Alopecia areata dermoscopy: what the examination can show

It is a close visual examination performed with a handheld magnifying device and light. The device may touch the scalp or be held just above it, and the assessment does not remove hair.

A dermatologist looks for features such as short broken hairs, tapered hairs, dark dots where hairs have broken at scalp level, and small yellow openings at follicles. Some patterns suggest active shedding near a patch edge, while fine regrowing hairs can indicate recovery.

No single dermoscopic feature confirms the diagnosis by itself. The clinician interprets the pattern alongside the shape and location of bald areas, scalp condition, nail changes, medical history, and hair-pull findings. Scaling, scarring, marked redness, or unusual broken-hair patterns may point toward another explanation and change the assessment.

Leave the affected area easy to inspect and tell the dermatologist about camouflage fibres, sprays, oils, or medicated products used on it. Bring dated photographs if the patch has changed, because comparison can reveal expansion or regrowth that is hard to recall.

Mention itching, pain, flaking, recent hair practices, and loss affecting the eyebrows, eyelashes, beard, or body. Dermoscopic photographs may be saved during clinical care so later images can be compared in the same area. Treatment is selected from the full clinical picture rather than the magnified image alone.

Book a dermatology assessment for a new smooth bald patch, continuing enlargement, several new areas, or hair loss involving eyebrows or eyelashes. Seek earlier review if the scalp is painful, inflamed, crusted, draining, or showing shiny areas without visible follicle openings, because these features need assessment for infection or scarring hair loss.

Sudden widespread shedding also deserves clinical evaluation, particularly when accompanied by illness symptoms or a recent medicine change. Dermoscopy can narrow the possibilities, but blood tests or a small scalp sample may sometimes be considered when the appearance remains unclear.

Ask which magnified features were seen, whether they suggest current activity or regrowth, and whether the scalp shows evidence of scarring. You can also ask how progress will be documented, which diagnosis alternatives remain, and what change should prompt an earlier follow-up.