Atlas of trichoscopy: a patient guide

Trichoscopy, also called scalp dermoscopy, uses magnification and light to examine features that may be difficult to see with the unaided eye. An atlas organises example images of hair shafts, follicle openings, surrounding skin, scale, blood-vessel patterns and changes in hair thickness.

The atlas is a comparison aid, not a diagnosis by itself. Similar-looking findings can occur in different disorders, and image quality, hair products, skin tone, hair colour and the scalp area examined can affect appearance. A clinician interprets the pattern alongside your history, scalp examination and, when appropriate, other tests.

Bring a list of medicines, supplements, recent illnesses, chemical treatments and hairstyles that place tension on the hair. Tell the clinician when shedding or thinning began, whether it is sudden or gradual, and whether relatives have a similar pattern. Photos showing how the area has changed can add useful context.

Follow the clinic's instructions about washing and styling. Unless told otherwise, avoid concealing fibres, heavy oils or coloured scalp sprays on the day because they may obscure the surface. The clinician may photograph several scalp areas so that later images can be compared in a consistent way.

Arrange a medical assessment for sudden or rapidly progressing hair loss, smooth bald patches, broken hairs, persistent scaling, or a scalp that is painful, very itchy or inflamed. Prompt evaluation also matters if the skin looks shiny or scarred, because some inflammatory conditions can damage follicles if they remain active.

Seek urgent care when scalp redness or swelling spreads quickly, pus is present, or scalp symptoms occur with fever or feeling seriously unwell. These features can indicate an infection or another problem that needs timely examination rather than image comparison alone.

Ask which visible features support the working diagnosis, what alternative explanations remain, and whether blood tests, fungal testing or a scalp biopsy would change the plan. You can also ask which scalp location will be photographed again, how treatment response will be judged, and whether your current hair-care practices could affect the findings.