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Prof. Lidia Rudnicka: Every case of baldness requires a doctor's consultation

MedExpress Team

Medexpress

Published June 6, 2025 07:40

Every case of alopecia requires diagnosis by a dermatologist, because it is a medical symptom of more than 500 different diseases and always has a cause, often systemic: genetic, hormonal, inflammatory, cancerous, drug-induced or other.
Prof. Lidia Rudnicka: Every case of baldness requires a doctor's consultation - Header image
Fot. Getty Images/iStockphoto

Misdiagnosis or too late diagnosis of the cause of baldness can cause irreversible hair loss and even be life-threatening especially when it is a symptom of a serious systemic disease. That's why it's important to see a dermatologist at the very first signs of baldness. Only a doctor has the tools and knowledge necessary to take a medical history, perform a medical examination, perform diagnostic procedures
(including biopsies, for example) and order additional tests

If baldness is a symptom of a disease unrelated to dermatology (e.g.: cancer, leukemia, thyroid disease, parathyroid disease, diabetes, gastrointestinal bleeding, anemia, malabsorption), the dermatologist will refer the patient to the appropriate specialist.

If alopecia is a symptom of a dermatological disease, such as: androgenetic alopecia, alopecia areata, follicular lichen planus, lupus erythematosus, alopecia folliculitis, etc., then only a doctor has the knowledge of the efficacy and safety of the drugs used in these diseases and the authority to prescribe these drugs.

Baldness is therefore a complex diagnostic and therapeutic task for doctors. It is definitely not just an aesthetic problem. Supplementation, especially with the ever so popular biotin, is not enough. Especially since, according to the FDA, the use of biotin for "hair loss" without a proven deficiency is a mistake. This is because biotin adulterates the results of certain laboratory tests, such as: for hyperthyroidism, cortisol, parathormone or testosterone. It also alters the result of a pregnancy test or a troponin test used in the diagnosis of a heart attack, which can be very dangerous for the patient.

Trichology (tricho-hair , logia - science) is a branch of science within dermatology. In Poland, non-dermatologists ( including so-called "trichologists") are sometimes in the business of diagnosing and treating diseases that involve alopecia, which can be very dangerous to health and life. It should be noted that even some universities train "clinical/medical trichologists" who are not doctors, giving the impression of acquiring competence in dermatological diagnosis and treatment (i.e., skills that a doctor acquires after a total of more than 12 years of study and exams). Some people with such a "professional title" have a very good understanding of the boundary between aesthetics and medicine and do valuable work in caring for the appearance of hair shafts, but unfortunately sometimes such an understanding of the limitations of their own skills is not present. Anyone with a hair loss problem should verify that the specialist they go to is a doctor. This can be done online at the Central Register of Doctors.

In summary, only dermatologists have the diagnostic tools and medical expertise to correctly identify the cause of alopecia and decide on the appropriate treatment. For many scalp diseases, there are new, effective drugs available only by prescription, such as JAK inhibitors in alopecia areata or new drugs used in androgenetic alopecia.
From the point of view of the patient's health, it is important to make a quick and correct diagnosis and undertake treatment without undue delay.

Prof. Lidia Rudnicka
Organizer of the EHRS Congress in Warsaw May 29 -31, 2025
President of the Hair Dermatology Society
https://www.youtube.com/c/profLidiaRudnicka/videos

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