Biopsy
Occasionally the desired results are not achievable due to lack of donor supply. In such cases, we discuss the best possible outcomes achievable and any ways to optimise the native hair growth.,Sometimes a hair transplant is not suitable for you at this time, but requires some preliminary treatments to improve the quality of the native hairs or to stabilise the hair loss and reverse any miniaturised follicles as much as possible. There are a range of treatments that can help with this, namely the following:
A scalp biopsy is a minor diagnostic procedure in which a doctor removes a small sample of scalp — including hair follicles — to find the cause of unexplained or unusual hair loss. Carried out under local anaesthetic in about 15–30 minutes, it is especially useful for telling scarring (cicatricial) and non-scarring alopecias apart, which guides the right treatment.
When it is used
- When the diagnosis is unclear from examination and trichoscopy alone, or when hair loss is patchy, scarring or not responding as expected.
- To distinguish conditions such as female pattern hair loss from chronic telogen effluvium, or to catch a scarring alopecia early.
The procedure
- Technique: A 4 mm punch is the standard, taken deep enough to include the fat layer so the whole follicle is sampled; sometimes two samples are taken.
- Comfort: You feel a pinch as the local anaesthetic goes in; the biopsy itself is not painful.
- Closure: The site may be closed with one or two dissolving stitches.
- Site selection: Trichoscopy helps choose the best spot — the sparsest area in non-scarring loss, or the active edge of a scarring patch.
How the sample is read
- Horizontal sections show follicle counts and the ratio of fine (vellus) to thick (terminal) hairs — useful for pattern hair loss and telogen effluvium.
- Vertical sections show inflammation and the skin layers — useful for scarring alopecias; combining both gives the fullest picture.
Recovery & results
- You can usually return to normal activities the same day, though the scalp may feel tender for a few days.
- Keep the area dry for 24–48 hours and avoid swimming, hot tubs and vigorous exercise for about 5–7 days.
- Pathology results generally take around 1–2 weeks; a small scar may remain but is usually hidden by surrounding hair.
An accurate diagnosis is the foundation of effective treatment — a biopsy is recommended only when it will genuinely confirm or change your care plan.
Alternative Hair Treatments
- Hair loss prevention / stabilisation medications
- Exosomes
- PRP
- LLLT — Laser therapy
- Supplements
- TrichoTest — Fagron