What is meant by a "clinical diagnosis?"

What is meant by a "clinical diagnosis?"

The diagnosis of most types of hair loss is achieved through what is termed a "clinical diagnosis".  Many individuals incorrectly believe that the diagnosis "shows up" in a blood test or in a hair sample sent off for fancy mineral analysis. That's not how a hair specialist achieves the diagnosis of a person's hair loss.

A "clinical" diagnosis means that a patient needs to have the scalp carefully examined in the CLINIC by a CLINICIAN and the CLINICIAN needs to listen to the patients entire story (sometimes called the CLINICAL history) of his or her hair loss. Laboratory values are not required in making the diagnosis but might be helpful in making other diagnoses.

Examples

Consider the 32 year old man who has hair loss in the crown. He is concerned that the diagnosis he was given of male balding might not be correct because his lab tests are normal and his testosterone levels and DHT levels in particular are normal. One needs to remember that the diagnosis of androgenetic alopecia is a "clinical diagnosis" and so if the CLINICIAN in the CLINIC seen miniaturization of hairs in the area of hair loss there is a good chance what we are dealing with is androgenetic alopecia.

I could give countless other examples. Many types of hair loss are diagnosed through clinical diagnosis. Lab tests might still be helpful in the work up but they are not needed to make the diagnosis. 

Consider the 23 year old female with hair loss whose labs for ferritin, thyroid (TSH) and hemoglobin come back normal. What type of hair loss does she have?  Without the opportunity for me to review the clinical history and examine the scalp clinically, I would only be guessing.

Conclusion

Most hair loss diagnoses are made through a clinical diagnosis.