Hair loss affects men and women and in most cases has a hereditary cause. Generally, men are more prone to losing hair from the front and top of the head while the rest of the scalp hair remains intact. In women, the front hairline is largely unchanged while thinning of hair occurs on top of the head. While the condition may be observed physically, is there a specific blood test to determine hair loss? Let’s find out.  

Can Blood Test Help to Determine Hair Loss Causes?

In most cases, men don’t go for tests to find out the cause of hair loss. However, women normally go for a test to determine the cause of their hair loss. It is worth to note that losing hair is a personal experience and tests are carried out on an individual basis.

Men with Hair Loss

Men whose baldness follows the male balding pattern also called androgenetic alopecia requires no lab test.  However, when it affects a young male, testing may be required to determine cholesterol levels which may cause lipid abnormalities. Similarly, men whose hair loss may be the result of autoimmune issues like lichen planopilaris or alopecia areata should undergo blood tests to check for TSH (thyroid), total blood count (TBC), iron (ferritin), B12, ESR and ANA. Tests for total and free testosterone may also be carried out.

Women with Hair Loss

In case of a woman, it is important to carry out a blood test to determine hair loss cause because there are more conditions that can present this way. Tests carried out on women with hair loss include total blood count, TSH and iron. In case of young women who have acne or excess facial hair, it is necessary to test for adrenal hormones (DHEAS), ovarian hormones (androstenedione) in addition to total and free testosterone and SHBG (sex hormone binding globulin). Other tests may be necessary including those to check for polycystic ovarian syndrome, FSH, LH, blood sugar, zinc levels and vitamins D and B12. 

In conclusion, no test to determine hair loss can be ordered for everyone. However, by caring listening to a patient and carrying out a physical examination, a doctor can find out if a lab test is necessary.

Other Methods to Diagnose Hair Loss Cause

Medical History

In the course of determining the cause of a patient’s hair loss, a dermatologist will interview the patient to find out the pattern of hair loss, the time when it began, favorite hairstyles, if other members of the family have undergone hair loss, besides other related details like other medical conditions, favorite foods and recent pregnancy.

Physical Exam

Besides a blood test to determine hair loss, a dermatologist examines the scalp for inflammation, scarring, sores or redness. He will also approximate the amount of hair being lost, hair breakage and pattern of hair loss.

Additionally, the dermatologist will carry out simple tests to determine how healthy your hair is including the following:

Pull and Tug Test

This is a simple test to determine the severity of hair loss. The test involves grasping about 40 strands of hair from parts of your scalp and tugging at them. If at least six strands come off, you are suffering from active hair loss and may have one of several conditions as follows:

• Telogen effluvium, whereby you lose hair from many parts of the scalp as a result of interruption in process of hair production
• Anagen effluvium in which there is rapid hair loss due to medical treatment
• Loose anagen syndrome, resulting from hair whose rooting is not firm enough within the follicle. This condition is more common in young children
• Early androgenetic alopecia also known as male pattern hair loss in males and female pattern hair loss in women
• Advanced alopecia areata, which is an autoimmune condition whereby the immune system goes rogue and attacks body tissues such as hair follicles.

In a tug test, your doctor grasps some hair in two hands with one near the tip and the other near the root. He then tugs to find out if some strands will break at the middle. Through the tug test, the doctor finds out how brittle or fragile your hair strands are. This test is commonly used if the doctor suspects that your hair could have shaft abnormality which may lead to thinning, weakening and breakage.

Card Test

The card test helps to determine the health of your hair shafts find out how many strands of new hair are growing. The test involves placing a small rectangular card that is covered in felt on a part of your scalp. Using the contrasting colors of hair and felt, the dermatologist counts the different types of hair including new and broken strands. Extremely thin hair can signal the presence of telogen effluvium while short strands of hair whose tips are broken indicates an abnormality of hair shafts.

Trichometric Analysis

Trichometric analysis is an advanced computerized examination system that analyzes the characteristics of a patient’s scalp and hair. The system includes a digital assessment system consisting of a small handheld tool which has a tiny, high definition (HD) camera which takes photographs of the hair and scalp. The magnified images are displayed on a computer monitor and analysis of the number, diameter and condition of hair strands and scalp carried out to determine the appropriate treatment.

Fungal Culture

This is another blood test to determine hair loss that involves a laboratory culture to confirm presence of fungus in the cells of the hair or scalp. The test is recommended where fungal infection such as scalp ringworm or tinea capitis is suspected to be causing the loss of hair.

The dermatologist scrapes or swabs the scalp for a sample of the skin or hair. Fungal culture test takes several weeks for the incubated sample of possible fungus to test positive.

Punch Biopsy

In most cases, a dermatologist can determine the cause of the hair loss through physical examination and may use trichometric analysis for confirmation. Where additional information is required for instance, if scalp lesions are present, a scalp biopsy may be done. The process is known as biopsy because it involves the use of a device of pencil size and shape to make an incision on the scalp so as to remove a tiny tissue sample which is taken to a lab for testing. Punch biopsies help to distinguish between different types alopecia.

Photography

Besides blood tests, dermatologists may use photography to see how treatment for hair loss is working. This may involve taking photographs from different angles before commencing treatment and during each the following appointments.