This may be an appropriate step for diagnosis after clinical assessment, if visually there is not enough distinctive information to clarify the underlying concern.

There are circumstances when a dermatologist may decide to do a biopsy when the evaluation indicates:

Non-scarring or scarring alopecia

Undefined and overlapping etiology of hair loss

Other suspected auto immune or inflammatory condition to help identify the process

Biopsy results would help identify the process and facilitate a directed plan for treatment that would involve more sustainable long-term success.

What to expect during the procedure

Anaesthetic: Local anaesthetic is delivered in a fan technique to numb the area for the scalp biopsy process.

Biopsy: Using a punch tool (standard alopecia biopsy protocol) two small specimens of skin are obtained

Closure: The area will be either sutured or cauterized with a mild form of heat to minimize scaring.

The procedure will take approximately 30 minutes.

Aftercare: Avoid washing the area for 48 hours, some bleeding may occur or bruising, or risk of infection- these events are rare after this type of procedure, while this is routine, it is always possible.

Pathology and Results

The tissue specimens will be sent to a Pathologist who has further training in diagnosing hair diseases. The empiric diagnostic experience is important for scalp and hair disorders.