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Alopecia (loss of hair from head or body) is fairly common problem. Alopecia is more common among males than females. There are several different types of alopecia, for example alopecia areata (loss of hairs from patches), alopecia totalis (complete baldness of head), alopecia universalis (loss of all body hairs), and androgenic alopecia (male pattern of hair loss) etc. Alopecia occurring females is usually more troubling (more psychological trouble than physical trouble) to the sufferer than alopecia or hair loss occurring in males. Hair loss in females should be evaluated appropriately.
Clinical evaluation should be done to determine the cause (as there are various causes of alopecia) of alopecia and some tests can be done to find out the cause. Male pattern of baldness and female pattern of hair loss usually do not need testing as both are not associated with increased hair loss.
The Hair Pull Test for alopecia:
In the pull test, a gentle traction is applied on a group of hairs (approximately 40-60 hairs) from proximal to distal end, in three different areas of scalp. The grasp is made with help of thumb, index finger and middle finger. The pull test is done for evaluation scalp hair loss. Normally less than three hairs come out with each pull from each area and if more than 10 hairs come out with every pull or approximately 10% of pulled hairs come out, the pull test is considered positive. The hairs which come out in pull test are than examined under microscope. The person should not shampoo or wash hairs for 24-48 hours prior to the test for accurate result.
Advantages of the Hair Pull Test in diagnosis of alopecia:
The pull test is helpful (positive) for diagnosis of telogen effluvium, anagen effluvium, and alopecia areata. The test is positive in whole scalp in case of acute telogen effluvium. Sometimes the number of hairs pulled may not be positive for the pull test, but may still be significant, for example only a few anagen hairs which comes out in the test, may indicate cicatricial alopecia if root sheaths are thickened.
Disadvantages or limitations of Hair Pull Test:
The biggest disadvantage of the hair pull test in diagnosis of alopecia is non consistent nature of the test in different individuals. It is very difficult to standardize the test as the inter-individual variation among investigators may be so wide, e.g. the amount of force applied may vary from person to person while testing, the pulling force applied may not be evenly distributed in the bundle of hairs etc. The exact number of hairs grasped may not be same every time. Another great disadvantage or limitation of the pull tests is that, a negative result does not rule out diagnosis of alopecia.
This is a guest post by Jupitor Chakma, who writes in his Health Blog regularly about important health topics. Visit his health blogs for regular updates on health matters.
