Thankfully, due to social media and the age of more personal sharinging via the internet, hair loss is becoming less of a taboo subject and almost gone are the days when it was headline news that ‘Celebrity X’ has suddenly regained a full hairline or a wig/hair extension was showing.
By reducing the stigma surrounding the topic, more people are able to have honest conversations concerning hair loss and the treatments for it. This means that there is greater access and recognition for professionals working in this field which will ultimately raise the standards of care.
For the majority of people experiencing hair loss, even with the multitude of information available, it can be difficult to know who to turn to. The first indication of any problems often occurs well into the condition, when the thinning or balding is noticeable to them and the people close by. In some cases, upto 50% of the hair can be lost before a significant change is seen.
Men can usually tell when their hair starts to recede as the hairline is often very visible or hair cuts will not ‘sit’ the same way as usual, on the other hand for women, if the change is not sudden, a gradual increase in lost hair from brushing, combing and washing will often be ignored as it can be very subtle.
It can be embarrassing and so many people would try as much as they can to keep it to themselves or seek information via the Internet which can be misleading as several companies prey on this vulnerability by offering solutions which do not effectively treat the problem especially when the cause is not diagnosed. These treatments are also usually very costly and can leave some in a bad financial position.
If you or someone who know has a hair or scalp problem and is not sure what to do, then they need to book an in person consultation with a Trichologist.
What is Trichology?
Trichology is the study of the hair and scalp. It incorporates aspects of chemistry and human biology to understand the mechanics of the hair cycle and associated disorders. A trichologist, therefore, is a person who practices trichology and focuses on diagnosing, treating and supporting those with hair and scalp conditions.
Although it is not well known in the wider community, it is a field of study that has existed professionally for over 100 years and is well established in the scientific world, boasting many journals and continual research which aids in the production of several popular cosmetic lines.
What does a Trichologist do?
The trichologist will work as many others in the medical field do, by using the information gathered through consultation and testing to reach a diagnosis. Patients will usually seek out their services once a problem becomes unmanageable.
Initially, they will consult with the patient to diagnose the problem using verbal and physical clues from examination of the hair and scalp and then will provide suitable treatment options.
If a patient presents with severe hair loss, a trichologist will firstly take a detailed patient history to find out if the cause could be systemic and may use a tool called a tricosope to observe the area in question. In some cases, they may ask the patient to have a blood test, which can highlight nutritional or hormonal discrepancies.
Once a diagnosis is reached, considering all of the above information collated during the discussion and testing, the patient will then be presented with a formal diagnosis and be given a prognosis with any treatments they recommend. The treatment options are often topical (used directly on the scalp and hair) and if oral prescriptions are needed, they may refer the patient on to a Doctor.
Most trichologist formulate products which can be used to solve common occurrence such as itchy, dry or inflamed scalp. These conditions are often mild and improvement is rapid.
Other treatments include scalp stimulation via massage, laser or heat and in some cases referral for hair transplants or wigs.
If a diagnosis cannot be reached, the Trichologist may refer the patient to other medical professionals for more extensive testing which could help to uncover the problem.
Some conditions will only require one visit and have a quick course of treatment, this could be a case of Tinea Capitis or ringworm, where the diagnosis is very straightforward and the treatment would be oral antifungals.
On the other hand, some patients may have to work with the trichologist longer term especially in cases of hair loss like alopecia areata, where the aim of the treatment is to monitor the progression of the condition and try different option to at least halt or reverse it as much as possible.
The majority of patients will be able to work through their condition and achieve ‘normalcy’ with their hair, however for some, the damage may be permanent and the scalp may have sustained damage or the hair follicles will no longer produce viable hairs. This makes it extra important to see a Trichologist as soon as you notice any problems or have concerns with your hair.
List of conditions that a Trichologist can treat
It is difficult to make an exhaustive list of all the various conditions that fall under the scope of trichology but below are a few of the common common complaints that many will present with
Androgenic Alopecia (male/female pattern balding)
Central Centrifugal Cicatricial Alopecia
Diffuse Hair Loss
Discoid Lupus Erythematosus
Frontal Fibrosing Alopecia
Doctors Vs Dermatologist Vs Trichologist
When seeking out help people often think that only a doctor or dermatologist will be able to help but this is not always correct.
Doctors especially general practitioners do not spend more than a few weeks if any, on conditions concerning the hair and scalp. As they are a secondary sexual function, many doctors will often dismiss cases as it is not essential to health and does not take priority. Understand, this does not mean that doctors are not qualified to treat these cases as they certainly are, however they usually do not have as in depth knowledge because they take a broader approach to healthcare. Patients will be treated but may not get a thorough understanding of the cause and treatments available, as a doctor’s consultation usually lasts less than 15 minutes but with a trichologist you can usually expect to spend up to an hour taking a detailed history and clinical exclamation.
There are a lot of similarities between a trichologist and a dermatologist as they are both focused on the skin. A dermatologist is usually more costly and may not carry out some of the treatments a trichologist would as most are prescribed for self medication. While a dermatologist will have greater scope in the range of treatments they can offer and also the ability to arrange specialist testing, wait times and referral can be a barrier.
Saying all this, it is very common for a trichologist to refer patients back to a dermatologist or to the local general practitioner and vice versa as the three work very well in synergy and all have their specific niche.
You can decide to see any professional but it is imperative that you are able to get the required information and suitable aftercare.
Choosing a Trichologist
Trichology has been around for over 100 years and there are a few respected institutions which are tasked with training and overseeing people who want to become trichologist and holding them accountable once they do.
Based on your location you should be able to find a trichologist within a short distance as it is becoming a popular profession, but there are some strict requirements you should look for before you decide to book an appointment:
Check their credentials
A trichologist will spend at least two years studying rigorously whether it be distance learning or at a physical institution. Ask where they trained so you can check the company to see how they work.
Worldwide there are three main institutions that it’s best to see trichologist from
World Trichology Society http://worldtrichologysociety.org/
The Institute of Trichologists https://www.trichologists.org.uk/
International Association of trichologist https://www.iattrichology.com/
All of the above hold trichologist to a very strict code of ethics and provide them with rigorous training which produces a not only logical trichologist but also one with a clear moral code to work from, by preventing misconduct and insuring not only the well-being of the patient but also to keep the profession of trichology in high esteem.
Check they are insured, as with all public companies, your safety is important and safety guidelines should be clearly displayed in the office. If you decide to have a treatment or take any form of product or oral supplement, ask for the information sheet and be wary of any side effects they may have.
The consultation should be paid and not free. Most institutions will require that we charge for consultations, at first glance this may seem strange or completely financially focussed however it promotes honesty and transparency. When free consultations are used, you can expect to pay dearly for any subsequent visits or be tied into a long lasting contract for multiple treatments. By paying upfront and for individual sessions, the patient is always in control and aware of the cost.
A good trichologist will do their best to give you a clear diagnosis and timeline of your condition(s), explaining the cause, prognosis and treatment if available. If this is not possible, they will recommend you to other professionals who can help, but will not continue treating you just for the sake of it without any clear benefits. It is common practise to work with doctors and dermatologists as mentioned above, but also some will have an array of surgeons and wig makers on a paid referral basis but full disclosure should be given and there is no obligation on the patients end to use any of these services.
A good Trichologist WILL
- Be fully trained by a recognized institution and have all of the revlovent insurance and safety covers
- Spend time explaining the condition in as much detail as possible
- Be clear and open about pricing
- Only provide care when requested
- Suggest more suitable options if this falls outside their scope
- Work with other professional to promote the best outcome for the patient
- Treat all patients with the utmost respect and kindness
- Say when they are unable to reach a diagnosis
A good Trichologist WON’T
- Offer a free consultation or long contract based treatment plans
- Offer treatments for a condition that has no proven outcome
- Conduct themselves in an unprofessional manner
- Give false sense of hope or make promises in permanent hair loss cases