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Specific examinations

The trichogram, hair roots under the microscope

A trichogram is a diagnosis method for ascertaining how far hair loss has progressed and the chances of successful treatment. A trichogram is often performed, as it throws light on the state of a patient's hair roots.
To determine the number of hair roots, the state of hair sheaths and which percentage of hairs are in each of the three phases of the hair growth cycle, hair samples are generally taken from two different places on the scalp. For best results, more than 50 hairs should be removed with their roots, and examined and counted under the microscope. By doing so, it is often possible to draw conclusions on the type of hair loss and how far advanced it is. Sensitive patients often find a trichogram painful. A less painful method providing even better results is the so-called TrichoScan.

TrichoScan for a non-invasive, accurate diagnosis

A TrichoScan, also known as a photo-trichogram, combines a microscope with software, using IT to determine the state of a patient's hair. Whereas a trichogram requires hairs to be physically extracted, all that a TrichoScan requires is for the area to be examined (ca. 16 - 20 mm) to be shaven. This shaven part of the scalp is then coloured, dermatoscopically photographed and analysed. The digital photo creates a video image which is then assessed by the software, determining hair density. When doing a TrichoScan to determine the state of a patient's hair roots, the shaven patch of the scalp is again coloured and photographed three days later. If the hairs are in their resting or falling-out phase, they will not grow during this period, thereby providing the doctor with important indications of the type of hair loss. Clear advantages of a TrichoScan: a TrichoScan is painless and the result can be archived, allowing changes to be tracked. In addition, Dr. Feriduni and his patient can both view the state of the latter's hair on the computer monitor, exactly tracking the results of the therapy.

microDERM®Hair - digitally tracking hair growth and hair loss

The microDERM®Hair hair diagnosis method, like a TrichoScan, offers the possibility of digitally tracking changes to a patient's hair. The number of hairs, hair length and hair density are calculated automatically and displayed graphically, providing optimal support for a qualified analysis and diagnosis of hair loss. Therapy results and changes made during the course of the treatment can be displayed, stored (or printed out) and objectively checked. The use of microDERM®Hair is quick and painless. It entails shaving a 10 x 10 mm patch of the scalp to a length of 1 mm and then taking photographs of it. These are then displayed on the monitor and stored in a database. Some 2 - 4 days after the first photos are taken, a second set of digital photos of the same shaven patch is taken.
 
microDERM®Hair automatically processes the photos, analysing all relevant factors and displaying the results in graphical form. This analysis and the resulting findings are then used by Dr. Feriduni as a basis for discussing / recommending possible treatment methods and tracking treatment results.
Lab tests, ruling out possible causes of hair loss

There are various possible causes of hair loss, often not apparent at first glance. In particular when hair loss is patchy, the cause can be medication, certain illnesses or deficiencies. To gain an exact picture whether for example a thyroid problem or iron deficiency is causing the hair loss, lab tests are recommended. As a way of pinpointing illnesses or deficiencies and treating them accordingly, the following lab tests are available:
 
  • Blood tests
    With blood containing a great amount of information, a blood test is therefore a good way of pinpointing any illness. Some 10 ml of blood are sufficient to perform a range of different tests. 
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  • Checking a patient's hormone status 
    Growth, development and aging, but also a body's defence mechanisms, are processed by hormones, as are nutrients. In women in particular, a blood test can provide an insight into the most important hormones, giving indications of developments and changes, including those affecting our hair. Hormone status should be checked in the early follicle phase or at the end of a woman's monthly cycle.

  • A hair and mineral analysis 
    • Chemical elements (e.g. heavy metals) and organic compounds deposited in the body over recent months and a potential cause of hair loss can be detected by the hair and mineral analysis. A hair and mineral analysis cannot replace any other analysis method and only has limited informational value. Even so, it can still be useful as a way of making further diagnostic observations and thereby gaining greater insight.


Scalp biopsy

Deep wounds, radiotherapy and scarring can be just as damaging to the scalp as fungal, bacterial or viral infections and autoimmune diseases - and similarly cause hair to fall out. Should there be any suspicion of a disease of the scalp or should the hair disease diagnosis not be 100 % certain, in most cases it is a good idea to perform a scalp biopsy. A scalp biopsy is carried out by removing a small piece of the scalp (a strip 0.8 - 1.0 mm long and no wider than 3 mm) with a scalpel under local anaesthesia. This is then examined microscopically and histologically.
 
A scalp biopsy consists of a histological examination, looking for instance at the number and structure of hair follicles, and checking whether there are any inflammatory or other processes that may be causing the destruction of hair follicles leading to hair loss.
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