What Is the Main Idea?

Hair loss can be hereditary or a normal symptom of aging, but it can also be a sign of illness. The recent paper “Efficiency of Hair Detection in Hair-to-Hair Matched Trichoscopy”, published in the journal Skin Appendage Disorders, describes the trichoscopic techniques used to monitor the progression of hair loss and support treatment efforts. This post summarizes the authors’ findings.

What Else Can You Learn?

What is the impact of hair loss? And what are some of the causes, besides hereditary and aging? This post summarizes the answers.

What Is the Impact of Hair Loss?

Hair loss may seem trivial at first: It’s commonly associated with male aging and as yet, there are no non-invasive interventions that reliably slow or prevent so-called male pattern baldness. However, hair loss shouldn’t be seen as trivial. Hair has considerable personal and social importance in many cultures and its loss can be very troubling.

Anyone, regardless of gender, can experience hair loss, but it is most common in cisgender men. Male hair loss is associated with aging, lack of virility, loss of attraction, and other markers of social status. In cisgender and transgender men, its impact includes lowered self-esteem, decreased confidence, and depression.

Female hair loss is associated with illness, depression, and lack of self-care. In cisgender women, its impact includes depression, lowered self-esteem, avoidance of social situations, and altered self-image. Transgender women experience hair loss similarly, but it is also linked with increased gender dysphoria. There have been no studies focused on hair loss in non-binary presenting individuals.

What Causes Hair Loss?

Hair loss has multiple potential causes, including genetic predisposition, hormone levels, aging, autoimmune diseases, skin conditions (including psoriasis and certain types of dermatitis), thyroid disorders, anemia, and extreme weight loss (including eating disorder-related weight loss). Hair loss can occur during pregnancy and due to polycystic ovary syndrome. It can also occur during chemotherapy and radiation therapy.

Because of this range of possible causes, some of which have treatment options, some of which do not, it is important for dermatologists to have accurate diagnostic methods. That’s where trichoscopy comes in.

What Is Trichoscopy?

Trichoscopy is another name for scalp dermoscopy: a non-invasive technique for examining the hair and skin of the scalp. It uses magnifications from 10× (usually done with a manual dermoscope) to 1,000× (requiring a videodermoscope). It is generally used for diagnosing hair and scalp diseases. As you may know, dermatological diagnoses are complicated by the superficial similarities in presentation between various dermatological conditions. The close magnification of dermoscopy reveals differentiating details.

Trichoscopy has another use beyond the diagnosis of diseases of the hair and scalp: monitoring how hair loss is progressing and the effects of any treatment. The authors of “Efficiency of Hair Detection in Hair-to-Hair Matched Trichoscopy” compared the various examination and assessment techniques.

Microscopic hair images can be processed statistically using a few different methods. In the referenced study, these were compared. The average errors in determining the change in the hair count were calculated and the authors concluded that the best approach is to combine manually corrected image processing with follicular mapping and hair-to-hair matching. Manual correction of auto-processed results is almost twice as accurate as auto-processing on its own. However, adding follicular mapping and hair-to-hair matching overcomes limitations that manual correction alone cannot — for example, when hair shafts are sticking together in tight follicular units.

Is This Applied Commonly?

Unfortunately, the described combination procedure remains time-consuming, so it’s not possible for every dermatologist to apply it. However, there is ongoing development, and it may become available for regular use in the future. For now, it’s important to know that in challenging diagnostic cases where treatment may be possible, there are advanced techniques that could provide answers.

Note: Some of the authors of the paper declared that they have relationships with companies that may provide treatment or diagnostic equipment relevant for described medical conditions. It is normal for authors to declare this in case it might be perceived as a conflict of interest. More detail can be found in the Conflict of Interest Statement by visiting the original article page.

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