#trichoscopy

[donovanmedical]

Alopecia areata is an autoimmune inflammatory hair loss condition that directly impacts the quality of hair that gets produced. Inflammation at the level of the hair bulb leads to a variety of so called "dystrophic" hairs. These generally break off at the level of the scalp but may also be easily pulled out by the patient or clinician. The arrow points to a break in the hair shaft where the hair is particularly fragile. #alopecia #hair #hairloss #trichoscopy

[donovanmedical]

The "trichogram" is an older technique for assessing hair loss. It was first developed in 1957 and involves quickly pulling out the roots of 50-70 hairs. The hairs are all mounted on a glass slide and examined under the microscope. By carefully comparing an affected area of hair loss to a presumed unaffected area alot of information can be ascertained. In androgenetic alopecia, there is a marked increase in the proportion of telogen hairs in the frontal scalp (as well as a variation in hair shaft diameter) compared to the occipital scalp. In a pure telogen effluvium the trichogram results are similar in the front and back of the scalp. A trichogram can also provide helpful information in assessing active alopecia area (where an increase in dystrophic hairs are seen) and hair loss from various toxins. The technique is not commonly used these days as dermoscopy (trichoscopy) has provided a more sensitive and non invasive means of assessing complex scalp disorders. #trichogram #telogen #telogeneffluvium #trichoscopy #dermoscopy

[donovanmedical]

Diagnosing hair loss in individuals with darker skin types employs the same principles as for lighter skin types. However, a few features are unique including the the greater likelihood for scalp inflammation to create areas of hypopigmentation and hyperpigmemtation. In this photo of a male with androgenetic alopecia several findings are present. The redness and fine scale is consistent with seborrheic dermatitis. The patient also has folliculitis and a pustule can be seen in the upper portion of the photo. In the bottom left of the photo, areas of whitish hypopigmentation can be seen and in the bottom right areas of darker hyperpigmentation can be seen. The tiny white dots that are speckled al over the scalp represent the openings of the eccrine glands. #hair #hairloss #trichoscopy #dermoscopy

[donovanmedical]

Alopecia areata is an autoimmune condition that affects approximately 2 % of the world. A variety of treatments are available. For patches of alopecia areata, the most effective treatment by far is steroid injections. When the scalp is examined a few weeks after a patient has received steroid injections a mixture of hair regrowth and hair loss is typically seen. In alopecia areata, hairs that are in the losing stage include broken hairs (arrow) and so called exclamation mark hairs (asterisk). Over time as hair growth dominates, the proportion of broken hairs and exclamation mark hairs will be reduced. #alopecia #hair #dermoscopy #trichoscopy

[donovanmedical]

Exclamation mark hairs are short hairs that are thick at the top and thinner as they enter the scalp. These hairs are well known to occur in the autoimmune condition alopecia areata but can also occur in trichotillomania (shown here), poisoning situations (ie thallium) and have also been reported in dissecting cellulitis. #hair #trichoscopy #dermoscopy #trichotillomania #alopecia #hairloss

[donovanmedical]

Are my hair extensions safe? I'm often asked if wearing hair extensions is okay. Often it is fine, but one needs to monitor over time if any hair damage is occurring. Individuals feeling pain, "pins and needles" should consider loosening the extensions or changing the method of application. Individuals showing clinical signs in the office of hair damage may also consider changing the method of application. Consider the patient shown in the photo. She has been using extensions for some time now. She has a few broken hairs (labelled B) and several miniaturized hairs (labelled V for vellus) in any area that did not previously show miniaturization. These two signs are evidence of hair damage. A recommendation was made to change the extension in this case and treatment with a corticosteroid was given to reduce inflammation that is common in such cases of early traction alopecia. #hair #traction #tractionalopecia #hairloss #trichoscopy

[thepurplekoalabouquetposts-blog]

Trichoscopy

Trichoscopy is a non-invasive procedure which does not cause any pain or wound, it is often preferred as the first line investigation in diagnosis of hair disorders and diseases. Damages caused to the hair by external factors like shampoos, hair colors, water and other factors can be well diagnosed with trichoscopy even without cutting them (conventionally, hair was cut and put under the microscope to see the same changes).

[donovanmedical]

A variation in size of follicles is typical of androgenetic alopecia (hereditary thinning). This has been termed "anisotrichosis." In this photo of a female patient with androgenetic hair loss, it can be seen that some hairs are thick and some are much thinner. The decrease in caliber is due in part to a decease in the size of a part of the follicle known as the dermal papilla. Reference Sewell L et al Anisotrichosis: A novel term to describe pattern alopecia. J Am Acad Dermatol 2007; 56: 856. #hair #aga #hairloss #dermoscopy #trichoscopy