5 questions for your doctor

A two-month wait, a few minutes of examination, and there you are back on the pavement. That’s when the questions come: will it grow back? How long should I give this treatment? On a forum, one young man describes exactly that¹.

Testimonials posted on the HairLossTalk forum¹.

He’s not the only one to leave with questions. A UK survey asked 361 people with alopecia about their appointments².

Zucchelli et al. survey, 2023, 361 people with alopecia in the UK.²

These figures have their limits: participants were recruited through a patient charity, most were women and people with alopecia areata, and the data date from 2019². Still, they show one thing: a short appointment works best for the person who arrives with written questions. Here are five. For which doctor to see about hair loss, there’s a separate article.

1. What type of hair loss is it?

This is the question that shapes all the others. The charity Alopecia UK puts it bluntly: “alopecia” on its own isn’t a proper diagnosis, and you should leave knowing which type you have³. Temporary shedding, pattern hair loss, alopecia areata and scarring alopecia don’t behave the same way and aren’t managed the same way. The AAD warns that without an accurate diagnosis, treatment is often ineffective⁴.

Ask whether any tests are needed, too. For typical pattern hair loss, the French Society of Dermatology (SFD) says no lab test is routinely necessary: the diagnosis is based on examining the scalp⁵. For temporary shedding, a blood test can rule out a thyroid problem or iron deficiency⁶. If you leave with a request for blood tests, ask what they’re looking for.

2. What happens if I do nothing?

The answer changes everything. Temporary shedding usually gets better without treatment, and taking medication doesn’t speed up regrowth⁶. Pattern hair loss, on the other hand, progresses very slowly, over years or even decades, and faster when it starts young⁷. For other types, the main goal is to stop things getting worse: not every type of hair loss can be treated, but a dermatologist may be able to prevent further loss⁴.

This question helps you decide without pressure. Knowing whether your hair can grow back on its own, or not tells you whether you have time on your side.

3. How long before I can judge whether it’s working?

Hair loss treatments are slow. The AAD warns that it can take months before you see results⁴. For pattern hair loss, the BAD says one common treatment needs at least 6 months, possibly up to 12⁷, and the SFD puts the maximum effect at around one year⁵. Some treatments even cause temporary shedding in the first few weeks, which doesn’t mean they’re failing⁷.

So ask when to review it, and what will count as success: shedding that stabilises, or visible regrowth? Alopecia UK advises making sure you understand how long you’ll be trying the treatment for before you leave³.

4. What happens if I stop?

For pattern hair loss, the answer is clear. The BAD points out that all topical and oral treatments only work for as long as you keep using them⁷. The SFD calls them “suspensive”: once you stop, hair loss gradually returns to its natural course⁵.

Better to know before you start. Ask what the treatment involves day to day, for how many years, and what you lose if you take a break.

5. What side effects could I get?

Not “in general”: for you, with your age, your health and your other medicines. No one treatment works for everyone, even two people with the same type of hair loss, and sometimes several need trying⁴. Mention if you’re planning a pregnancy: the SFD notes that one common pattern hair loss treatment must not be used during pregnancy⁵. And note who to contact, and how, if you get a side effect³.

Your doctor can suggest a treatment that suits your situation; these five questions are there so you choose knowing what to expect.

What to bring

A short appointment needs preparing. Alopecia UK suggests jotting down your details beforehand and bringing photos³. Come with:

• when it started, and whether it came on suddenly or gradually: the AAD stresses that your dermatologist needs to know⁴;
• what happened about three months before: giving birth, a fever, surgery, a diet, coming off the pill. That’s the usual gap between a trigger and temporary shedding⁶;
• a list of your medicines, including supplements and vitamins bought over the counter³;
• the products you’ve already tried for hair loss, with dates and what you noticed;
• any hair loss in your family, and autoimmune conditions in close relatives³;
• photos of the changes you’ve noticed³, and your latest blood test results if you have any.

One practical detail: the BAD notes that the pull test, where the doctor gently tugs on a lock of hair, can be falsely reassuring if your hair was washed in the previous 48 hours⁶. When you book, ask whether it’s better to hold off on your next wash.

During and after the appointment

Take notes, or bring someone who can take them for you. Before you leave, repeat back what you’ve understood: Alopecia UK recommends it, to check nothing got lost³. Afterwards, keep a short diary of what happens, for the next appointment³.

Talk about how you’re feeling, too, if your hair loss is getting you down. The BAD says hair loss can affect self-esteem and that it’s worth raising your emotional wellbeing with your healthcare professional, who can offer support⁷. Given how many patients in the UK survey were dissatisfied on this point², it’s best to bring it up yourself.

Photos for question 3

Asking “how long before I can judge?” only makes sense if you can compare. Six months on, the mirror won’t help: the light, the angle and your hairstyle have changed, and your memory of “before” has faded. Two truly comparable photos answer better than an impression.

With Calvap, you take one photo a week of the areas you care about. Your previous photo appears as a see-through overlay so you can line up in the same spot. The journal records when you started a treatment, missed days and changes. At your follow-up, you show the doctor a timeline of dated photos, and you judge together on facts. Your photos stay on your phone.