Dermatologist for hair and scalp · Wrocław
Hair loss in Wrocław: dermatological diagnosis before treatment
Thinning, a receding hairline, a widening parting, increased hair loss and patches of baldness may have different causes and require separate diagnosis. The dermatologist assesses the pattern of loss, the scalp, the pace of change and the possible causes, so that the treatment corresponds to the diagnosis and not to the advertising of a preparation.
What can hair loss look like?
Hair naturally passes through phases of growth and rest, so single hairs in the drain do not settle the question of disease. What matters more is the change against your own norm: lower density, a different ponytail circumference, more visible scalp, a receding hairline, a widening parting or an area where the hair has disappeared.
A receding hairline, the crown or a wider parting
Such a distribution may fit androgenetic alopecia in men or women, but the appearance and the pace must be assessed in the context of age, family history, hormones, medicines and the condition of the scalp.
More hair during washing and combing
Diffuse loss may appear with a delay after a fever, an operation, childbirth, a large change in body weight, a heavy strain on the body, a change of medicine or a deficiency. The time course matters particularly here.
Patchy loss
Round or irregular patches may have different causes, including alopecia areata or an infection. The dermatologist assesses the skin, the hair at the edge, the nails and any symptoms elsewhere on the body.
Itching, pain, scale, pustules or crusts
The problem is then not confined to the hair shaft. Psoriasis, seborrhoeic dermatitis, eczema, folliculitis and other conditions of the scalp require treatment of the skin, not merely a change of shampoo.
Mechanical damage to the hair
Bleaching, high temperature, tightly pinned hairstyles, extensions, helmets or repeated friction may damage the shafts or overload the follicles. Shorter, broken hairs require a different assessment from hairs falling out with the bulb.
Eyebrows, eyelashes and body hair
The loss of eyebrows or eyelashes and changes in facial and body hair are an important part of the picture. Tell the doctor about them, even if the main reason for the visit is thinning on the head.
Why does hair fall out? The main groups of causes
Heredity is common, but it is not the only answer. One person may have more than one type of hair loss at the same time, for example androgenetic alopecia and transient telogen effluvium after an illness. That is why the effectiveness of a random preparation in an acquaintance does not predict the effect in another person.
Androgenetic alopecia
It is chronic in character and leads to the gradual miniaturisation of some of the follicles. In men it often begins at the temples or the crown, in women more often with a widening parting and a loss of density. Early diagnosis makes it possible to talk sooner about protecting the existing hair.
Telogen effluvium
A greater number of hairs pass into the resting phase after a strain on the body. The triggering event may precede noticeable shedding by weeks or months, so past infections, procedures, childbirth, weight loss, physiological stress and changes of medicine all matter.
Alopecia areata
This is a disease connected with the immune system, which may cause patches without hair and sometimes the loss of eyebrows, eyelashes or body hair. The extent and the course vary, so the treatment is matched to the current picture.
Inflammatory and scarring alopecia
Inflammation may damage the follicles and lead to permanent loss of hair. Pain, burning, intense itching, redness, crusts, pustules or smooth shiny skin without visible follicular openings call for earlier assessment.
Diseases of the scalp and infections
Scale, inflammation and infection may increase shedding or breaking. A “hair growth” shampoo alone does not treat the cause. The disease of the scalp has to be diagnosed and brought under control first.
Medicines, diseases and confirmed deficiencies
The hair cycle may be affected by general diseases, hormonal disorders, deficiencies and drug therapy. Do not stop a medicine or start high doses of supplements on your own. The connection is assessed on the basis of the history and of results chosen for the situation.
When to arrange an earlier consultation?
Not every case of hair loss is an urgent problem, but some pictures may lead to permanent loss of follicles or indicate an infection and should not wait many months for assessment.
Sudden patches
A new area without hair, rapid enlargement of a patch or simultaneous loss of eyebrows and eyelashes.
Pain and inflammation
Burning, tenderness, intense itching, purulent pustules, oozing, crusts or rapidly increasing redness of the scalp.
Scarring
Smooth, shiny skin, disappearance of the follicular openings or a clear widening of the area in which the hair does not grow back.
General symptoms
Hair loss combined with significant weakness, fever, unintended weight change or other new symptoms calls for a wider medical assessment.
How does the dermatologist examine the hair and the scalp?
The consultation covers the history of the problem, examination of the distribution of the thinning and assessment of the skin and the hair shafts. The doctor may use a dermatoscope or a trichoscope to magnify the image of the follicular openings, the shafts and the vessels. In selected situations additional tests, a mycological examination or a biopsy of the scalp are needed.
History
The time and pace of the loss, diseases, childbirth, fever, operations, diet, medicines, supplements, hair care and hair loss in the family.
The pattern
Comparison of the hairline, the parting, the temples, the crown and the occiput, and assessment of whether the problem is symmetric, diffuse or patchy.
Skin and hair
Looking for scale, erythema, pustules, scarring, broken hairs, varied shaft diameter and signs of regrowth.
The next step
The decision whether a clinical diagnosis is sufficient or whether targeted tests, photographic documentation, treatment or observation are needed.
What should be clear after the first visit?
The patient should know which type of hair loss the doctor suspects, which features speak for that diagnosis and what still cannot be settled. It is also important to establish the aim: stopping an active process, reducing inflammation, protecting the follicles, improving density or observing spontaneous regrowth. If additional tests are needed, the doctor should explain which question each of them is to answer.
When is a review of the diagnosis needed?
The plan is not closed once and for all. A change of pattern, new patches, pain, itching, pustules, loss of eyebrows or the absence of the expected stabilisation may justify an earlier follow-up and a review of the diagnosis.
Does everyone need a blood count, ferritin, hormones and vitamins?
No. A broad “hair panel” performed without a history may produce incidental deviations and miss the real cause. The range of tests depends on the type of hair loss, the diet, menstruation, pregnancy or childbirth, hormonal symptoms, diseases, medicines and the result of the examination of the scalp.
When may blood tests be needed?
When the history suggests anaemia or a deficiency, a thyroid disorder, a hormonal problem, a general disease or diffuse shedding after a significant strain on the body. The doctor chooses the particular parameters and interprets them in the patient’s context.
Why is supplementation without indications not neutral?
An excess of some components may also be harmful, affect the tests or delay the correct diagnosis. Correcting a confirmed deficiency is different from buying many preparations without establishing the cause.
A laboratory result alone does not replace an examination of the scalp. Borderline values, earlier supplementation, diet, chronic diseases and current symptoms change its meaning. For that reason the results should be discussed together with the time course of the shedding and the clinical picture. If tests were done earlier, bring the full document with the date and the laboratory’s reference range, not only single figures copied out.
What can the treatment of hair loss look like?
Management may cover treatment of the scalp, topical or systemic therapy, correction of a confirmed deficiency, a change of hair care, reduction of mechanical tension or observation after transient telogen effluvium. The methods have different indications, contraindications and different times needed for assessment.
The aim at the beginning
In chronic alopecia the success of the first stage may be slowing the loss and achieving stability, not immediate thickening. With inflammation the priority is protecting the follicles and controlling the symptoms.
Regularity
Some therapies work only while they are used systematically, and the effects appear slowly. The doctor should explain the horizon of assessment, the way of application, the adverse effects and the moment of follow-up.
Monitoring
Photographs in similar light, with the same parting and angle, are more reliable than memory. The assessment covers density, the pace of progression, regrowth and the condition of the scalp.
How to distinguish real improvement from the impression of a single day?
The hair cycle is long, and the number of hairs visible after washing depends among other things on how often the hair is washed, its length and the way it is combed. Daily counting of single hairs therefore usually increases anxiety but describes the trend poorly. More information comes from comparing photographs taken in constant conditions, assessing the width of the parting and the hairline, and examining the scalp at a planned follow-up.
At a follow-up visit it is worth discussing how regularly the recommendations have been followed, the tolerance of the therapy, new symptoms and health events that may have changed the hair cycle. The absence of rapid thickening does not always mean the absence of an effect, and a short-lived fluctuation in the number of hairs shed need not indicate deterioration. A change of plan is decided by the overall assessment of the course, the photographs, the examination and the aim set at the beginning.
A procedure does not replace a diagnosis. Mesotherapy, plasma, devices or in-clinic procedures may have a place in selected plans, but they do not treat every cause. It first has to be established whether the problem concerns miniaturisation of the follicles, a shift of the hair cycle, inflammation, infection, scarring or breaking of the shafts.
How to prepare for a visit in Wrocław?
Information to give during the visit
- a list of medicines, supplements, diseases and allergies;
- the results of tests done for another reason or recommended earlier;
- the dates of important events: infections, operations, childbirth, a large change of body weight;
- photographs of your hair from several months ago, if you have them.
Preparing the scalp
- do not mask the changes with powder or a colouring spray just before the examination;
- do not apply heavy oils or lotions directly before the visit;
- do not feel obliged to “grow” a large amount of hair in the brush;
- note the dyes, hairdressing procedures and cosmetics you use.
You do not have to identify the type of alopecia yourself before the visit. What does help is a short chronology: when the problem began, whether it was sudden, which areas changed first and whether itching, scale, pain or pustules occurred. If you use preparations on the scalp, note their names, the frequency and the duration of use. The consultation can then concentrate on differentiating the causes instead of reconstructing information from memory.
Why does a dermatologist begin the assessment?
A dermatologist deals at the same time with the hair, the follicles and the scalp. This makes it possible to distinguish an aesthetic problem from inflammation, an infection or a scarring process and to decide whether a further consultation is needed. The visit should lead to a written, comprehensible plan and to criteria for follow-up.
Women
Pregnancy, childbirth, menstruation, hormonal symptoms, contraception, the menopause and deficiencies may all matter. The treatment plan has to take into account the possibility of pregnancy and the safety of the particular therapy.
Men
A receding hairline and thinning at the crown do not always call for a “strong procedure”. An earlier assessment of the pattern and the scalp makes it possible to discuss the possibilities and the limitations. See also the page dermatology for men.
Every patient
Hair loss may affect self-esteem, relationships and work. That is a legitimate reason for a consultation. A good doctor does not make light of the burden, but does not promise regrowth without a diagnosis either.
Information about the doctors who see patients in Wrocław is available in the profiles of dr n. med. Małgorzata Micał-Strąk and lek. Ireneusz Pijanowski. The availability of a particular range of consultations is confirmed by reception.
Hair loss Wrocław: FAQ
Is daily hair loss normal?
Hair naturally ends its cycle and falls out, but what matters is the change against your own norm. A consultation is needed for a noticeable loss of density, a wider parting, a receding hairline, patches without hair or increased shedding that persists and progresses.
Can stress really cause hair loss?
A heavy strain on the body may precede diffuse telogen effluvium, but the symptom often appears with a delay. “Stress” should not be an automatic answer without analysing diseases, medicines, diet, the scalp and the pattern of loss.
Does androgenetic alopecia also affect women?
Yes. In women a widening parting and a loss of density are more often visible, and in men a receding hairline or thinning at the crown. The diagnosis requires assessment, because other types of loss may coexist.
Do I need trichoscopy?
Magnifying the image of the skin and the hair may support the diagnosis, but it does not replace the history and a full examination. The doctor decides on the need for and the availability of the examination depending on the clinical picture.
Which tests should be done before the first visit?
There is no single obligatory set. If you have recent results, bring them. New tests are best chosen after the history, so that they correspond to the probable cause and do not lead to random supplementation.
Do ferritin and the thyroid always explain hair loss?
No. They may be important in selected situations, but hair falls out for many reasons. A normal single result does not exclude androgenetic alopecia, alopecia areata, a disease of the scalp or a scarring process.
Are hair supplements enough?
They help above all when they correct a confirmed deficiency. They do not replace the treatment of inflammation, infection, androgenetic alopecia or alopecia areata. An excess of some components may be harmful.
When can the effect of treatment be assessed?
Hair grows slowly, so the horizon depends on the diagnosis and the method. Often the halting of progression is assessed first and only later the density or the regrowth. The doctor sets the follow-up date and the way of photographing.
Can the hair fall out again after treatment is stopped?
In chronic types of alopecia the effect of some therapies depends on their continuation. With a transient cause the plan may be different. Do not change the treatment on your own; discuss maintenance, a break and the possible consequences.
Are mesotherapy or plasma the best first step?
Not for everyone. A procedure should follow from the diagnosis and not replace the diagnosis. With an infection, inflammation or scarring alopecia the priority and the way of proceeding may be entirely different.
Can I book an online consultation?
It may be helpful for collecting the history and discussing results and photographs, but with patches, pain, scale, pustules, scarring or an unclear picture an in-person examination is often needed.
Where can the price of the visit be checked?
The current, approved prices are in one common HappyDERM price list. The range of tests and treatment follows from the consultation, so a procedure should not be chosen solely by its name in the price list.
Related information
Psoriasis of the scalp
Scale, redness and itching may increase breaking and temporary loss of hair.
Seborrhoeic dermatitis
Recurring scaling and inflammation require treatment of the scalp, not only care of the hair shaft.
General dermatology
See the range of consultations and other problems of the skin, hair and nails.
Medical sources used in preparing this page
- American Academy of Dermatology: Hair loss – diagnosis and treatment.
- American Academy of Dermatology: Hair loss – causes.
- American Academy of Dermatology: Hair loss – signs and symptoms.
- American Academy of Dermatology: Types of hair loss.
- American Academy of Dermatology: Male pattern hair loss – diagnosis and treatment.
- NHS: Hair loss.
The content is educational and does not replace a consultation, an examination or individual recommendations. The diagnosis, the range of tests and the way of treating are set by a doctor. Do not stop medicines and do not begin high-dose supplementation without a consultation.