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Dr. Christopher Tzermias

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Trichoscopy, Always the First Step Against Hair Loss

The large number and diversity of factors causing hair loss make the diagnosis and the selection of the appropriate treatment challenging


Hair loss has great psychological impact since it 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.

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The valuable role of trichoscopy

Trichoscopy 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 imperative.

Trichoscopy is the most reliable method for the diagnosis of scalp diseases. Trichoscopy is actually hair and scalp dermoscopy with the use of a hand-held dermoscope or polarized light video microscope. The thorough recording of hair follicle status in terms of number, quality and hair thickness every three or six months is an objective measure for the comparison of the recommended treatment’s efficacy, allowing us to record every square centimeter of the surface of the scalp before and after.

Through trichoscopy the following elements are recorded:

  • Number of existing hair follicles
  • The corresponding number of hair
  • Hair thickness
  • Number of single hair follicles
  • Defects of the hair shaft and hair root
  • Defects of the perifollicular epidermis and blood vessels

Electronic processing of trichoscopy findings

The processing of trichoscopy images is carried out electronically through a modern, validated software, which automates the process of counting and examining the findings. It is especially designed to offer a complete picture, particularly useful for the diagnosis of the type of hair loss in each case. Furthermore, it is a great objective comparative and assessment tool for hair treatment effectiveness.

This program is connected through a computer to the dermoscope, maximising the accuracy in the examination, diagnosis and monitoring of hair loss treatment, as an IQ software that supports trichoscopy, the basic method of diagnosis and monitoring of hair loss.

Based on trichoscopy’s findings, it is possible to detect areas of greater hair thinning, since it calculates the distance among the existing hair follicles. The examination’s results are absolutely accurate and precise, since the software allows the calculation of both the head’s curvature and the total surface scalp area.

Monitoring of results based on objective measurements.

Given that trichoscopic examination not only works as an diagnostic tool, but also as the most objective indicator for the monitoring of the findings, this software offers comparative images and percentage measurements, making clearer the progress of treatment. The knowledge of the exact way of hair loss course and progress it is possible to modify or enhance the treatment regimen.

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.


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