If your hair is thinning, your scalp is itchy, or you’ve noticed more strands in the shower, you’re far from alone. But while many people rush to change shampoos, start supplements, or book salon scalp treatments, these often overlook the real issue the skin beneath the hair.
That’s where a dermatologist comes in.
Your scalp is skin too, and it can develop the same problems as the rest of your body: inflammation, infection, hormonal imbalances, or immune reactions. These deeper factors often drive hair loss long before you can see the damage on the surface.
In this article, we’ll explore what your dermatologist looks for when assessing scalp and hair health, the advanced tools they use to detect hidden problems, and the medical and regenerative treatments that go beyond cosmetic fixes.
Why Hair Loss Needs a Skin-Focused Approach
Hair loss isn’t just about what you put on your hair it’s about what’s happening within your scalp.
Each hair follicle is a tiny organ surrounded by oil glands, nerves, and blood vessels. These follicles are sensitive to hormones, immune signals, and inflammation. When any of these go off balance, the follicle’s growth cycle shortens, leading to shedding or thinning.
A dermatologist doesn’t just look at your hair strands; they analyse the scalp environment the quality of the skin, circulation, and cellular health underneath.
This medical perspective helps uncover root causes that cosmetic treatments can’t reach, including:
- Chronic inflammation or dermatitis
- Fungal or bacterial infections
- Hormonal triggers such as androgens
- Nutrient deficiencies or autoimmune responses
- Reactions to medications or topical products
The Difference Between a Salon Scalp Treatment and a Dermatology Assessment
A salon scalp treatment may exfoliate, massage, or nourish the surface and that can be helpful for mild dryness or product build-up.
However, it can’t identify why your hair is thinning, why your scalp burns, or why shedding persists despite perfect care.
Dermatologists combine clinical expertise with medical technology to evaluate scalp health at a microscopic level. They don’t guess they measure, test, and image.
At the London Dermatology Centre, a Scalp Dermatologist in London can identify issues invisible to the naked eye and create a tailored treatment plan that addresses both surface and systemic factors.
How a Dermatologist Examines Your Scalp
A professional scalp assessment often includes several stages:
1. Detailed Consultation
You’ll discuss your medical history, family patterns of hair loss, recent stress, diet, and product use. Many cases of shedding link back to hormonal shifts, thyroid imbalance, or autoimmune responses that need investigation.
2. Scalp Examination and Imaging
Dermatologists use magnification and trichoscopy a specialised camera system to study hair follicles, density, and scalp condition. This helps detect:
- Miniaturised follicles (seen in androgenetic alopecia)
- Inflammation around follicles (folliculitis)
- Scaling or redness (seborrheic dermatitis or psoriasis)
- Blocked pores or excess oil
3. Pull or Wash Test
A gentle hair-pull test reveals how much hair is actively shedding. This can help distinguish between temporary shedding (telogen effluvium) and progressive hair loss patterns.
4. Blood and Hormone Tests
Your dermatologist may check for deficiencies (iron, vitamin D, zinc), thyroid dysfunction, or elevated androgens (like DHT) that contribute to thinning.
5. Scalp Biopsy (if needed)
In complex cases, a small scalp sample is analysed to identify inflammatory or autoimmune conditions such as lupus or lichen planopilaris.
Together, these steps form a complete picture of your scalp’s health something no shampoo or home remedy can replicate.
Common Scalp Conditions That Cause Hair Loss
Dermatologists often find that what looks like “hair loss” is actually a scalp disorder disrupting follicle health.
1. Seborrheic Dermatitis
This oily, flaky condition can clog follicles and trigger inflammation. It’s caused by yeast overgrowth and worsened by stress or climate changes.
2. Psoriasis
Thick plaques and redness can suffocate follicles. Treatment focuses on calming immune activity and reducing scaling.
3. Folliculitis
This is inflammation or infection of the follicles, often caused by bacteria or yeast. It can lead to scarring if untreated.
4. Telogen Effluvium
A common temporary shedding phase triggered by stress, illness, childbirth, or medication changes. The follicles eventually recover once the trigger is addressed.
5. Androgenetic Alopecia (Male or Female Pattern Hair Loss)
The most common genetic form of hair loss, caused by sensitivity to the hormone DHT, leading to gradual follicle shrinkage.
6. Alopecia Areata
An autoimmune condition where the body mistakenly attacks its own follicles, causing patchy or diffuse hair loss.
7. Contact Dermatitis
Hair products containing fragrances, preservatives, or harsh chemicals can irritate the scalp, leading to inflammation and shedding.
By identifying the precise condition, dermatologists can apply targeted therapy stopping hair loss at its source.
What Your Dermatologist Can See That You Can’t
With trichoscopy and digital scalp analysis, dermatologists can visualise microscopic features such as:
- Follicular density: How many hairs per square centimetre.
- Hair shaft diameter: Detecting miniaturisation before it’s visible.
- Inflammatory markers: Red dots or pustules around follicles.
- Vascular changes: Altered blood flow in inflammatory conditions.
- Scaling and sebum patterns: Indicating microbial imbalance or barrier dysfunction.
These insights reveal whether your hair loss is due to active inflammation, hormonal factors, or scarring allowing for early intervention before permanent damage occurs.
Advanced Diagnostic Technologies
Leading dermatology clinics now integrate imaging and lab diagnostics for a full 360° view of scalp health:
Trichoscopy
A non-invasive camera system magnifying the scalp up to 100x to assess hair follicle structure, inflammation, and density.
AI-Powered Scalp Mapping
Digital tools can quantify follicle health, density, and thickness over time making it easier to track treatment progress.
Lab Analysis
Tests may include thyroid function, ferritin levels, hormone profiles, or autoimmune markers to identify hidden triggers.
Fungal or Bacterial Cultures
When scalp infections are suspected, cultures pinpoint the specific organism responsible, ensuring precise treatment.
Medical Treatments Dermatologists Use for Hair Loss
Once diagnosis is clear, dermatologists can prescribe evidence-based treatments tailored to your exact condition.
1. Prescription Medications
- Minoxidil: A topical solution that stimulates follicles to grow longer and thicker.
- Finasteride or Dutasteride: Oral medications that block DHT, used in men and some women.
- Spironolactone: A hormone modulator often prescribed for female pattern hair loss.
- Anti-inflammatory creams or foams: Used for psoriasis, dermatitis, or folliculitis.
2. Platelet-Rich Plasma (PRP) Therapy
PRP uses your own platelets to release growth factors that stimulate dormant follicles and enhance blood flow.
This regenerative approach strengthens hair roots and promotes natural regrowth over time with minimal downtime.
3. Microneedling with Growth Factors
Microneedling creates micro-channels in the scalp, encouraging collagen formation and better absorption of topical treatments like PRP or peptides.
It can be particularly effective in improving scalp thickness and reversing early hair loss stages.
4. Low-Level Laser Therapy (LLLT)
Laser light therapy stimulates cellular energy in follicles, improving density and reducing inflammation.
This pain-free, home-friendly treatment can complement medical therapies for better results.
5. Corticosteroid Injections
For autoimmune conditions such as alopecia areata, targeted steroid injections can calm inflammation and help regrow hair in bald patches.
6. Antifungal or Antibiotic Treatments
If scalp infections are identified, medical creams or oral medications clear the source protecting follicles from damage.
7. Regenerative Medicine and Stem Cell-Based Therapies
Emerging techniques use stem-cell extracts and exosomes to reactivate follicles and repair scalp tissue. These therapies show promising results in improving scalp health and density over time.
Scalp Health Maintenance: What You Can Do at Home
While medical treatments correct the underlying cause, daily care keeps your scalp balanced and resilient.
1. Keep the Scalp Clean Not Stripped
Use mild, pH-balanced shampoos that remove oil and buildup without drying the scalp. Avoid sulphates and strong detergents.
2. Exfoliate Occasionally
A gentle scalp exfoliator once or twice a month clears dead skin cells and promotes healthy circulation.
3. Protect from Sun and Heat
UV rays and high heat weaken follicles and degrade collagen. Use UV-protective sprays or hats outdoors.
4. Manage Stress
Stress hormones directly affect follicle cycling. Meditation, exercise, and consistent sleep improve scalp microcirculation and collagen function.
5. Nourish from Within
A diet rich in protein, omega-3s, zinc, and iron supports follicle function. Consider supplements if deficiencies are confirmed by your doctor.
6. Avoid Tight Hairstyles
Constant tension from ponytails, extensions, or braids can cause traction alopecia a preventable form of hair loss.
Signs You Should See a Dermatologist
If you notice any of the following, it’s time for a professional assessment:
- Sudden or patchy hair loss
- Persistent dandruff or itching
- Pain, redness, or sores on the scalp
- Scaly or crusted lesions
- Hair thinning that doesn’t improve after several months
- Family history of early hair loss
Early diagnosis leads to better outcomes. Conditions like androgenetic alopecia respond best when treated before follicles become permanently miniaturised.
What to Expect at a Dermatology Consultation
When you visit a Scalp Dermatologist in London, your experience will be more comprehensive than a cosmetic consultation.
Here’s what usually happens:
- Medical history review – including hormones, medications, and family genetics.
- Scalp and hair imaging – magnified photography or trichoscopy.
- Microscopic analysis – examining hair shaft and root condition.
- Blood and hormone testing – to detect internal imbalances.
- Diagnosis and plan – outlining a step-by-step treatment strategy.
Most patients start seeing visible improvement in scalp health and reduced shedding within 3–6 months of targeted medical therapy.
The Link Between Scalp Health and Overall Wellness
The scalp often reflects what’s happening elsewhere in your body.
For instance:
- Thyroid disorders can cause hair shedding.
- Nutrient deficiencies reveal themselves as brittle hair or flaking skin.
- Autoimmune conditions may first appear as scalp inflammation.
That’s why dermatologists view scalp and hair as part of your overall health, not isolated beauty issues. A healthy scalp is an indicator of internal balance.
Why Early Intervention Matters
Once follicles become scarred or dormant, regrowth becomes far more difficult.
Dermatologists aim to catch issues early before inflammation or hormonal imbalance causes irreversible loss.
By combining scalp imaging with lab analysis, they can track progress and adapt treatments as your condition evolves.
Combining Medical and Aesthetic Scalp Treatments
Modern dermatology embraces both science and aesthetics.
You can pair medical therapies (like PRP or laser) with rejuvenating scalp treatments for optimal results. For example:
- Microneedling + PRP enhances collagen and blood flow.
- Laser therapy + topicals improves absorption and healing.
- Prescription medication + scalp care routine maintains long-term results.
This hybrid approach ensures that your scalp stays both healthy and beautiful.
FAQs:
1. How can I tell if my hair loss is normal or something more serious?
It’s completely normal to shed between 50 and 100 hairs a day that’s part of your hair’s natural growth cycle. However, if you’re noticing more hair on your pillow, in your shower drain, or seeing visible thinning or bald spots, it’s time to dig deeper. Persistent shedding, patchy hair loss, or scalp irritation often signals an underlying medical cause, such as hormonal imbalance, inflammation, or nutrient deficiency. A dermatologist can examine your scalp under magnification and run tests to find out what’s really happening beneath the surface, so you’re not left guessing.
2. Why should I see a dermatologist for hair loss instead of a trichologist or salon expert?
While trichologists and salon professionals understand hair health, they aren’t medically trained to diagnose or treat internal or systemic causes of hair loss. A dermatologist, on the other hand, is a medical doctor who can identify whether your thinning hair stems from hormonal issues, immune reactions, infection, or inflammation. They use advanced tools such as trichoscopy and lab tests to pinpoint the cause and can prescribe medical treatments like PRP therapy, hormone regulation, or prescription medication. In short, a dermatologist looks beyond the surface to treat the root cause, not just the symptoms.
3. What happens during a scalp assessment at the dermatologist’s office?
Your appointment usually starts with a detailed conversation about your hair concerns, family history, stress levels, and recent health changes. After that, your dermatologist will closely examine your scalp using magnification or trichoscopy a high-resolution imaging technique that reveals follicle density, inflammation, and scalp condition. Depending on what’s found, they may also perform a gentle pull test to evaluate shedding or recommend blood and hormone tests to check for internal triggers. In some cases, a tiny scalp biopsy is taken to confirm specific diagnoses like autoimmune-related hair loss. The process is thorough, precise, and completely personalised.
4. Can stress really cause hair loss?
Yes and more often than people realise. Chronic stress increases the level of cortisol in your body, which can disrupt your hair’s natural growth cycle and push more follicles into the shedding phase. This condition is known as telogen effluvium. The good news is that stress-related hair loss is usually temporary once the trigger is managed. Dermatologists often recommend a combination of medical treatments, such as minoxidil, along with stress management strategies like improved sleep, mindfulness, and nutrition to help your hair recover.
5. What types of tests can identify the cause of my hair loss?
Dermatologists use several diagnostic tools to uncover what’s really driving your hair loss. Blood tests can check for thyroid issues, iron or vitamin D deficiency, and hormonal imbalances such as elevated DHT levels. In some cases, your doctor may recommend a scalp biopsy to detect autoimmune or inflammatory conditions. Advanced imaging techniques like trichoscopy help visualise follicle structure and density, revealing signs of miniaturisation or inflammation before they’re visible to the naked eye. These insights allow your dermatologist to tailor a treatment plan that actually targets the cause rather than masking the symptoms.
6. How long does it take to see results from hair loss treatments?
Hair growth is a gradual process follicles take time to recover and enter a new growth phase. Most patients begin to see improvement in scalp health and reduced shedding within three months of starting treatment. Noticeable new growth typically appears between six and nine months, depending on the therapy used. Treatments like PRP, microneedling, or medications such as minoxidil and finasteride work best when used consistently and under professional supervision. Patience is key; the goal is steady, long-term improvement rather than instant results.
7. Are regenerative treatments like PRP or stem-cell therapy safe?
Yes, when performed by qualified medical professionals, regenerative treatments such as PRP (Platelet-Rich Plasma) and stem-cell-based therapies are considered safe and effective. PRP uses your own platelets, extracted from your blood, to deliver growth factors directly to dormant follicles, encouraging them to re-enter the growth phase. Stem-cell and exosome therapies go a step further, using bioactive components to repair damaged scalp tissue and rejuvenate follicles. Since these treatments rely on your body’s natural healing process, they have minimal side effects and can complement other medical therapies for even stronger results.
8. Can hair really grow back once it’s been lost?
That depends on the type and stage of hair loss. If the follicles are still active but simply dormant as seen in conditions like telogen effluvium or early androgenetic alopecia regrowth is often possible with the right treatment. However, if the follicles have been replaced by scar tissue, as in scarring alopecias, regrowth may not occur. This is why early diagnosis is crucial. Seeing a dermatologist at the first signs of thinning gives you the best chance of reversing the process before permanent damage sets in.
9. How do I maintain scalp health between treatments?
Between professional treatments, you can support scalp health by keeping it clean, balanced, and well-nourished. Use a mild, sulphate-free shampoo to remove buildup without stripping natural oils. Avoid tight hairstyles and harsh chemical treatments that stress the follicles. Incorporate gentle scalp massages to stimulate circulation, and protect your scalp from UV damage with hats or SPF sprays. A nutrient-rich diet with enough protein, omega-3 fatty acids, and iron also plays a major role in maintaining strong, healthy hair. Think of at-home care as an extension of your dermatology treatment not a replacement for it.
10. When should I book a consultation with a dermatologist?
If your hair loss seems sudden, patchy, or is accompanied by scalp pain, redness, or itching, it’s best not to wait. These could be signs of an underlying condition that needs medical attention. Similarly, if you’ve been trying over-the-counter treatments or supplements for months without improvement, that’s a sign you need a professional assessment. A dermatologist can provide an accurate diagnosis, combine multiple therapies if needed, and monitor your progress over time. The sooner you start, the better your chances of restoring healthy growth and preventing permanent loss.
Final Thoughts: Restoring Scalp Health with Expert Care
Healthy hair starts with a healthy scalp and no amount of salon treatments or supplements can substitute for a proper medical evaluation. If you’ve been dealing with persistent shedding, itching, or thinning, the key isn’t just finding the right product but uncovering why your follicles are struggling in the first place. That’s where professional guidance makes all the difference.
By consulting a qualified Scalp Dermatologist in London, you’ll receive a detailed, science-based assessment that goes beyond surface-level symptoms. From trichoscopy and lab testing to advanced regenerative therapies, dermatologists can identify underlying causes such as hormonal imbalances, autoimmune reactions, or inflammation and create a tailored plan to restore both scalp and hair health. If you’re considering seeing a scalp dermatologist in London, you can get in touch with us at the London Dermatology Centre for a personalised consultation and expert care.
References:
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2. Van Kuzniak-Jodlowska, A. et al. (2025) ‘The use of imaging techniques in the diagnosis of hair and scalp disorders’, Clinical, Cosmetic and Investigational Dermatology, 18, pp. 45-58. Available at: https://www.ncbi.nlm.nih.gov/articles/PMC12472112/
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4. Alessandrini, A. et al. (2021) ‘Common causes of hair loss – clinical manifestations, updated evaluation, and diagnostic pitfalls’, Journal of the European Academy of Dermatology and Venereology, 35(5), pp. 1104-1114. Available at: https://pubmed.ncbi.nlm.nih.gov/33290611/
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