What is trichology? The science of hair health and its place in modern medicine

What trichology is

Trichology is the branch of knowledge concerned with the hair and scalp: their structure, growth, health and the problems that affect them. It draws on anatomy, biology and physiology, as well as on dermatology and endocrinology, to explain why hair grows, why it is lost and when it can recover.

In different countries the title and training of people who work in this field vary. In many places hair and scalp disorders are diagnosed and treated by dermatologists, while trichologists may focus on assessment and care. Whoever you see, the principle is the same: find the cause before choosing a treatment.

The hair growth cycle

Each hair follicle goes through a repeating cycle. Understanding it is the basis for every approach to hair care and restoration, including hair transplantation.

Anagen: active growth

In the anagen phase the hair grows actively. On the scalp this phase commonly lasts from two to seven years, which is why most scalp hairs are in anagen at any given time.

Catagen: transition

Catagen is a short phase of about two to three weeks. The follicle shrinks and stops producing new hair, preparing for rest.

Telogen: rest

Telogen lasts around three months. The hair no longer grows but stays in place while a new hair begins to form beneath the skin.

Exogen: shedding

Exogen is sometimes described separately: it is the stage when the old hair is shed and makes way for the new one. Losing a certain number of hairs each day as part of this cycle is normal.

When this cycle is disturbed, for example when many hairs enter the resting phase at once or the growth phase becomes shorter, noticeable thinning can follow.

How hair and scalp problems are diagnosed

Diagnosis usually starts with a conversation about when the problem began, family history, diet, stress, recent illness and medication. The specialist then examines the scalp and hair.

• Trichoscopy. Magnified examination of the scalp and hair shafts, often with a digital camera, helps to distinguish between different types of hair loss.
• Hair pull test and hair counts. Simple tests show whether shedding is increased.
• Blood tests. These can check iron stores, thyroid function, hormones and other factors when the history suggests them.
• Biopsy. In unclear cases, especially when scarring is suspected, a small sample of skin may be examined.

Treatment and prevention

Depending on the diagnosis, treatment may include topical products, medication prescribed by a doctor, procedures such as mesotherapy or platelet-rich plasma, and correction of underlying causes such as nutritional deficiencies. The evidence behind these options varies, and a doctor should explain what can realistically be expected.

Prevention matters too: gentle hair care, avoiding tight hairstyles and harsh chemical treatments, a balanced diet and early attention to changes in the scalp can help prevent some problems from getting worse.

Hair loss in men and women

Men

The most common form in men is androgenetic alopecia, or male pattern hair loss. It usually begins with a receding hairline and thinning at the crown and is linked to the effect of dihydrotestosterone (DHT) on genetically sensitive follicles. Options discussed with a doctor may include medication such as minoxidil or finasteride and, when hair loss is stable and the donor area allows, a hair transplant to restore lost coverage.

Women

In women hair loss is more often diffuse, with general thinning over the top of the head rather than a clear pattern. It may be linked to hormonal changes, stress, nutritional deficiencies or genetics. Treatment may include minoxidil, hormonal therapy chosen by a doctor and, in some cases, procedures that aim to support hair growth.

What they have in common

Genetics and age play an important role in both sexes. In every case, an individual approach based on an accurate diagnosis is the key to choosing sensible treatment.

Common scalp conditions that affect hair

Seborrhoeic dermatitis

This condition causes red, flaky patches, sometimes with itching and heavy dandruff. Excess sebum and yeast activity often play a part. Treatment focuses on calming inflammation with medicated shampoos and, when needed, other medication.

Scalp psoriasis

Psoriasis can form thick plaques on the scalp that cause discomfort and, in some people, shedding. Treatment ranges from topical products to light therapy and systemic medication in more severe cases.

Fungal infections

Fungal infections of the scalp can cause patchy hair loss and need antifungal treatment prescribed by a doctor.

Folliculitis

Inflamed hair follicles can be painful and, if the problem persists, may damage follicles. Treatment depends on the cause and may include antibacterial therapy and adjusted care.

Lichen planopilaris

This is a rare inflammatory condition that attacks follicles and can lead to scarring and permanent loss in the affected area. Early treatment with anti-inflammatory medication may help to slow its progress, which is why unusual symptoms such as redness around follicles, burning or itching deserve prompt attention.

Trichology and hair transplantation

Trichology and hair transplantation complement each other. A transplant moves healthy follicles from the donor area to thinning areas, but it does not treat the cause of hair loss. That is why the diagnosis comes first: the type of hair loss, whether it is still progressing and the condition of the scalp all influence whether surgery makes sense.

FUE is commonly used for androgenetic alopecia, and a combined FUE and DHI approach can be used for androgenetic alopecia and to add density. Active scalp inflammation should usually be treated before any surgery, and in scarring conditions a transplant is considered only with great caution and after specialist assessment. Medical treatment may continue after a transplant to help protect the remaining native hair.

Consultation at City Medical Centre

City Medical Centre works with international patients and specialises in hair transplantation. If your hair loss has been diagnosed and you want to know whether a transplant could be an option, you can book a free first consultation, including online. Send photos of your hair and donor area, and the doctor will assess your case and name the cost, which is then fixed in the contract. A personal coordinator stays with you from your first message to the end of recovery, and photos and questions can be sent by WhatsApp. Read more on the hair transplant page.

Frequently asked questions

What does trichology study?

Trichology studies the hair and scalp: how hair grows, why it is lost and which conditions affect the scalp. It combines knowledge from anatomy, biology, dermatology and endocrinology to find the cause of a problem before a treatment is chosen.

How long does a hair grow before it falls out?

A scalp hair commonly grows for two to seven years in the anagen phase, then passes through a short transition of two to three weeks and rests for about three months before it is shed and replaced. Losing some hair each day is normal.

What tests are used to diagnose hair loss?

Common tools include a detailed history, magnified examination of the scalp known as trichoscopy, simple pull tests and, when indicated, blood tests for iron, thyroid function and hormones. In unclear cases a small skin biopsy may be taken.

Does a hair transplant treat the cause of hair loss?

No. A transplant moves healthy follicles to thinning areas but does not stop the process that causes hair loss. That is why diagnosis comes first, and why medical treatment is sometimes continued after surgery to protect the remaining hair.

Can I have a hair transplant if I have a scalp condition?

Active inflammation, such as a flare of dermatitis or psoriasis, usually needs to be treated first. In scarring conditions a transplant is considered only with great caution and after specialist assessment. The decision is made by a doctor after examination.