When is a scalp biopsy necessary to diagnose hair loss?

Doctor's Answers 2

We do not need to do a skin biopsy to diagnose hair loss in most cases. Common causes of hair loss such as male and female pattern hair loss, telogen effluvium and aloepcia areata are usually diagnosed clinically without a need for biopsy.

In cases of scarring alopecia, where there is destruction of the hair follicles and in cases where the diagnosis is uncertain, a skin biopsy will usually be needed.

A scalp biopsy is generally not necessary for diagnosis of hair loss. Doctor's diagnosis of hair loss is generally clinical, which means that the doctor can usually tell the degree of hair loss and its cause through a thorough history and physical examination.

A blood test may sometimes be needed to confirm the cause of hair loss but this is rarely needed. Cheers!

Regards, Dr. Terence Tan

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From your description, it does sound like you may have telogen effluvium. In telogen effluvium, there is increased hair loss due to a preceding stressful event, such as high fever, crash dieting and emotional stress. The surgery in June may be a triggering event. By definition, hair fall is considered abnormal if there is loss of over 100 strands of hair a day. This condition is usually self limiting and the hair fall usually last for 2 – 4 months . The new hairs will eventually grow out.

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