EEMCO Guidance for the Assessment of Hair
Shedding and Alopecia
G.E. Piérard, C. Piérard-Franchimont, R. Marks, P. Elsner, and the EEMCO
Group
Skin Pharmacology and Physiology 2004
Knowledge of the hair follicle anatomy and the dynamics of hair
cycling is substantial.
Recognizing the anagen, catagen and telogen phases as well as
teloptosis and the hair eclipse phenomenon clearly characterizes the
typical hair chronobiology.
Physiological modulators include hormones, neuromediators,
miscellaneous biomolecules, seasons, micro-inflammation and ageing.
For individuals who present with the complaint of increased hair
shedding or alopecia, a host of evaluation techniques are available in
addition to history, physical examination and laboratory assessment.
Various clinical hair techniques can help in assessing the efficacy
of drugs and cosmetics on hair growth. The methods are quite similar to
those used to establish a definite diagnosis in dermatological practice.
Great strides have been made during the recent decades in the
methodology of hair growth trials in dermatology and cosmetology.
Clinical evaluations benefit from a few additional specific
techniques that enhance the perception of hair (re-) growth, shedding
and alopecia.
These assessments include the determination of hair patterning and
density that may be helped by the 'black-and-white felt' examination.
Daily hair counts, the 'hair pull test' and the 'hair feathering test'
are also available.
Instrumental methods provide reliable quantitative information that
is useful if there are adequate controls.
Some photographic methods, the trichogram, hair weighing and variants
of the hair growth window technique including the phototrichogram,
videotrichogram and tractio-phototrichogram provide insight into the
complexities of hair cycling and shedding.
Skin biopsy is indicated for diagnostic purposes, especially when the
hair loss is accompanied by
scarring.
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