The 30-second scalp examination that changes how we plan hair restoration.
Before we recommend any hair restoration protocol, we run a trichoscopy. A handheld dermoscopy device magnifies the scalp 20 to 70 times, allowing us to assess what is actually happening at the follicle level.
What we look for. Hair shaft diameter variation, which signals miniaturisation, the early step in pattern hair loss. Scalp condition, redness, scaling, oiliness, all of which inform the protocol. Empty follicles versus follicles with miniaturised hairs, which tells us whether regrowth is biologically possible in a given area. Yellow dots, peripilar signs, and other patterns that distinguish androgenetic alopecia from telogen effluvium, traction, scarring, or autoimmune patterns.
Why this matters. A client may walk in convinced they have one type of hair loss when the trichoscopy shows another. The protocol changes. Treating androgenetic alopecia with the same approach as a stress-driven telogen effluvium produces underwhelming results. Treating scarring alopecia with regenerative therapies meant for non-scarring loss wastes time and money.
The exam takes around 30 seconds per region. We take photographs for the file so we can track progress objectively over the months that follow. At the three-month review point, we re-examine and compare. Hair growth is slow, and clients sometimes underestimate the change because they see themselves daily. Side-by-side magnified images at three months tell the truth.
We do not start any hair protocol, PRP, exosomes, mesotherapy, peptide-based regrowth, without this exam first. It is included in the consultation. If you have been told you need a course of hair injections without a scalp examination, push back. A protocol without a baseline is just a guess.
For clients new to hair restoration, a trichoscopy alone, with no treatment plan, is a useful first step. We can show you what is happening, explain the options, and let you decide.