Scalp Biopsy -
A Comprehensive Guide

Doctors typically take a biopsy of your scalp if you are losing hair without a known cause. Doing this helps them identify the underlying cause and suggest the best course of action for therapy. A scalp biopsy can be a frightening and scary experience. But, the procedure is usually brief and should not cause any severe pain or discomfort.

First, we will describe what a scalp biopsy is below. Then, we will see how your doctor uses one to provide a precise diagnosis of your hair loss.

What is Meant by a Scalp Biopsy?

A scalp biopsy is a medical procedure in which the doctors remove a small sample of your skin for testing. A skin biopsy is performed by healthcare professionals using a variety of methods. One of these methods is a punch biopsy. This uses a small circular tool to remove a patch of skin, also known as a shave biopsy.

Sometimes doctors use a surgical knife to remove the skin fragment delicately. This process is called an excisional biopsy. Thanks to a scalp biopsy, your healthcare professional can accurately diagnose any illnesses or problems that affect your scalp. Your healthcare provider may do a follicular count or a scalp biopsy to check for signs of hair follicle damage in androgenetic alopecia. A biopsy may reveal evidence of scalp or autoimmune-related hair loss.

When is a Scalp Biopsy Becomes Crucial?

Your doctor might advise a scalp biopsy if there is no known cause for your hair loss. Your medical professional may benefit from a scalp biopsy if:

A scalp biopsy may also be required if you have an atypical mole or another sort of skin growth on your scalp. Your doctor may be able to assess whether an unusual scalp growth needs more attention by taking a biopsy.

A scalp biopsy can help diagnose various forms of hair loss, including the following.

Androgenetic Alopecia or Male Pattern Baldness

Dihydrotestosterone (DHT), an androgen hormone that can harm your hair follicles and genetic factors, contributes to this type of irreversible hair loss. To identify female pattern hair loss, a related kind of hair loss that affects women, a scalp biopsy may also be employed.

Scarring Alopecia or Cicatricial Alopecia

Scarring alopecia, also known as cicatricial alopecia, is the name given to several different types of hair loss in which the hair follicles are harmed by scar tissue. Scarring hair loss frequently begins slowly and worsens, occasionally affecting the entire scalp.

Telogen Effluvium

A brief shed of hair such as this happens when your hair enters the telogen phase of the hair growth cycle too quickly. Many factors, such as stress, illness, surgery, and nutritional inadequacies, can cause it.

Areata Alopecia

This type of patchy, non-scarring hair loss is brought on by an autoimmune reaction. From small, rounded bald patches to severe hair loss, it can vary in severity.

Alopecia Induced By Dermatophytes or Tinea Capitis

Typically, a scalp infection, tinea capitis, commonly known as scalp ringworm, induces hair loss of this kind. When severe, it can destroy the hair follicles permanently and cause significant irritation.


Impulsive and/or obsessive hair tugging can result in trichotillomania. It typically starts in a person’s early teen years and can appear in those who experience certain mood and anxiety disorders.

The Process of Scalp Biopsy

The process of receiving a biopsy can be intimidating, but it is usually short and easy. Moreover it like will likely not result in much pain or suffering. A biopsy is a swift, easy, and in-office procedure. The doctor will first clean the afflicted area of your scalp before using a specific tool to remove a little bit of the skin.

Follow your doctor’s instructions carefully and remain still throughout the process. Typically, your doctor will take a biopsy in the direction that your hair grows. The biopsy sample will be cut into horizontal or vertical parts for analysis after the surgery.

Your healthcare professional might need to collect more than one sample of skin in some instances. Your healthcare professional could also numb the area with a local anesthetic before performing the treatment to prevent pain.

Your healthcare professional will dress the afflicted region following the biopsy. Depending on the biopsy method, the area might need to be sutured shut. To avoid infection and promote skin healing, be careful to adhere to your healthcare provider’s care instructions.

Other Techniques Used to Diagnose Hair Loss or Alopecia

Healthcare providers usually resort to focusing on the skin when the reason for your hair loss is unclear. They usually initiate this by collecting a sample of the skin. Not all types of hair loss require a scalp biopsy for diagnosis. During your consultation, the doctor may employ one or more strategies depending on your hair loss symptoms.

General Examination of the Body and Hair

Sometimes standard physical examination might identify hair loss. Your doctor may determine you have male pattern baldness if you report a receding hairline or hair thinning.

Talk about your Symptoms

Your doctor can inquire about your hair loss symptoms. You can be questioned about how much hair you lose per day or when you first noticed that you were losing hair.

The Hair-Pull Test

Applying pressure to a tiny section of your hair and counting the hairs that are pulled out are the steps in this type of test. This test can help your doctor determine how much hair you are losing.

The Hair Pluck Test

This kind of test entails utilizing a surgical clamp to grab a larger quantity of your hair. The doctor then pulls it from your scalp for examination. They test the retrieved hair to determine a possible cause of your hair loss.


A dermatopathologist may examine your hair after removing hair from your scalp to check for clubbed hairs. They might even look for unique traits of your hair bulb or other indications of a particular form of hair loss.

Culturing Test for Bacteria or Fungi

You might undergo this kind of test if you exhibit signs of skin infection like tinea capitis. A condition known as fungal alopecia can result from some scalp infections, which also cause inflammation.

Treatment of Hair Loss

Several types of hair loss are treatable. This is done via the use of hair loss medication to treat the underlying causes. Or your doctor might suggest making variations to your regular hair care habits. Depending on the underlying root cause of your hair loss, your doctor may recommend one or more of the following hair loss treatment options.

By Using Finasteride and Minoxidil

If male pattern baldness is the cause of your hair loss, utilizing hair loss medication can help you slow it down, stop it from getting worse, and maybe even turn it around. The FDA now approves two drugs to treat male pattern baldness. They include minoxidil, which promotes hair growth at the scalp level, and finasteride, which inhibits the creation of DHT.

Numerous studies show that finasteride and minoxidil are beneficial in delaying hair loss and promoting growth.

A research study discovered that the drugs work especially well when combined. Around 94.1 percent of males reported benefiting from a combination of finasteride and minoxidil for a full year. We know through medical studies that minoxidil and finasteride promote hair growth and stop hair loss.

Treat Any Other Conditions That Cause Hair Loss

If male pattern baldness is not the reason for your hair loss, then look at other causes. Drastic weight loss, fungal infections, or scalp inflammation can be a probable underlying reason as well. If so get it looked over by your healthcare professional immediately. Addressing the root cause of your hair loss before you start treating it is crucial in long-term hair health.

Your healthcare professional may recommend particular dietary or lifestyle changes or prescribe medication to treat an infection or another scalp condition based on the study and results of your biopsy.

Make Certain Changes To Your Hair Care Habits

Making minor adjustments to your hair care routine can occasionally enhance the condition of your hair and lessen the severity of hair loss.

This could entail altering your diet to include foods that encourage healthy hair growth. Moreover, your doctor will recommend hair care products like a good branded Hair Thickening Shampoo and Thick Fix Conditioner to support optimal hair growth.
Though lifestyle adjustments are unlikely to reverse male pattern baldness on their own, medicines can support them. Science-based hair loss therapies such as finasteride and minoxidil have reportedly delivered ideal results.

Do You Require a Scalp Biopsy?

Getting a scalp biopsy usually only takes a few minutes. After the process, it is important to closely follow your healthcare provider’s instructions to help your skin recover quickly and instantaneously.

Your healthcare provider will recommend an adequate scalp treatment for hair loss option based on the results of your biopsy test, your symptoms, personal requirements, and other factors.

Bottom line

Not all patients need a scalp biopsy to determine the root cause of hair loss and to choose the best treatment options. But the first step in realizing why you are losing your hair and what you can do about it is to schedule a hair loss consultation.

We invite you to schedule an evaluation at the Saad MD urgent care. Contact us online or book a telemedicine appointment to receive a personalized hair consultation and treatment plan.