Insight into the Hair Loss Consultation Process as a Trichologist

An Interview with Dr. David H. Kingsley – President of the World Trichology Society

The National Hair Council asked Dr. Kingsley to share his expertise on what women and men concerned about hair loss need to know, as well as insight into the Hair Loss Consultation Process from a trichology perspective.

1. So Dr. Kingsley, what is trichology and what does a trichologist do?

Trichologists are hair and scalp specialists who look at hair loss problems in a holistic way.

Trichologists are trained in the life sciences and evaluate clients on the basis of personal history, lifestyle, genetic factors, and environmental conditions. With this information, a trichologist can suggest individualised treatments, give nutritional advice, and recommend lifestyle changes to improve the health and appearance of the hair and scalp.

If your hair loss is causing you stress or affecting your quality of life, a trichologist will be able to spend time advising you on how best to cope with your condition as part of the treatment regimen. 
Like other non-physician health specialists, a trichologist should work closely with your medical doctor to find out whether any medical problems are associated with your hair loss, such as thyroid disease or anaemia.

2. At what point should women and men start considering professional help for thinning hair and hair loss?

Usually, most people quickly become aware of their own hair loss; they see more hair shedding or they see more of their scalp, or both. Hair shedding is the amount of hair that falls out during your normal daily lifestyle, such as by combing, brushing, or washing your hair. Hair thinning is less hair density in a particular area of the scalp, such as a wider parting or a receding hairline.

A person should seek professional advice if he or she is noticing either excessive hair loss for more than 2-4 weeks or thinks his or her hair is thinning.

3. In a typical Hair Loss Consultation, what does a trichologist look for, and which methods are used to get answers?

There can be numerous causes of hair loss and the ‘skill’ of the trichologist is to find out which factors are causing each patient’s condition. Finding the causes of any type of hair loss is like solving a jigsaw puzzle, each piece fits together to show the whole picture of why the hair is falling out. Some pieces (such as genetic) are larger, and some (such as certain vitamin deficiencies) are smaller.
For a thorough assessment, a trichologist should spend approximately 60 minutes with each patient, looking at their hair and scalp, taking a full medical/lifestyle history, and suggesting blood tests to be taken at their physician.

When looking at the hair, the trichologist will look at the distribution of any hair thinning (which can often indicate why it is falling out). By comparing the partings at different positions—for instance, the crown area, front area, sides, and back—differences in hair quantity can be seen and the amount of thinning can be determined.

Trichologists often use a magnifying lens or computer microscope to help see how many of the hairs have become finer in diameter, which can also be an indicator of the cause.

Finally, the amount of hair loss can be assessed by pulling at the hair in different places (called “the pull test”), followed by a scalp examination to see whether there is any flaking, itching, redness, acne-like breakouts, or other lesions.

4. What happens at the end of a consultation? What should people expect as a next step after a visit to the specialist?

Sometimes, it is necessary to eliminate one possible cause before moving on to the next. To achieve this it may be necessary to see the patient for a ‘follow-up’ visit as, often, not all the facts can be accumulated during the initial visit.

Once the blood test results are received and the analysis is completed, a treatment regimen that focuses on each of the reasons for the hair loss should be suggested.

As hair loss is often caused by more than one factor, it may be necessary to treat the condition with a multi-faceted approach including, for example, a combination of minoxidil, laser therapy, scalp applications, hair strengtheners and supplements.

5. Is there anything women and men can start doing on their own, as soon as they notice the first signs of hair loss?

Absolutely, I suggest people are pro-active when dealing with their hair loss, and I’m a firm believer that hair loss is best treated from both outside and inside the body.

The first thing is to try and assess if any lifestyle activities can be changed in a positive way. For example, exercising and/or relaxing may help reduce stress influences on the hair, and improving the diet by eating small, regular meals and plenty of protein (the hair contains about 95% protein) may help hair loss caused by poor eating habits.

Secondly, take certain supplements that have been shown to help the hair. One such drug-free supplement that I frequently recommend as part of my treatment regimen is Nourkrin® WOMAN or Nourkrin® MAN ( This OTC supplement has been shown in studies to help regulate and normalise the Hair Growth Cycle.
When using a treatment regimen, it is important to do so for a minimum of 3 to 6 months; as the triggers probably occurred about this length of time before the onset of the hair loss.

– Dr. David H. Kingsley holds a PhD in Hair Loss Research and is globally recognised as a leading expert in the science and practice of hair loss prevention.



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