Trichology: What is it? Trichologist, Common Diagnoses, Procedures and Conditions that Affect the Scalp

It is the specialized science of the structure, function and diseases of human hair.

Clinical Trichology is the diagnosis and treatment of diseases and disorders of the human hair and scalp.

What is a Trichologist?

A Trichologist is a hair and scalp specialist who is capable of diagnosing and treating many hair and scalp conditions in both health and disease.

Reasons to consult a Trichologist

Hair loss

Hair loss can cause great distress, and there are many misunderstandings about its causes and treatment.

Probably the most common type of hair loss is the so-called ” male pattern baldness “, which despite its name, can affect both women and men, and for which, in men, it seems not there is a specific product, readily available treatment.

This is a problem that requires comprehensive management, and a qualified Trichologist must understand the patient’s anxiety and help them come to terms with hair loss. Some women who suffer from this condition can be helped with medical assistance and the use of hormonal treatment.

There are many other types of hair loss that can and do respond to treatment and advice without medical assistance.

There are also some types of hair loss that can have a natural or spontaneous recovery. Excessive hair loss can often be a symptom of some other problem or variation in the body’s metabolism, and for this reason, cooperation between the patient’s physician and the Trichologist is often necessary.

Scalp problems

Scalp problems, ranging from dandruff to more inflammatory conditions, take up much of a Trichologist’s time.

As with hair, these problems can be symptomatic of some other metabolic variation. The stress , poor diet or even some food allergies may be responsible for the accumulation and shedding of dead skin cells.

Managing excessively oily hair and scalp is another area in which the advice of a qualified Trichologist is often sought. Here, guidance on the correct type of shampoo for any particular individual, and on its frequency of use, could be particularly relevant.

Hair texture problems

Problems with hair texture can be caused by excessive exposure to heat or harsh chemicals, or by many of the other stresses and strains that we put our hair through.

In such cases, cooperation with the hairdresser is obviously important, and indicates that the Triologists’ training overlaps with both the medical and the cosmetic in areas not normally covered by either doctors or hairdressers.

Hair texture problems generally respond very well to appropriate advice and treatment, as the cause (s), once discovered, can often be reduced or eliminated entirely.

Pharmaceutical preparations

In cases of scalp disorders in particular, your Trichologist may prescribe treatment creams and shampoos for use in the clinic or at home.

These will be manufactured by the Trichologist (if he or she is licensed by the Drug Control Agency) or by other licensed Trichologists who specialize in the manufacture of such preparations. These products should always be used strictly in accordance with the instructions.

Additional services

For those looking to obtain additional hair (sometimes referred to as “hair replacement”) in the form of wigs, extensions, or weaves, appropriate guidance and recommendations can be offered.

The Trichologist can guide, give advice and support to those people who regularly pull their hair. Similarly, information, guidance, and support are also provided to those who have lost hair through chemotherapy treatment.

Common Diagnostic Tests Your Trichologist Will Perform

It is important for a Trichologist to physically examine your hair and ask lifestyle questions to establish scalp conditions to assess and apply the correct cause of treatment, regardless of symptoms or concerns.

Some things your Trichologist will need to know:

Medical history

It is essential that you give your Trichologist an overview of your medical history, as a previous condition may be contributing to your hair or scalp loss.

Family history and genetics can also play a role. The more information you can give, the easier it will be for your Trichologist to establish and treat the cause of hair loss and discomfort.


Not eating a well-balanced diet can often dramatically affect hair growth and condition. Lack of vitamins, iron, zinc, and folic acid will prevent hair growth.

Your hair is the last point on your body to get nutrients, as your internal organs will get the nutrients first, so making sure you have a good amount in your system means your hair will too.

Stress – usually caused by major life events or trauma

Stress is one of the most common causes of alopecia (dramatic hair loss). Informing your Trichologist about any major life events or changes will help assess why you are experiencing hair loss.


This is a combination of your diet, sleep habits, whether you drink alcohol or smoke. Like any health check, telling your Trichologist all the details means they can give you the correct treatment.

Hair care routine

Having a good hair care routine and treating your hair gently works wonders.

Your Trichologist needs the way you currently style your hair so they can advise you on ways to improve hair quality and scalp condition at home so you can help prevent damage.

Procedures that your Trichologist will carry out

Blood test

Blood provides a lot of information about what is happening in your body. Crucial blood tests can determine what is causing the discomfort and hair loss.

Blood tests look at your iron levels (including ferritin, iron stores), your red and white blood cells, minerals and vitamins, folic acid, and your thyroid. Your Trichologist will also occasionally perform hormonal tests.

Blood tests will also be performed regularly throughout the course of treatment to ensure that the medication or other prescribed treatment is working effectively. You can order blood tests from your GP, however a GP reads the tests differently than a Trichologist.

What seems normal and healthy to a GP may not be to a Trichologist who can read the results to find out what is causing the hair loss if any common marker appears.

Hair and scalp exam

Your Trichologist will take time (usually around 40-50 minutes) to thoroughly examine your hair and scalp. This initial consultation helps your Trichologist determine scalp conditions and possible irritations and discuss what may be causing your hair loss or scalp problems.

Your hair can provide your Trichologist with many tell-tale signs of underlying conditions that contribute to hair loss.

Conditions that mainly affect the scalp

Scalp conditions are different from alopecia, but conditions like dry scalp can cause hair loss or slow hair growth as secondary symptoms, if left untreated.

It is proven that some scalp conditions can cause hair loss.

Dermatitis seborreica

Also known as seborrheic eczema, seborrheic dermatitis is the most common form of dandruff and is caused by a genetic sensitivity to the yeast Malassezia.

Note: This dandruff, characterized by greasy scales, affects people of different races equally.

Irritants or contact dermatitis

Irritating skin chemicals found in relaxers and some shampoos, conditioners, and other hair treatments can cause dry, flaky scalp to itch.

Depending on the severity, they can also develop inflammation and pustules.

Irritation can also be caused by excessive heat used near the scalp, or cold and dryness in the environment.


This is an autoimmune condition characterized, on the scalp, by small, silvery, dry scales adhering to the skin. It is believed to be primarily a genetic condition that has environmental triggers, such as stress.

Pitiriasis amiantacea

These are layers of scales that adhere to the hair. This is usually accompanied by the presence of staph bacteria. In other words, it is a staph infection.


This is the infection and inflammation of the hair follicles.

Note: the form known as folliculitis keloidalis affects mainly black men, and sometimes black women, in the occipital area at the back of the scalp.

This is believed to be caused by the sensitive nature of the occipital area of ​​the scalp combined with the use of hair clippers.

Acne miliaris necrotica

It is a rare form of acne of the hair follicles.

Ringworm of the scalp, or ringworm of the head

It is a circular fungal infection that can cause hair breakage and loss of the area.

Note: Ringworm of the scalp likes dark, damp conditions.

As mentioned above, it is important to note that untreated scalp conditions can trigger others.

For example, when scratched, the itchy scales of seborrheic dermatitis, irritant dermatitis, and psoriasis can turn into a bacterial infection of the scalp, pityriasis amantacea. Irritant contact dermatitis can turn into hair loss.