It’s normal to shed up to 80-100 hairs per day [1], but if you’re noticing more hair loss in the shower than usual, it may be best to see a hair doctor.
Trichologists are known as hair doctors despite the fact that not all of them are medical professionals. A trichologist is a hair and scalp specialist who can help you from the first signs of hair thinning and balding. They can diagnose and treat bald patches, dry brittle hair, hair shedding, and a wide range of other types of hair loss.
A scalp doctor can identify the root cause of the problem, suggest a treatment plan, and refer you to other hair specialists or a medical doctor if required. In this article, we’ll explore:
The Institute of Trichologists (IOT) is the largest provider of trichology education and training in Europe. Hair doctors associated with IOT receive registered education programmes that qualify them to diagnose and treat hair and scalp conditions [2].
These hair doctors help diagnose and treat conditions including androgenetic alopecia, telogen effluvium, alopecia areata, hair breakage, and common scalp issues, such as seborrheic dermatitis or scalp psoriasis. They also conduct research on hair care products you may buy in a shop or see in a salon. However, they are not able to perform surgery unless they also have medical training and there are restrictions on which medications they can prescribe.
Trichologists’ training length varies depending on their specific qualification, but all of them undergo hands-on practice training, academic coursework, mentorships, observation, and exams. Training lasts anywhere from 6 months to several years, and many scalp doctors come from a clinical or hair care-related background.
Trichologists are unique because their speciality focuses solely on the hair and scalp. Their training overlaps with the medical and cosmetic fields, meaning they possess a unique skill set that is not fully covered by either a doctor or hairdresser.
At your first appointment, your trichologist will start by asking several questions about your medical history, hair care routine, lifestyle, diet, and reason for seeing them. This helps them decide which trichology tests to perform, how to treat you, and whether you need a referral to another hair specialist or scalp doctor.
They will then thoroughly examine your head and scalp. Your trichologist may complete a hair analysis to check whether your hair has any structural damage or if there are signs of parasites, a bacterial or fungal infection, such as a yeast infection on the scalp. If your hair is falling out, they may also arrange hair loss blood tests.
When your trichologist has diagnosed the cause of your symptoms, they will recommend the next step in your treatment plan. This may include:
In this article, we’ve already discussed the role of a trichologist. But what about other hair specialists they may refer you to?
Dermatologists are medical doctors who have expert knowledge of conditions of the hair, skin, nails, and scalp.
While there is an overlap between dermatologists and trichologists, the difference lies in the level of specialisation in hair health. In general, dermatologists have a broader medical knowledge, but trichologists are more deeply specialised in hair and scalp conditions.
As medical doctors, dermatologists are also able to prescribe medications, such as steroid injections for alopecia areata or antibiotics for severe cases of scalp folliculitis. For this reason, trichologists and dermatologists often refer patients to each other.
If non-surgical methods don’t successfully restore your hair, you may be a candidate for a hair transplant. Hair transplant surgeons are mostly plastic surgeons or dermatologists who have specialised in hair restoration surgery [3].
However, some hair transplant surgeons come from different clinical backgrounds, such as neurosurgery, where they have already gained expert knowledge about operating on the scalp. A trichologist may refer you to a hair transplant surgeon if they believe that is your best chance of restoring your hair or if you want to find a long-lasting cure since a hair transplant is permanent.
Most people with a hair or scalp condition could benefit from a visit to the trichologist. A trichologist can often advise on the following [4]:
While trichologists cannot treat every hair or scalp condition they encounter, they are required to have some general medicine knowledge, particularly endocrinology [4]. This allows them to diagnose accurately and refer patients to the right healthcare professional.
While a trichologist may need to involve other medical professionals if surgery or prescription medication is required, a trichology assessment is often the best place to start. With their expert knowledge, these specialists can identify the reason your hair is falling out, provide holistic advice and treatment within their scope of practice, and refer you to the appropriate professional for any further treatment.
Androgenetic alopecia, also known as male or female pattern baldness, is the most common type of alopecia. It affects up to 80% of men and 50% of women over the course of their life [5]. This condition may have a genetic component and can be managed with medication or hair transplant surgery.
Male pattern baldness often starts with a receding hairline and temple hair loss and progresses over the years, leading to an M-shaped hairline and a bald spot on the crown. Eventually, it can cause total baldness, particularly in men who start experiencing hair loss at a younger age – some men start losing hair any time after puberty.
In female pattern hair loss, hair thins slowly over the whole scalp (known as diffuse thinning). Like male pattern baldness, it can begin any time after puberty, but most women do not experience hair loss until they start to get older. It is much less common for female pattern hair loss to cause complete baldness.
Alopecia areata is an autoimmune condition, meaning the body’s defence system attacks healthy tissues. In the case of alopecia areata, this includes the hair follicles. In rare cases, this can eventually lead to alopecia totalis, in which the scalp becomes completely bald. However, it usually remains limited to a few patches and often resolves spontaneously without treatment.
The damage to hair follicles causes hair to fall out and prevents new hair from growing. This disease can affect people of any age or gender, and hair loss can be sudden. Alopecia universalis is a similar condition that causes a complete loss of all scalp and body hair.
Trichotillomania (TTM) is a psychological condition that occurs when someone cannot resist the urge to pull out their hair. The hair may be pulled out from the scalp, eyebrows, eyelashes, genital area, beard, or moustache. It usually starts in children aged 10-13 [6].
People with TTM experience increasing tension and an intense urge to pull out their hair. When they do, they feel a sense of relief. It’s not clear what causes TTM, but possible explanations suggest it could be [6]:
Telogen effluvium is often triggered by factors such as emotional and psychological stress, drugs, and physical trauma [7]. It is a condition in which many of the hair follicles on the scalp enter the telogen (resting) phase of the growth cycle, but the next growth phase doesn’t begin. This means hair falls out all over the scalp without regrowing.
Telogen effluvium doesn’t usually cause complete baldness, but it can cause significant hair loss. It usually starts around 3 months after a triggering event and resolves within 6 months if the event ends [8]. Telogen effluvium lasting longer than 6 months is classed as chronic.
Anagen effluvium occurs when the anagen (growth) phase of the hair cycle is interrupted. It is a type of hair loss associated with chemotherapy, but it can be caused by radiation, toxic chemicals, and some inflammatory diseases [9].
Anagen effluvium is usually a temporary type of hair loss, and hair regrowth usually starts after a 1-3 month delay [9]. However, it can sometimes lead to permanent baldness.
Tinea capitis is a fungal scalp infection that often causes childhood hair loss. It’s also called scalp ringworm.
It can cause an itchy scalp with red, scaly areas, oozing blisters, and circular bald patches that grow bigger as the condition progresses. Most children recover well from tinea capitis as long as it is diagnosed and treated early.
Cicatricial alopecia, also known as scarring alopecia, describes a group of inflammatory conditions that cause permanent hair loss [10]. Inflammation destroys the hair follicles and replaces them with scar tissue, making it impossible for hair to regrow.
Hair loss may be a slow, gradual process or happen suddenly. Cicatricial alopecia can occur at any age and affect people of any gender, although it is very rare in children. Additional symptoms may include swelling, itching, and lesions on the scalp that look like a rash [8].
There are many treatments available for hair loss, and a hair specialist can help you decide which one is right for you. Treatment options include:
Whether you’re considering a hair transplant, alternative treatments or simply looking for some advice, our trichologists can help. They can provide expert advice on cutting-edge treatments, natural remedies for hair loss, such as the best diet for healthy hair, blood tests for hair loss, and referrals to some of the best hair transplant surgeons in the UK.
Wimpole Clinic offers two main types of hair transplant: follicular unit extraction (FUE) and follicular unit transplantation (FUT). It’s possible to get a natural-looking hair transplant without anyone knowing – check out our before and after hair transplant gallery to see what your new hair could look like.
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