Dominating Your Dermatology Appointment

In this guide, we’ll reveal how to approach your dermatology appointment for a hair loss diagnosis:

• What a great dermatologist should do at your appointment
• How to properly prepare for the appointment
• How to take control of an appointment to deliver the best value for money and time

The first step to getting the most value out of an appointment is to know what to ask.

Upon noticing their hair loss, many people make appointments with a local specialist (like a dermatologist or a trichologist) and expect that their expensive clinic visit is going to consist of a personalized exam, a clear diagnosis, and step-by-step instructions on how to improve the condition of their hair. We have come to learn, through many years of connecting with Perfect Hair Health members, that this is not always the case. In fact, we receive regular anecdotes suggesting that a large percentage of dermatologist visits for hair loss end in dissatisfaction.

By better understanding what should happen in the dermatologist's office, we can better prepare for our visits and get the most out of each session.

First, here’s what a great dermatologist should do at your hair loss appointment:

1. Review patient's medical history. Conditions like irritable bowel disease, hypothyroidism, deficiencies in iron deficiency or vitamin D, and autoimmunity can all play a role in hair loss. A good dermatologist should be evaluating each hair loss patient for the symptoms associated with these conditions. Our Regrowth Roadmap includes symptom trackers to better help our members understand their hair loss case.
2. Learn about a patient's hair situation. There are certain data points that a dermatologist should investigate in order to understand their patient's full hair loss case. Is there a family history of hair loss? What is the rate of loss? Was the onset rapid or slowly over time? Has the patient experienced and traumas, illnesses, or big health events 2-4 months prior to the onset of their hair loss?
3. Analyze hair. Every dermatologist visit should include an up-close examination of the patient's scalp. There is a lot that can be learned from an "across the room" examination. However, every clinic visit for hair loss should include microscopic examination of the patient's scalp. There are certain variables that can only be determined with microscopic examination.
   • Hair diameter diversity. The thickness, or diameter, of our hair follicles can inform a hair loss professional a great deal. If there is diameter diversity among the hair follicles, this is an indication that follicle miniaturization has occurred. Hair follicle miniaturization is a hallmark feature of certain hair loss disorders, like androgenic alopecia.
   • Terminal vs. vellus hairs. The ratio of terminal to vellus hairs is an important indicator of certain hair loss conditions and their rate of progression. For instance, as androgenic alopecia advances, we notice that terminal hairs become vellus hairs with increasing frequency. Finally, if there is a complete absence of vellus hairs, this can be indicative of scarring alopecias like frontal fibrosing alopecia.
   • Hair densities in thinning vs. thick scalp regions. Differences in hair follicle density between affected and unaffected areas of the scalp can inform a dermatologist about the progression of your condition. This is a useful tool that can inform about conditions that may not yet be cosmetically visible "across the room."
4. Examine scalp tissue. The scalp tissue is an important piece of any hair loss case. Understanding the health of this tissue can inform not only a dermatologist's diagnosis, but also the path to treatment. There are certain hair loss conditions that can only be ruled out by close, microscopic examination of the scalp tissue.

Based on the findings of the steps listed above, a good dermatologist may recommend a scalp biopsy if something appears peculiar about your scalp, hair, or health history.

We've listed the steps that a good dermatologist should take in the exam room. However, we have learned through many members' stories that this does not match up with a large percentage of peoples' experiences. There appear to be many dermatologists who spend five minutes with their patients, glance at their heads, recommend a few prescriptions, and attempt to upsell them into PRP.

The best way to make sure that your dermatologist visit goes well is to show up prepared. Arrive at the clinic with a list of questions that will force the dermatologists to perform a close examination. These questions will guide the appointment so that you are guaranteed to walk out with the information you need.

The first goal is to prepare a 60-second summary of our entire hair loss history. One minute is all that's needed to inform the dermatologist of the necessary backstory in order to begin the actual examination. Limiting the amount of time spent on case history dramatically increases the amount of time the dermatologist has to focus on performing a close examination of our scalps.

Before your next dermatologist appointment, prepare the answers to the following questions:

Practice recounting this information in 60 seconds or less. This way, the dermatologist receives all of the most important information without wasting precious in-person time.

Bring this to your next dermatologist appointment! Download and print it here.

Once provided with a succinct case history, dermatologists should proceed with an examination of the scalp. However, we know that this doesn't always happen. If this is the case, proceed with the following questions in order to take control of the visit:

Bring this to your next dermatologist appointment! Download and print it here.

A visit to a hair loss professional—like a dermatologist—can help identify key facts about our hair loss case. By following the guidelines above, we hope your next dermatologist visit is packed with value.