condition. Hair pulling, washing, and palpation are methods that are used for this purpose. 

To keenly observe the scalp, instrument-aided techniques like, trichoscopy and sebumetry, are performed for further analysis.

3. Videodermatoscopy

In this process, a camera and magnifying glass are used together to closely monitor the scalp. This is a non-invasive procedure that helps find the hair diameter and thickness. A densitometer can also be used during this phase.

4. Diagnosis & Treatment Plan

Based on the root causes that are identified, the trichologist will suggest further tests like scalp biopsy, blood tests, or trichogram. It’s upon you whether you want to conduct those tests the same day or later. 

The results will determine tehe type of hair loss and the trichologist will make a treatment plan for you that will cover therapies you need and the lifestyle habits to adopt. 

What Can A Trichologist Do For Hair Loss?

The hair trichologist can diagnose hair loss and develop treatment plans, which include topical treatments, lifestyle changes, and guidance on post-hair treatment care. 

They can also assess the specific hair loss type, like androgenetic alopecia or telogen effluvium. 

Is A Trichologist A Doctor? 

The trichologist is not a medical professional or doctor. Hair trichology focuses on the scientific study of hair and scalp, offering non-invasive assessments and non-pharmacological management.

They only deal with non-medical therapies and can recommend you to a dermatologist or other specialist if needed. They can work with dermatologists or hair transplant surgeons to assist in the hair treatment journey.

How Much Does a Trichologist Cost?

The cost of a trichologist depends upon the location, experience, and the instruments used. 

Service	UK	US	Turkey
Initial Consultations	£60 to £200	$200 to $475	$50 to $150 USD
Trichoscopy	£295	$200 – $500	$100 – $200
Follow-up Consultations	Up to £50	$80 – $250	$30 to $100 USD
General Hair Trichology	Varies by clinic	$200 to $475	Varies by clinic and service

Why Choosing a Certified Trichologist Matters?

The choice of a certified trichologist is essential for a reliable diagnosis and treatment of hair loss. Trichologists go through training and are awarded certificates from the accredited institutions. The certificates ensure that they have completed the necessary training 

• They follow industry standard techniques for the assessment and diagnosis of disease.
• Certification helps prevent misinformation or ineffective treatment plans.
• It ensures that your hair loss treatment is in safe hands, allowing you to focus on recovery without worrying about costs.

Trichologist vs Dermatologist: Which One Is Best For You?

Both trichologists and dermatologists can help with your hair health, but there is a difference in how they deal with your condition. Here is a brief comparison between the two. 

Differences	Dermatologist	Trichologist
Specialization	Diseases of skin, hair, and nails	Disease related to hair and scalp
Treatment Approach	Medical	Non-medical
Diagnosis & Tests	Surgical tests such as scalp biopsy	Non-surgical and non-invasive diagnosis
Hair Restoration	Can perform hair transplant, PRP, etc.	Plan your treatment journey
After-Care Treatment	Prescribe medications	Recommend topical ointments and lifestyle changes

How Do You Become A Trichologist?

If you want to be a trichologist, you’ll need a professional training certification as a hair and scalp specialist. This training will have theoretical and practical lessons about diagnosis of hair loss and scalp diseases along with their management and after-care strategies. 

There is no specific educational background required to be eligible for this training. 

1. Enroll in an institution offering a hair trichology program, an example of which is The Institute of Trichologists, UK.
2. Gain theoretical and practical knowledge related to hair health.
3. Attend hands-on training workshops for hair and scalp assessments, both physical examinations and instrument-aided techniques, to build expertise.
4. Pass your exam to get a training certificate as a trichologist.
5. Practice what you learned and keep yourself updated with advanced research and techniques on hair trichology.

What is the difference between a hair test and a hair follicle test?

Hair test involves just testing hair strands; however, in hair follicle test, hairs are completely taken out with roots to test the follicles.

Can a trichologist write a prescription?

Trichologists do not possess authority and cannot prescribe medications for hair loss. 

Can a trichologist perform PRP?

Trichologists cannot do injections such as PRP or corticosteroids; they can just assess your hair and scalp health and provide personalized treatment plans.