The Clinical
Examination
What Does a Clinical Examination for Hair Loss Involve?
Step 1 — Visual Assessment of Hair and Scalp (Macroscopic Examination)
The macroscopic examination involves evaluating the scalp with the naked eye to identify visible patterns and signs of hair thinning.
During this stage, the doctor will:
- Identify whether the hair loss follows a recognised pattern, which occurs in approximately 80% of men and 40% of women
- Distinguish patterned hair loss (male or female pattern hair loss) from less common, non-patterned causes
- Look for specific features such as hairline recession in women or localised bald patches, as seen in conditions like alopecia areata
- Stage the severity of hair thinning using recognised classification systems
Accurate staging helps guide treatment planning and monitor progression over time.
Step 2 — Detailed Scalp Imaging (Videotrichoscopy)
Following the visual assessment, a videoscope with 40x–100x magnification is used to examine the scalp and hair follicles in greater detail. This is known as videotrichoscopy.
This detailed imaging allows the doctor to:
- Assess follicle miniaturisation
- Evaluate hair shaft thickness and variation
- Examine follicular units for density and distribution
- Identify scalp inflammation or other underlying scalp conditions
- Assess overall scalp health and hair strength across different regions
This information provides a clearer understanding of the biological activity occurring at the level of the follicle and scalp base.
Scroll to see different causes
of The Clinical Examination
The Clinical
Examination
How Does A Doctor Examine You To Diagnose Your Hair Loss?
[Abstract 1 minute read]
- Doctor will look for a ‘pattern’ of hair loss, which occurs in 80% of men and 40% of women
- Less common types of hair loss may also be identified
- Doctor will be able to stage the severity of the problem
- A videoscope will be used to assess hair strength and scalp condition over different areas of the scalp
- The examination also will be used to plan which mode of hair restoration suits you most
- Careful and detailed examination and grading is a key to success in any hair restoration treatment
After the discussion about your history of hair loss and scalp conditions, a hair restoration doctor will examine you to determine to aim to achieve a diagnosis of your hair loss condition. This examination involves a ‘macroscopic’ examination i.e. looking at the scalp with the naked eye, and a more detailed view of the scalp called ‘videotrichoscopy’, using a high powered 40x – 100x magnifier specifically to examine the hair and the scalp at its base.
The macroscopic examination involves determining if it is a ‘patterned’ hair loss – male or female pattern hair loss, or whether another condition is causing the hair loss or thinning.
The doctor will also look for patches of baldness e.g. in alopecia areata and hairline recession in women.
This examination will also stage the severity of the patterned hair loss. There are a number of classifications used for this, the most common being the Norwood-Hamilton Scale for men and the Ludwig or Savin scale for women.
Scroll to see different causes
of Male Pattern Hair Loss
FAQs
Dermoscopy (or videotrichoscopy) is a magnified imaging technique that allows the doctor to examine your hair follicles, scalp health and hair shaft structure in detail. It helps identify miniaturisation, inflammation and early disease signs that are not visible with the naked eye.
Densitometry measures hair density and the number of hairs within each follicular unit. It helps determine how much donor hair is available and whether hair restoration techniques such as FUE or regenerative therapies are suitable.
A thorough assessment ensures the correct diagnosis, prevents unnecessary or ineffective treatments, and helps the doctor determine whether your hair loss is reversible, progressive or requires medical, regenerative or surgical intervention. Accurate staging and follicle analysis are essential for safe and predictable results.
The visual scalp assessment and videotrichoscopy are painless. The only slight discomfort may occur during the hair-pull test, where a small bundle of hair is gently tugged to assess shedding.
Most forms, including pattern hair loss, inflammatory conditions, autoimmune disorders and traction-related thinning, can be identified through the visual assessment and videotrichoscopy. Rare or unclear cases may need blood tests or a biopsy.
Typically 15–30 minutes, depending on the complexity of your hair loss. More detailed evaluations may take slightly longer.