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Scalp Biopsy: Does it Help Diagnose Hair Loss?

Katelyn Hagerty FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 9/21/2021

If you’re starting to lose your hair without a clear reason, your healthcare provider may need to take a biopsy from your scalp to determine the root cause of your hair loss and recommend the most appropriate form of treatment.

Getting a scalp biopsy can be a nerve-racking prospect. However, it’s generally a quick process that shouldn’t result in any significant pain or discomfort.

Below, we’ve explained what a scalp biopsy is, as well as how your healthcare provider may use a biopsy to provide a more accurate diagnosis for your hair loss.

We’ve also covered the basics of the scalp biopsy process, as well as what you should expect if you need to get a biopsy to identify the cause of your hair loss.

What Is a Scalp Biopsy?

A scalp biopsy is a minor medical procedure in which a healthcare provider will remove a small piece of your skin from your scalp for testing and analysis.

Healthcare professionals use several techniques to do a skin biopsy. These include removing a sample piece of skin using a small circular tool (a punch biopsy) and shaving away a small area of skin using a razor blade (a shave biopsy).

In some cases, the piece of skin may be carefully excised using a surgical scalpel (an excisional biopsy).

A scalp biopsy allows your healthcare provider to provide an accurate diagnosis of any diseases or conditions that affect your scalp. 

For androgenetic alopecia, your healthcare provider may use a scalp biopsy to look for signs of destruction to hair follicles, or to perform a follicular count. 

A biopsy can also show signs of hair damage from autoimmune conditions or scalp disorders.

When Is a Scalp Biopsy Necessary?

Your healthcare provider may suggest a scalp biopsy if you’re experiencing hair loss without a clear cause. A scalp biopsy can help your healthcare provider:

    A scalp biopsy may also be necessary if you have an unusual mole or other type of skin growth on your scalp. 

    By performing a biopsy, your healthcare provider may be able to determine if an unusual growth requires further attention.

    Many forms of hair loss may be diagnosed after a scalp biopsy, including the following:

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      The Scalp Biopsy Process

      While getting a biopsy can seem daunting, it’s usually a quick and simple process that isn’t likely to cause significant pain or discomfort. 

      A biopsy is a simple, in-office procedure. Your healthcare provider will clean the affected area of your scalp, then remove a small amount of skin using a special device. 

      Make sure to follow your healthcare provider’s instructions and stay still throughout the procedure.

      Your healthcare provider will usually take a biopsy in the direction of your hair growth. After the procedure, the biopsy sample will be divided into horizontal or vertical sections for analysis. 

      In some cases, your healthcare provider may need to take more than one skin sample.

      In order to prevent pain, your healthcare provider may use a local anesthetic to numb the area before performing the procedure. 

      After the biopsy, your healthcare provider will dress the affected area. Depending on the biopsy technique, the area may be sutured closed. 

      Make sure to follow the care instructions provided by your healthcare provider to prevent infection and help your skin recover.

      Other Techniques Used to Diagnose Hair Loss

      Dermatologists and other healthcare providers that specialize in skin and hair will typically take a biopsy sample when the cause of your hair loss isn’t obvious.

      Not all forms of hair loss need to be diagnosed with a scalp biopsy. Depending on your hair loss symptoms, your healthcare provider may use one or several of the following approaches during your visit:

      Our guide to what dermatologists do for hair loss goes into more detail about how male pattern baldness and other forms of hair loss are diagnosed and treated. 

      How to Treat Hair Loss

      Most forms of hair loss are treatable, either through the use of hair loss medication, by treating the underlying cause or by making changes to your hair care habits. 

      Depending on the underlying cause of your hair loss, your healthcare provider may recommend one or more of the following hair loss treatment options.

      Use Finasteride and Minoxidil

      If your hair loss is the result of male pattern baldness, you can slow it down, stop it from getting worse and even potentially reverse it by using hair loss medication.

      Currently, the FDA has approved two medications to treat male pattern baldness. These include finasteride, which works by reducing DHT production, and minoxidil, which works by stimulating hair growth at the scalp level.

      Numerous studies have shown that finasteride and minoxidil are effective at preventing hair loss and stimulating hair growth.

      In one study, researchers found that the medications are particularly effective when they’re used together, with 94.1 percent of men displaying improvements after using finasteride and minoxidil over a period of 12 months.

      We offer finasteride and minoxidil online, with finasteride available following a consultation with a healthcare provider who will determine if a prescription is appropriate. You can also purchase finasteride and minoxidil together in our Hair Power Pack

      Treat Any Conditions That Cause Hair Loss

      If your hair loss is caused by something other than male pattern baldness, such as rapid weight loss, stress, a fungal infection or scalp inflammation, it’s important to treat the underlying cause before you focus on stimulating hair regrowth. 

      Based on your biopsy analysis and results, your healthcare provider may prescribe medication to treat an infection or other scalp issue, or suggest certain changes that you can make to your diet or lifestyle. 

      Some scalp conditions may require ongoing care and attention. Closely follow the instructions provided by your healthcare provider. 

      Make Changes to Your Hair Care Habits

      Sometimes, making small changes to your hair care habits can improve the health of your hair and reduce the severity of your hair loss.

      This could mean using hair care products designed to support optimal hair growth, such as our Hair Thickening Shampoo and Thick Fix Conditioner, or changing your diet to include food that promotes healthy hair growth

      While changes to your lifestyle are unlikely to reverse male pattern baldness on their own, they may help improve your results from science-based hair loss treatments like finasteride and minoxidil. 

      Our guide to the best treatments for thinning hair goes into more detail about how you can slow down, stop and reverse the effects of male pattern baldness and other forms of hair loss. 

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      Do You Need a Scalp Biopsy?

      A scalp biopsy is a quick, simple procedure that involves removing a sample of skin from your scalp for testing and analysis. 

      Your healthcare provider may suggest a biopsy if you have hair loss without a clear, obvious cause, or to get more information about a skin condition. 

      Getting a scalp biopsy typically only takes a few minutes. After the procedure, it’s important to closely follow your healthcare provider’s instructions to help your skin recover quickly. 

      Your healthcare provider will recommend an appropriate treatment option based on the results of your biopsy test, your symptoms, personal needs and other factors.

      Worried about your scalp health? You can learn more about rashes, hair loss and other issues that may affect your scalp in our detailed guide to the most common scalp conditions

      8 Sources

      Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

      1. Skin Biopsy. (2020, December 3). Retrieved from https://medlineplus.gov/lab-tests/skin-biopsy/
      2. Vidal, C.I. (2015, July-August). Overview of Alopecia: A Dermatopathologists Perspective. Missouri Medicine. 112 (4), 308–312. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6170065/
      3. Hughes, E.C. & Saleh, D. (2021, June 8). Telogen Effluvium. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430848/
      4. Pickett, H. (2011, November 1). Shave and Punch Biopsy for Skin Lesions. American Family Physician. 84 (9), 995-1002. Retrieved from https://www.aafp.org/afp/2011/1101/p995.html
      5. Zito, P.M., Bistas, K.G. & Syed, K. (2021, March 27). Finasteride. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513329/
      6. Badri, T., Nessel, T.A. & Kumar, D.D. (2021, April 13). Minoxidil. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482378/
      7. Hu, R., et al. (2015, September-October). Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients. Dermatologic Therapy. 28 (5), 303-308. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/dth.12246
      8. Ho CH, Sood T, Zito PM. Androgenetic Alopecia. Updated 2021 Aug 11. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430924/

      This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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