I know my concern
Concerns
Plain explanations of the most common presentations, and what each one usually means.
Start here
If you’re not sure whether you’re in the right place.
Most people arrive here having read a great deal and understood very little of it. This page explains what trichology is, what I can and can’t do, and how to tell whether a consultation would actually help you. About six minutes.
01 Definitions
What trichology is
Trichology is the study of hair and the scalp: the structure of the hair itself, the skin it grows from, and the things that change either. A trichologist assesses hair and scalp, takes a detailed history, and helps you understand what may be happening and what to do about it.
Think of it as the part that comes first: working out what you’re actually dealing with, before anyone starts treating it. It works alongside medicine rather than instead of it: more on how the two fit together just below.
What a trichologist does
- Takes a full history: health, timeline, life events, medication, family, hair habits.
- Examines the hair and scalp closely and systematically.
- Interprets what’s found in the context of everything else.
- Advises on care, handling, scalp condition and reasonable next steps, and says when a doctor is needed.
02 Who does what
Trichologist, dermatologist, GP.
| Trichologist | Dermatologist | GP | |
|---|---|---|---|
| Medically qualified | No | Yes, a doctor specialising in skin, hair and nails | Yes, general medicine |
| Can diagnose disease | No | Yes | Yes |
| Can prescribe | No | Yes | Yes |
| Can biopsy the scalp | No | Yes | By referral |
| Typical appointment | 60 minutes | 10–20 minutes | 8–10 minutes |
| Focus | The whole picture around your hair, in detail | Diagnosis and medical treatment | Ruling out systemic causes, referral |
| Best for | Understanding, context, ongoing care | Suspected disease, scarring, treatment | Blood work, general health, referrals |
These aren’t alternatives. Many people need more than one, and the most useful thing I can do is sometimes to help you get to the right one.
03 Who does what
Between the two of us, you’re covered.
What I do
- Take the full history, the one nobody has had time to take.
- Examine your hair and scalp closely, and tell you what I’m seeing.
- Read it all in context: your health, your timeline, your life, your family.
- Give you a plan, in order, with a way to measure whether it’s working.
- Tell you which tests are worth asking for, and write out the questions.
- Stay with it while things change, which they will, slowly.
Where a doctor comes in
- Naming a condition. A diagnosis has to come from a doctor.
- Prescriptions of any kind.
- Ordering and interpreting blood work.
- A scalp biopsy, where one is needed.
- Treating anything medical, including autoimmune and scarring hair loss.
I’m not a doctor. That isn’t something I’m tucking away in small print: it’s how the two jobs fit together, and knowing the difference is half of what gets people unstuck. Most of the people I send to a doctor come back afterwards, and we carry on from there.
Worth doing first
Bring a doctor in straight away if:
- Hair has come out suddenly in patches, especially with any change to the skin.
- The scalp is painful, burning, sore, or has visible sores.
- The skin where hair has been lost looks smooth, shiny or scarred.
- Hair loss is rapid and accompanied by other symptoms: weight change, fatigue, fever, joint pain.
- The person losing hair is a child.
- You are losing hair from other parts of the body too.
- Anything about it frightens you.
None of this is me sending you away. It’s the fastest route to an answer, and I’d rather you had it. Come back afterwards and we’ll make sense of it together.
04 Fit
When it may be worth seeing a trichologist
- You’ve been shedding more than usual for more than three months.
- The change is visible to you but has been dismissed by others.
- You have a diagnosis but no context for it.
- Your scalp is uncomfortable and shampoos haven’t helped.
- You’ve tried several things and don’t know whether any of them worked.
- You want to understand it before spending more money on it.
05 Next
Where to go from here.
I want to understand you
My approach
The method in full, what I look at, what I don’t do, and how I handle uncertainty.
I want to get organised first
Before your appointment
A free two-page sheet: the timeline that finds most causes, how to take the photographs, and the questions worth asking your doctor. Useful whether or not you ever see me.
I’m ready
Consultations
What happens, what it costs, what you receive, and what video can and can’t do.
Still not sure?
That’s a reasonable place to be. Read the Journal, or book when you’re ready. Nothing here expires.
Not ready? Start here or read the Journal.