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Trichoscopy – Always the first step against hair loss

hair loss

Hair loss has great psychological impact since it mainly affects the hair and scalp, which is a really important characteristic of our appearance and current cosmetic perception in general.

If normal hair loss is excluded, which involves the loss of hair due to natural regeneration process, at a pathological level hair loss is characterised by an increased number of hair that are lost on a daily basis and not replaced by new hair. This progressively leads to hair thinning, which is called alopecia.

The large number as well as the diversity of factors causing this disease make both the diagnosis and the selection of the appropriate treatment method a challenging process. In particular, treatment cannot provide correct and scientifically documented results if the appropriate staging is not followed and without monitoring during the treatment period.


This is always the first and essential step for the treatment of hair loss.

The process of hair thinning is so gradual that it is not even visible most of the times from the beginning. Hair loss may not be noticeable even for the person affected by it while it is not possible to understand and compare its progress, whether it will be stable or whether it will stop.

Therefore, it is obvious that the detailed and thorough study of the scalp before applying any treatment is of utmost importance.

Trichoscopy is a method for the diagnosis of scalp diseases, like dermoscopy focusing on hair and scalp with the use of a hand-held dermoscope or polarized light video microscope. The complete recording of hair follicle status in terms of number, quality and hair thickness every 3 or 6 months is an objective measure for the comparison of the recommended treatment’s efficacy, allowing us to record every square centimetre of the surface of the scalp before and after.

Through trichoscopy the following elements are examined and recorded:

  • Number of existing hair follicles
  • The corresponding number of hair
  • Hair thickness
  • Number of single hair follicles

The digital images that are created together with the diagnosis constitute a point of reference. The images are stored in a file for each individual and help us in monitoring and comparing the results to be able to reliably and objectively assess the outcome.

It has the following main advantages:

  • Provides clear and scientifically documented diagnosis of the type of hair loss.
  • Is an excellent criterion for the assessment of the effectiveness of pharmacological treatment of hair loss.
  • Trichoscopy’s role is valuable in monitoring any type of treatment for hair loss over time.
  • Allows the accurate calculation of available hair follicles in the donor area, which can be transferred in case of hair transplantation.

A detailed electronic file with all digital dermoscopic examinations of the patient is archived and it is always available, allowing proper and continuous monitoring of both hair loss and the progress of treatment.

The first crucial step for the treatment of hair loss has already been made.

About the author:

Christofer Tzermias

Specialised in the UK (Oxford & London) and in North America (New York & San Diego) in the field of LASER Dermatology, Dr Tzermias, has been providing dermatological state-of-the-art treatments using cutting-edge LASER and Energy based Devices for over 20 years. He has been Director of Interventional and LASER Dermatology Department at the Athens Medical Center for over 18 years and for the last 9 years is the Scientific Director of IQ - Intensive Quality Dermatology & Cosmetic Surgery Clinics, which at the 2017 Healthcare Awards won the ‘Innovation Award for Innovative Services’ for their pioneering contributions. Since 2018, IQ Dermatology & Cosmetic Surgery Clinics has also been operating in London, UK and in Muscat, Oman. Dr Tzermias is a Fellow of the world-renowned American Society for LASER Medicine and Surgery (ASLMS), a Founder Member of the European Society LASER Dermatology (ESLD), the Vice President of the ‘Open Health Alliance’ and he is also on the Board of Directors of Elitour - Greek Medical Tourism Council.

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