Dermatologists are doctors who specialize in diseases and conditions that affect the skin. To diagnose and treat alopecia areata, look for a board-certified dermatologist. They have proven, in-depth knowledge and training in their field and must stay updated to renew their certification every few years. In addition, some nurse practitioners and physician assistants have completed advanced dermatology training and have experience treating alopecia areata. Check out the NAAF Doctor Finder to identify a healthcare provider with expertise in alopecia areata.

Preparing for Your First Visit

Doctor visits can be stressful. However, you can take steps to prepare for the exam, which can help the appointment go smoothly.

• Ensure that your scalp (or your child’s) is in a position allowing easy inspection. Remove hair pieces or hairstyles that might make it difficult to see the skin. If you regularly wear a wig, ensure you can easily remove it. If not, wear a head covering for the visit instead.
• Remove artificial nails or nail polish. Your doctor will want to examine your nails. One of the symptoms of alopecia areata is ridging or pitting of the nails.
• Do not apply false eyelashes or make up to your brows. This would make it difficult for your doctor to examine those areas thoroughly.
• Set aside enough time for your visit. An initial visit with a dermatologist is usually longer than follow-up visits. When you confirm your appointment, ask how long it will be.

Bring:

• Gather your family’s medical history and see if anyone in your family has alopecia areata or another type of autoimmune disease. This includes biological parents, siblings, aunts, uncles, and first cousins. Alopecia areata is genetic, and about 20% of those with the disease have relatives with it or another autoimmune disease.
• If your primary care physician referred you, ask for a copy of your medical records and the referral. You’ll want this even if it was sent to the dermatologist’s office already.
• Print out or make a list of all medications you currently take. This includes over-the-counter drugs, as well as vitamins and dietary supplements.
• If you have commercial insurance, bring a copy of your membership card and your pharmacy information.
• Make a list (or take photos) of all hair and scalp products you (or your child) use and bring with you.
• If you have tracked your hair loss with photos, please bring those, as well.

During Your Visit

Information gathering: The first part of your doctor’s visit is usually for information gathering. Some questions can seem unrelated, but your answers may help your doctor diagnose you.

Examination: Your doctor will examine your scalp, face, hair (and hair-growing areas), and nails. They’re looking for any redness, scarring, swelling or sores on your scalp and any pitting on your fingernails. They’re also looking at the pattern and severity of hair loss. Your doctor may want to photograph your hair to track loss or regrowth.

Testing: Your doctor may also conduct or recommend certain tests during your exam, such as:

• Pull test: This test checks different parts of your scalp for active (current) hair loss. Your doctor will gently pull on some hair – about 40 strands. If more than six strands come out, this is active hair loss.
• Scalp biopsy: If your doctor isn’t sure about the diagnosis, they may conduct a biopsy, where they remove a small section of skin from your scalp skin to send to a laboratory for testing.
• Trichoscopy: Your doctor might use a tool called a dermatoscope, which is used to view the scalp and hair at a high magnification level. This lets your doctor look for certain signs that appear with alopecia areata.
• Blood tests: While blood tests don’t indicate if a person has alopecia areata, they can show if a disease is present that is causing hair loss. These include too little iron in the blood or thyroid disease, for example.
• Cultures: Cultures (taking a swab or sample) check for infections. Fungal infections like tinea capitus (scalp ringworm) are not uncommon.

Alopecia Areata Diagnosis  

Once your doctor determines that you or your child have alopecia areata, they will characterize the severity of the disease as mild, moderate or severe. The distinction is important because it may affect treatment recommendations.  Learn more about available treatments in the module, Available Treatments.

Work with your healthcare provider and their office staff to ensure your first visit – and future visits—go smoothly. Depending on your treatment plan, you might need to work with the office directly to acquire medications, schedule injections, etc.

What is shared decision-making?  

Choosing treatment (or not) is a personal decision—with any disease or disorder. Your doctor has the expertise. However, only the patient knows how alopecia areata makes them feel, so working with your healthcare provider is crucial. You must find the best course of action for your (or your child’s) alopecia areata.

Shared decision-making involves the patient and healthcare provider weighing all factors. Then, together, they decide what is best for the patient’s health and well-being. The patient is engaged, informed, and included in the decision-making process.

Studies show that patients who share treatment decisions with their providers have less regret about their choices. Confidence in your decision may help you stick to your treatment as prescribed and boost your satisfaction with your alopecia areata treatment.

Related Content