Evaluation of hair loss

The evaluation of a patient with hair problems is a fundamental step for the correct diagnosis of disease, as it gives important information and helps in choosing the diagnostic tools that should be utilized to confirm the clinical suspicion. The evaluation includes a clinical history and patient examination and is followed by invasive and noninvasive tests. Often, the sole clinical examination permits the correct diagnosis of the hair disease and the evaluation of its severity and progression. For this reason, time should be spent to get all of the necessary anamnestic data and to carefully examine the patient. Dermoscopy (trichoscopy) will afterward add additional data that can be further increased by scalp biopsy for histopathology and/or by other more specific tests. When approaching a patient with hair problems, it is mandatory to consider the strong psychological impact of hair diseases, which are very often associated with severe emotional distress. For this reason, patients should be managed with care by spending time listening to their complaints and by explaining in detail their disease and its possible treatments. The patient will only be able to properly adhere to treatment and to obtain the best result if she/he understands her/his hair problem and its possible solutions.