You’re losing your hair, but who do you call? Many people don’t know what type of doctor or professional to contact when they start experiencing hair loss or thinning. Your barber might be able to confirm, “Yep, there’s less than last time!” but that hardly serves as a diagnosis and certainly won’t help you get prescription hair loss treatments.
The best medical professional for that job is a dermatologist. You might think of dermatologists as “skin doctors” and not associate your scalp with your complexion, but hair follicles are located in the skin, and the two are most definitely closely related.
Dermatologists aren’t only concerned with acne and psoriasis, they specialize in treating the skin, nails, and hair. They’ve typically spent more than a decade in school, learning all sorts of sciencey stuff, including how to diagnose and treat various skin and hair disorders.
According to the American Academy of Dermatology, your dermatologist spent four years earning their bachelor’s degree, four years in medical school, one year as an intern and three years, minimum, as a dermatology resident. So, yeah, they’ve learned a few things along the way.
Once this period of education and training is over, a dermatologist can become board certified by completing a rigorous exam to confirm their knowledge. Board-certified dermatologists in the United States are typically certified by the American Board of Dermatology or the American Osteopathic Board of Dermatology.
When it comes to your hair, specifically, a dermatologist can help determine what’s causing your hair loss. They can identify what sort of hair loss is occurring, in order to recommend the best course of treatment or refer you to another specialist.
When you visit a dermatologist about your thinning hair, they’ll likely begin by asking you about your medical history, any medicines you might be taking, your lifestyle, and how your hair loss has progressed overtime — for instance, is this new or has it been gradually worsening.
Then, they’ll do a physical exam. They’ll examine your scalp and may look at other parts of your body to ensure the hair loss is localized to your head. They may pull on your hair to test its health and whether it’s fragile. They may use a “card test” to examine the density and shape of your hair strands.
Your dermatologist may recommend blood tests or other evaluations to rule out hormonal imbalance, vitamin and mineral deficiencies, and other diseases and medical conditions that may cause hair loss. These additional tests may include taking blood to look for iron deficiency or thyroid problems, taking a fungal culture to look for fungal infection like tinea or ringworm, or doing a scalp biopsy (also known as a punch biopsy) to get a sample of your scalp.
All of this will provide the healthcare provider with clues about what’s causing your hair loss, and therefore, what your diagnosis is.
For example, if the healthcare provider determines your hair is coming out in clumps and you reveal a recent traumatic event or extreme psychological stress, you may receive a diagnosis of telogen effluvium (generally temporary hair loss). If the healthcare provider recognizes the telltale signs of ringworm, you may receive a tinea capitis diagnosis. But most likely, your dermatologist may recognize the signs of androgenetic alopecia, or male pattern baldness.
Androgenetic alopecia, or male pattern hair loss, is the most common type of hair loss. It is hereditary and can begin anytime after puberty. The prevalence of male pattern hair loss increases with age, so while it’s possible to begin seeing hair thinning in your 20s or 30s, the likelihood you’ll experience it goes up with each decade of life.
In men, androgenic alopecia follows a predictable pattern, hence the name male pattern hair loss. It generally begins as thinning around the temples, spreading backwards across the head, and thinning at the crown, spreading outwards in a circle.
Diagnosing androgenetic alopecia is generally a matter of examining the scalp for that predictable pattern, noting it has a gradual onset, and asking about your family history of hair loss.
Finally, your dermatologist can recommend treatments for hair loss once a diagnosis is reached. Ultimately, this is likely why you’re seeing them: hope for treatment.
When it comes to androgenetic alopecia, there are treatments available.
There are two FDA-approved treatments available for male pattern hair loss: topical minoxidil and oral finasteride. Minoxidil can be obtained over the counter without a prescription, but finasteride will require a prescription from your dermatologist.
Your dermatologist can set proper expectations about the effectiveness of this medication, but they generally take several months to show improvement. Also, the treatment must be consistent -- if you stop using these treatments, your hair loss will resume.
Dermatologists are the appropriate medical professional to seek out when you’re experiencing hair loss. They’ve studied diseases of the hair and skin for many years and can help you determine what’s causing your condition and the best course of treatment. Board-certified dermatologists have taken an additional exam to signify the depth of their knowledge, and will be able to recommend options that may restore your hair, and your self confidence.