Alopecia other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Ogechukwu Hannah Nnabude, MD


There are tests that can be completed outside of the laboratory that will help to confirm the diagnosis.

Other Diagnostic Studies

Hair Pull Test

This is a test for the evaluation of excessive shedding, it is not diagnostic of a particular hair loss but indicates active hair loss is occurring. Hair should not be washed 24-48 hour prior to a hair pull test. It is performed by gently grasping 40-60 hairs and gently pull upward from different parts of the scalp. [1] A positive test is when three to six or more strands are pulled out. [2] [3] The pull test is positive in:

Evaluation of the pulled hair may uncover vital information. For example, if the bulb of the hair is dark, it indicates that the hair is in the anagen phase, or if it is white, it indicates that the hair is in the telogen phase.


This is a noninvasive test for the examination of the hair and scalp. The test utilizes a dermoscope or a video dermoscope. [7] The Alopecia Areata Predictive Score makes use of it to predict the treatment outcome in patients with patchy alopecia areata. [8]


A biopsy will reveal the most information regarding hair loss.

Microbiology Testing

Potassium hydroxide preparation and fungal cultures can be used in the diagnosis of tinea capitis. Wood's light can also be used to check for signs of fungal infection.


  1. 1.0 1.1 Xu L, Liu KX, Senna MM (2017) A Practical Approach to the Diagnosis and Management of Hair Loss in Children and Adolescents. Front Med (Lausanne) 4 ():112. DOI:10.3389/fmed.2017.00112 PMID: 28791288
  2. McDonald KA, Shelley AJ, Colantonio S, Beecker J (2017). "Hair pull test: Evidence-based update and revision of guidelines". J Am Acad Dermatol. 76 (3): 472–477. doi:10.1016/j.jaad.2016.10.002. PMID 28010890.
  3. Dhurat R, Saraogi P (2009) Hair evaluation methods: merits and demerits. Int J Trichology 1 (2):108-19. DOI:10.4103/0974-7753.58553 PMID: 20927232
  4. Castelo-Soccio L (2014). "Diagnosis and management of alopecia in children". Pediatr Clin North Am. 61 (2): 427–42. doi:10.1016/j.pcl.2013.12.002. PMID 24636654.
  5. Alves R, Grimalt R (2015) Hair loss in children. Curr Probl Dermatol 47 ():55-66. DOI:10.1159/000369405 PMID: 26370644
  6. Headington JT (1993). "Telogen effluvium. New concepts and review". Arch Dermatol. 129 (3): 356–63. doi:10.1001/archderm.129.3.356. PMID 8447677.
  7. Rudnicka L, Olszewska M, Rakowska A, Kowalska-Oledzka E, Slowinska M (2008). "Trichoscopy: a new method for diagnosing hair loss". J Drugs Dermatol. 7 (7): 651–4. PMID 18664157.
  8. Waśkiel-Burnat A, Rakowska A, Sikora M, Olszewska M, Rudnicka L (2020) Alopecia areata predictive score: A new trichoscopy-based tool to predict treatment outcome in patients with patchy alopecia areata. J Cosmet Dermatol 19 (3):746-751. DOI:10.1111/jocd.13064 PMID: 31301100

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