In many cases, the only symptom of alopecia areata is abrupt hair loss. The areas of baldness might spread and become more extensive. At other times, the patches will continue to expand until they become a single huge bald area. It is necessary to carry out a series of tests to gain certainty on the nature of the problem. The assessment of alopecia is discussed in detail in this article.
How Do Dermatologists Detect Alopecia Areata?
In addition to looking at your nails, your dermatologist will carefully inspect the area (or areas) where you are losing hair. The dermatologist would also ask certain questions. Testing is sometimes required to confirm that alopecia areata is the reason for a person’s hair loss. This is because there are a great number of factors that can cause hair loss. Some examples of these tests are as follows:
Complete Blood Count
This test is also known as a CBC. It is a test that analyzes the three types of blood cells found in your blood: platelets, red blood cells, and white blood cells. A CBC may be performed as a normal examination or for the following reasons:
- Examine your red blood cell count to determine whether you suffer from anemia, a condition in which your red blood cell count is lower than normal.
- Investigate the possibility of suffering from another health condition, particularly if you are experiencing symptoms such as tiredness, fever, bruises, or weakness.
- Carefully monitor your blood pressure.
- Investigate how your blood is influenced by chemotherapy, medical issues, and drugs.
Suppression And Stimulation Hormone Testing
To examine a hormone imbalance, experts do tests that are known as stimulation and suppression tests. They will administer hormones and other drugs to you that will either begin (stimulate) or halt (suppress) the production of specific hormones in your body. After that, they assess how your body reacts to the treatment. The following are examples of common forms of stimulation and suppression tests:
Cortisol reaction to cosyntropin: You will be given cosyntropin, which mimics the actions of ACTH (adrenocorticotropic hormone). ACTH is a hormone created in the pituitary gland and is responsible for stimulating the production of cortisol in the adrenal glands. The levels of cortisol are measured four times every quarter of an hour. Experts can confirm that you have adrenal insufficiency using this test.
Glucose tolerance test: Specialists provide you with a sugary beverage, which, as a result, should reduce your growth hormone concentrations. Every two hours, they take a blood sample and analyze it for growth hormone levels.
Cortisol reaction to dexamethasone: The dexamethasone tablet you take before bed should prevent cortisol from being produced. The following day, a blood sample is drawn to determine cortisol levels in the body. With the results of this test, specialists can either confirm or disprove the presence of Cushing’s syndrome.
Metyrapone suppression test: The doctor will instruct you to take one tablet of metyrapone before bedtime to inhibit cortisol synthesis. The following day, a blood sample is drawn to determine the levels of cortisol and ACTH. The results of this test either confirm or disprove the presence of adrenal deficiency.
It is possible to obtain samples for light microscopy by either plucking hair with rubber-tipped forceps or clipping the hair near the scalp. This test is done so that the expert may examine the hair shaft. The specimen is put through a sequence of lenses that can magnify it anywhere from 10 to 1000 times and have a resolving power of 0.2 micrometers.
Light microscopy makes it possible to easily identify physical hair shaft defects such as fractures, nodes, bands, constriction, twists, and curls. However, more intrusive sample collection and elaborate preparations are required in some cases.
Mounting 5–10 mm of shafts on glass slides utilizing dibutyl phthalate polystyrene xylene allows for simple light microscopy of the hair shaft to be conducted anywhere, including at the patient’s bedside (DPX).
It has already demonstrated a great deal of utility in documenting typical anomalies in children associated with various systemic conditions. Nevertheless, it is possible to observe non-specific modifications like splits and weathering in distal shafts, twisting, minor flattening, or grooving.
Hair Pull Test
A health care practitioner or dermatologist may do a hair pull test, a straightforward form of in-office testing, to evaluate whether or not you are regularly shedding hair. The doctor will hold about 20 to 60 hairs between your healthcare professional’s thumb, index, and middle finger, who will be gripping as close to the root of your head as feasible. They will pull on the hair with a moderate amount of force and do this to evaluate for hair loss.
It is typically considered to be an indication that you are actively shedding hair if your healthcare practitioner can take out from your scalp more than ten percent of the hairs that they have gripped when examining your scalp. Different names refer to the many types of hair pull tests. This test may also be referred to as a traction test, Sabouraud’s sign, or a hair loss pull test depending on the terminology used by your healthcare professional.
A scalp biopsy to treat hair loss can assist in the diagnosis of some factors that contribute to thinning hair. The sample obtained from a scalp biopsy can be evaluated to determine, among other things, whether or not the hair follicles have been damaged, whether or not there are skin inflammation or infections, and so on.
Consequently, a scalp biopsy can potentially detect the majority of the different types of hair loss, including female and male pattern baldness. It is possible, as is the case with all biopsies that the results of a biopsy will not be definitive, in which case a second biopsy will need to be performed. However, this is not always the case. Biopsies can yield useful information. It is also essential to remember that your scalp will undergo alterations as time passes.
Most of us will, at some point in our lives, undergo unavoidable hair loss. Thankfully, you can have a hair assessment and uncover the underlying cause of your hair loss, which will make treatment easier.