What it is
A magnified examination of the scalp — the hair shafts, the follicular openings and the skin immediately around them — done in the room with a handheld dermoscope or a scalp camera. It reads what the eye cannot: whether shafts are thinning to different calibres, whether the follicular openings are still there, and whether there is scale or redness around the hair. That is what separates temporary shedding from pattern loss and from a scarring alopecia, and it is done before treatment is chosen rather than after.
What this page covers
- Magnified examination of hair shafts, follicular openings and perifollicular skin
- Documenting density and hair calibre for comparison at follow-up
- Distinguishing telogen effluvium, pattern loss, traction and scarring alopecia
- Examination of the frontal and temporal hairline for frontal fibrosing alopecia
- Trichoscopy of the eyebrows and the beard
- Deciding when a scalp biopsy is needed
- Scalp photography for follow-up, with its own separate consent
Honestly
Trichoscopy supports a diagnosis; it does not replace the history, the examination and the blood tests, and it is not itself a treatment. Automated density software is not available in every clinic in the Kingdom, and the numbers such systems report depend heavily on how the site was marked and parted, so the plan rests on the findings read by eye. Loss of follicular openings, or scale and redness around the hair at the hairline, points to a scarring process and changes the plan on the spot — including holding back hairline laser and any cosmetic hairline work until that has been excluded.