Hair disorders include hair loss, increased hair growth, and hair structure defects with
increased breakage, as well as unacceptable cosmetic appearance, such as reduced shine,
strength, curliness, and elasticity. It is the task of the dermatologist to choose the right
diagnostic tool depending on the suspected clinical diagnosis. Moreover, certain tools are
best suited for diagnosis in private practice, whereas others can only be used to monitor
hair growth under treatment in clinical studies. The techniques can be classified as either
invasive (eg, biopsies in scarring alopecia), semi-invasive (trichogram, unit area trichogram),
or noninvasive (eg, global hair counts, phototrichogram, electron microscopy,
laser scanning microscopy) methods. Further, one must differentiate between subjective
and objective techniques. For the practicing dermatologist, body and scalp hair distribution
by use of different grading systems, the hair pull test, and dermoscopy belong in the
category of basic diagnostic tools. Basic techniques may be extended by computerassisted
phototrichogram and, in selected cases, by use of the trichogram and/or scalp
biopsies. For research purposes optical coherent tomography, electron microscopy, biochemical
methods, atomic force microscopy, and confocal laser scanning microscopy are
optional tools. For clinical studies global photographs (global expert panel), hair weighing,
phototrichogram, and different clinical scoring systems have proven to be objective tools
for documentation and evaluation of hair growth and hair quality.
Semin Cutan Med Surg 28:33-38 © 2009 Elsevier Inc. All rights reserved.

Hair disorders include hair loss, increased hair growth, and hair structure defects with
increased breakage, as well as unacceptable cosmetic appearance, such as reduced shine,
strength, curliness, and elasticity. It is the task of the dermatologist to choose the right
diagnostic tool depending on the suspected clinical diagnosis. Moreover, certain tools are
best suited for diagnosis in private practice, whereas others can only be used to monitor
hair growth under treatment in clinical studies. The techniques can be classified as either
invasive (eg, biopsies in scarring alopecia), semi-invasive (trichogram, unit area trichogram),
or noninvasive (eg, global hair counts, phototrichogram, electron microscopy,
laser scanning microscopy) methods. Further, one must differentiate between subjective
and objective techniques. For the practicing dermatologist, body and scalp hair distribution
by use of different grading systems, the hair pull test, and dermoscopy belong in the
category of basic diagnostic tools. Basic techniques may be extended by computerassisted
phototrichogram and, in selected cases, by use of the trichogram and/or scalp
biopsies. For research purposes optical coherent tomography, electron microscopy, biochemical
methods, atomic force microscopy, and confocal laser scanning microscopy are
optional tools. For clinical studies global photographs (global expert panel), hair weighing,
phototrichogram, and different clinical scoring systems have proven to be objective tools
for documentation and evaluation of hair growth and hair quality.
Semin Cutan Med Surg 28:33-38 © 2009 Elsevier Inc. All rights reserved.