Dermoscopic imaging of the hair and scalp, aka ‘trichoscopy’, has an important use for dermatologists and trichologists. While visual examination and pictures of the hair and scalp are very helpful in determining the cause, severity, and progression of many hair loss and scalp health conditions, trichoscopy can help to confirm diagnoses, capture subtle changes in the hair and scalp, and assess how active a certain condition is.
Do you ever wonder what your dermatologist or trichologist is doing when they examine your hair and scalp with a dermatoscope? I have outlined some common features that they are looking for.
Often, the first thing they’re looking for is the presence of follicular openings in order to determine if the hair loss is scarring (permanent) or non-scarring (where there is a possibility of reversal). If the follicular openings are absent, this points to scarring alopecias (some examples being lichen planopilaris and folliculitis decalvans). If the follicular openings are present, this points to non-scarring alopecias (such as alopecia areata, telogen effluvium and androgenetic alopecia).
Next, the dermatologist or trichologist will look to see if there are other signs that can help to confirm a specific diagnosis. For example, a variation in hair shaft diameter, or single hairs (as opposed to two to four hairs) emerging from hair follicles, will point towards androgenetic alopecia (AGA). Yellow dots, along with tapered hairs, or black dots (hair follicles broken at the surface), will signal alopecia areata (AA). The presence of multiple upright hairs (greater than five) emerging from a single opening may point towards folliculitis devalvans. The list goes on and on.
One thing to note is that while trichoscopy can be very helpful, it is important that the person who is doing the examination has undergone the appropriate training and knows what to look for. Like choosing any health or wellness practitioner, make sure to do your research when choosing someone to help you with your hair loss or scalp health issues.
I hope this helps shed some light on trichoscopy. If you’re in the greater Vancouver area, stop by for your close up ;)!
