What does trichoscopy show in alopecia areata?

A clinician uses a handheld or camera-based dermatoscope to inspect follicle openings, hair shafts, short broken hairs, and regrowth patterns that are difficult to see unaided. Findings are interpreted with the history and ordinary scalp examination rather than in isolation.

Features that may support alopecia areata include yellow dots at follicle openings, very short dark remnants, broken hairs, and hairs that narrow close to the scalp. Short upright or coiled regrowing hairs can indicate recovery. The mixture changes with activity, duration, treatment, and the area examined.

Trichoscopy also helps compare competing explanations for hair loss. Scale around follicles, variation in shaft width, loss of follicle openings, or characteristic breakage can steer the assessment toward inflammatory, inherited, traction-related, infectious, or scarring conditions.

The device is placed on or held just above selected scalp areas. Gel or another contact fluid may be used, and images may be stored to compare later visits. The examination does not remove hair and usually fits within a dermatology appointment.

Before attending, avoid applying heavy fibres, coloured scalp sprays, or thick oils unless the clinic advises otherwise, because residue can obscure detail. Tell the clinician about recent hair dye, scalp medicines, washing, itching, and treatments, since these can influence what is visible.

No single trichoscopy sign proves alopecia areata in every case. If the pattern is unclear, the dermatologist may examine other body sites, check hair pull findings, request tests guided by the history, or occasionally consider a scalp biopsy.

Seek an earlier review if hair loss is spreading quickly or comes with pain, pronounced redness, heavy scaling, crusts, pus, or smooth shiny areas. Eyebrow or eyelash loss also merits assessment because protection of the eyes and sensitive skin may need attention.

Ask which magnified features were present, whether they suggest active shedding or regrowth, and what other diagnoses remain possible. Find out whether photographs will be compared over time and which clinical change, rather than image detail alone, would alter treatment.