The Important Steps in Diagnosis
One can confidently diagnosethe cause of a patient’s hair loss after they have completed a few steps: (1) they have heard the whole story about the hair loss and patient’s past health (2) they have examined the scalp including up close with use of trichoscopy and (3) they have reviewed the patient’s blood tests. (4) Sometimes a fourth step is needed and that is review of the results of a patient’s biopsy. One essentially puts the results of steps 1,2,3 and 4 into the brain and then out pops the diagnosis.
We never diagnose hair loss by ordering up blood tests and sitting patiently for the results to come back. Blood tests can be an important part of the story but they are never the entire story. Similarly one never relies 100 % on the results of a biopsy. If one decides to do a biopsy and it comes back showing a non-scarring alopecia but the clinician in really thinking this is a scarring alopecia then one must either ignore the biopsy or take more biopsies from the patient’s scalp or get another pathologist to review the slide.
Diagnosing hair loss comes from reviewing information from multiple sources of information.
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887