What a scalp specialist should look for

It is important for the specialist to look at the scalp to see whether there is any flaking, itching, redness, acne-like breakouts, or other lesions. Although a lot of scalp conditions don't cause hair loss and are just cosmetically annoying, some can increase hair shedding or indicate what is causing the hair-loss problem.

You should be asked whether you have any periodic scalp tenderness (called trichodynia). The scalp can be sensitive for many reasons, so it is important for the specialist to ascertain the possible cause.

If you are in doubt about any scalp condition, or if your scalp feels constantly tender for any length of time (such as more than a few days), I suggest you see a specialist.

What to expect from a hair loss specialist

As there could be many things causing your hair loss, it is important that the specialist you see spends time with you. The specialist should look at your hair and scalp, take a full medical/lifestyle history, suggest blood tests, help you cope with your condition, and discuss all of your treatment options. Sometimes, the specialist needs to eliminate one factor before moving on to the next. Remember, many different factors may cause your hair to fall out. It is important to find each one so that any treatment you receive will be more effective.

This may sound obvious, but you would be surprised by how many people have said that a specialist they had seen either didn't look at their hair at all or only quickly glanced at it. The specialist should look at both your hair and scalp to see the distribution of your hair thinning, which can often indicate why it is falling out. By comparing the partings at different positions — for instance, the crown area, front area, sides, and back — differences in hair quantity can be seen and the amount of thinning can be determined. The distribution of hair could indicate the presence of a genetic condition or traction hair loss (also known as hair breakage), among other conditions. The specialist should also do a pull test in different areas of your scalp to see how much hair is coming out.

Also, the specialist may look at the hair under a regular microscope (usually a trichologist will do this) or take a biopsy of the scalp (only a physician is able to do this).

Thoughts on dermatologists

Although dermatologists are physicians that treat the skin, hair, and nails, not all specialize in hair loss. Therefore, before making an appointment, make sure that the dermatologist is up-to-date with the most recent hair loss research and takes the psychological impact of hair loss as seriously as he or she should.

Hair loss can cause a lot of emotional stress, and a dermatologist may not be able to give enough time during the appointment to discuss these emotional concerns. Find out whether a properly trained nurse or receptionist in the dermatologist's office has the role of helping you with emotional support.

Dermatologists are able to prescribe medicines that are not over the counter, such as Propecia for men or corticosteroids for conditions such as alopecia areata or psoriasis. Dermatologists can also do biopsies of the scalp, if the condition warrants that approach.

Choosing a hair-loss specialist

You feel that your hair is thinning and/or falling out. Now what should you do? Well, the first step is to find out why your hair is falling out. This will help point you in the right direction for choosing the treatments that are best for you. Therefore, make an appointment to see a hair-loss specialist such as a dermatologist or a qualified trichologist.

When searching for a hair-loss specialist, ask questions. Many people are afraid to ask the practitioner's office staff questions, for fear of sounding ignorant or being difficult. However, if you're worried about losing your hair, then you want to see someone who knows what he or she is talking about.

When you call an office, before making an appointment make sure that the replies to your questions make sense and that the person on the other end of the phone is helpful. Rightly or wrongly, if the secretary or receptionist is uncooperative, then it may indicate that the office in general (including the hair-loss specialist) could be unsupportive. Let's face it. If you need to call the office in the future about making further appointments or refilling prescriptions, the last thing you want to deal with is an unfriendly receptionist. The effort a company puts into their first point of contact can tell you a lot about them...

When professionals say the wrong thing

Some of the things I've heard that have been said to people with hair loss have been extremely hurtful. You would think that a physician or specialist would have a better bedside manner or show some empathy, but unfortunately some practitioners don't grasp the fact that many people with hair loss are worried and upset.

I've heard of one hair-loss specialist who said to a woman, "You're halfway through your life, and you've lost half your hair ... that seems fair." You can imagine why she ran out of his office crying!

Another physician not only showed no sympathy for a man's hair loss but also doubled the insult when he said, "It's a shame you're so short. People wouldn't be able to see your hair loss if you were taller." As you might expect, he wasn't too pleased.

Hair loss often contributes to a loss of self-esteem and increased anxiety and depression, so comments of this sort really aggravate people's concerns. What can you do if something like this is said to you? I suggest leaving the office immediately and complaining to the board through which the practitioner is licensed. Also, look for a professional who has been personally recommended to you by a friend. Lastly, try not to let it affect you. It is the specialist who has a problem - not you.

"I've seen so many doctors and I'm still losing my hair!"

If you have seen many specialists and are still not getting the results you are looking for, ask yourself whether you've given their advice a chance. Did you follow their suggestions for at least three months? Sometimes there are no easy answers as to why you are losing hair, and there's no magic pill that will stop your hair loss overnight. Often hair loss is a chronic condition that needs to be treated over time. Moreover, there is no reliable cure or definite regrowth formula. Sometimes nothing can be done to regrow all your hair; however, the advice that you have been given may help stabilize or slow down the condition. Remember that left unchecked (without treatment), some hair-loss conditions will continue unabated. Even these "partial" successes are, in fact, helping your hair loss.

In addition, some treatments may help your hair look better cosmetically, the importance of which should not be underestimated.

Hair loss and intimacy

Many people with hair loss have lowered self-esteem and feel less attractive to others. This is true even with married couples and people in long-term relationships. Some partners (especially women) refuse to talk about their hair loss with their spouse or significant other for fear of being seen as less attractive or even ugly. They try to reduce physical intimacy, as they are afraid that the proximity will reveal that their hair is thinning. Also, negative self-perception can lead to feeling less desirable and make it more difficult to get "in the mood".

I'll just say one thing to those in a relationship, remember that your partner loves you for yourself, not for your hair. If that doesn't turn out to be the case - find another partner.

Full head of hair can help job search?

Of course, no sooner have I said that being bald won't hurt your job prospects than someone else comes out with a statement refuting that completely.

Of course, it should be noted that the author of that statement is a hair restoration surgeon ;-)

Is hair loss affecting your career?

People feel that losing their hair affects their chances at progressing in a career, but studies do not show this to be true.

The summary of these studies is not to allow your hair loss to affect your self-esteem enough to think that you won't get promoted, because it generally doesn't make a difference to your boss.

However, if you become less outgoing, it may affect your ability to do your job properly.

Hats, gels and sprays - a few tips!

Hats do not make hair fall out even if they are tight. They may cause some breakage if you are too rough putting them on and taking them off (especially the finer, thinner hairs that are the product of genetic hair loss). So don't be afraid to wear a hat (or baseball cap); it will not cause more hair loss.

For social events, make your hair presentable with gels and sprays. As long as you don't incorrectly use hair products or brush them out vigorously (they are water soluble, so it's best to wash them out in the shower), then just use them as often you need to. The bottom line with your hair is that you want it to look its best when you leave the house. Do whatever you need to do (within reason) to attain a look that you're comfortable with!