Hair loss has many causes, and jumping straight to treatment without an accurate diagnosis wastes time, money, and — in some cases — grafts. Before considering any hair restoration treatment, these investigations should be on your radar.
Blood Tests
A targeted blood panel should include:
- Full blood count (FBC): Anaemia, including iron deficiency anaemia, is a common and treatable cause of hair shedding
- Ferritin: Iron storage — more sensitive than serum iron for hair loss; optimal level for hair health is typically above 70 μg/L, though “normal” ranges are lower
- Thyroid function (TSH, T4): Both hypothyroidism and hyperthyroidism cause hair loss
- Vitamin D: Deficiency is common in the UK and associated with hair loss in some studies
- Vitamin B12 and folate: Deficiency can cause diffuse shedding
- Zinc: Less commonly tested but implicated in hair loss when deficient
- Hormonal panel (for women): LH, FSH, testosterone, SHBG, DHEAS — to rule out PCOS and other hormonal causes
Trichoscopy
Trichoscopy — dermoscopy of the scalp — allows a specialist to examine hair follicles and scalp skin under magnification. It can identify: miniaturisation (suggesting pattern baldness), yellow dots or exclamation mark hairs (alopecia areata), perifollicular scaling (scarring alopecia), and hair shaft abnormalities.
Scalp Biopsy
In complex or uncertain cases, a small scalp biopsy provides definitive histological diagnosis. It is particularly valuable in suspected scarring alopecia where treatment must begin promptly to prevent permanent follicle destruction.
What Diagnosis Means for Treatment
Correctable causes (iron deficiency, thyroid disorder, nutritional deficiency) should be addressed before considering surgical intervention. Treating the cause may resolve the hair loss entirely. Pattern baldness diagnosed definitively makes the path to transplantation clearer.
Book a thorough hair loss assessment with Dr Anzal Qurbain — free →
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