Hair and Scalp Diagnosis Consult: Preparation Checklist that Improves Accuracy

Disclaimer: This article is for general information only and is not medical advice. Always speak with your own clinician for personalized guidance.

How do I prepare so my dermatologist gets a clear, accurate scalp exam?

You deserve an appointment that feels calm, thorough, and useful. This step-by-step guide shows you exactly how to prepare for a hair and scalp diagnosis consult. Think of it as a friendly pre-visit game plan from a dermatologist who wants you to feel heard, comfortable, and confident.

What will your clinician look for during a scalp consult?

Clinicians assess your symptoms, your routines, and the skin and hair themselves. They may use trichoscopy, which is a painless magnified exam that helps diagnose many hair and scalp diseases without a biopsy.³ Trichoscopy can reveal clues about dandruff, scalp psoriasis, alopecia areata, and scarring hair loss that are not obvious to the naked eye.³

Seborrheic dermatitis, the medical term for chronic dandruff with redness and flaking, affects an estimated 5.64% of adults worldwide, which is one reason many visits focus on itch and flakes.⁴

Step 1: Capture your story in 10 minutes

Write a brief symptom timeline. Subject, verb, object. Keep it simple.

• Symptoms started in March. Itch is worse at night. Flakes appear after shampooing.

• Triggers you notice: fragrance, wool hats, stress, dry heated air.

• What you tried and how it went: coal tar shampoo helped for two days, scalp oil burned.

Why it helps: A structured timeline speeds up accurate diagnosis and reduces guesswork. Bring it in print or on your phone. The National Eczema Association recommends preparing a short history and medication list for dermatology visits.⁷

Step 2: Make a clean, complete medication and product list

List every medication and supplement. Include prescription topicals, over-the-counter creams, oral meds, vitamins, herbal products, and recent injections. The American Academy of Dermatology urges patients to document all medications and supplements before appointments.¹

Photograph your products and ingredient labels. Shampoos, conditioners, leave-ins, oils, dry shampoos, gels, mousses, pomades, edge control, tonics, dyes, scalp serums, and devices all count. If you forget the bottle, a clear label photo works. A Canadian patient group specifically encourages bringing the actual medicines or good photos so your dermatologist can see usage and amounts.⁹

Why it matters for sensitive scalps: Up to 4.5% of the general adult population is allergic to fragrance mix ingredients, and 20 to 25% of patch-tested patients show fragrance allergy.⁵ Recent patch-test data continue to track shifting sensitizers, so exact names on labels are essential.⁶

Step 3: Prepare your scalp and hair for a clear exam

Arrive with clean, dry, detangled hair. If possible, shampoo the day before. Do not apply heavy styling products on the day of your visit. Heavy hairspray, powders, and fibers can obscure scale and follicles during a scalp check. A large health system notes that hair sprays and scalp powders make thorough scalp examination harder.¹⁰

Skip makeup and nail polish. Dermatologists need to see bare skin and nails. The AAD advises avoiding makeup, nail polish, and heavy moisturizers before dermatology visits.² This applies to the scalp line, eyebrows, and ears too.

If you must treat a flare before the visit, take photos first. Life happens. If you need to use a steroid, antifungal, or antibiotic before you can be seen, photograph the rash or scale first. This preserves visual clues if treatment calms the skin.

Step 4: Take helpful photos if the problem comes and goes

Use simple rules for clear images:

• Good daylight near a window or a bright bathroom light.

• Neutral background. Part hair to show scalp.

• Take a close, a mid, and a context shot.

• Include a coin or comb tooth for scale.

The American Academy of Dermatology provides specific guidance on taking well-lit, makeup-free photos that clearly show the area for evaluation, especially for teledermatology.¹

Step 5: Bring previous test results and a short question list

Collect prior results: Past biopsies, fungal cultures, hormone or thyroid labs, ferritin or iron studies, vitamin D and B12 levels, autoimmune work-ups, or previous diagnoses help your clinician avoid repeating tests. The National Eczema Association recommends bringing prior results and an updated list of therapies tried.⁷

Write 3 to 5 questions you want answered:

• What is my working diagnosis and what else are you considering?

• What is the plan if the first treatment does not help in four weeks?

• Which shampoo and leave-in should I use today and how often?

• When should I schedule a follow-up and what changes would prompt a sooner visit?

Short lists keep the visit focused and make sure you leave with a clear plan.

Step 6: Know what will happen during the exam

History and scalp exam. Expect questions about timing, itch, pain, shedding, hairstyles, chemical treatments, and new products. A visual exam may include trichoscopy. Trichoscopy is noninvasive and low cost, and it helps diagnose most hair and scalp diseases with high yield.³

Common diagnoses and first steps: For many with scalp redness and flaking, a dandruff shampoo is the first-line treatment and may be all that is needed for mild to moderate seborrheic dermatitis.⁸ For others, the plan may include antifungal washes, anti-inflammatory lotions, or short courses of medicated solutions designed for the scalp.

If contact allergy is suspected: Your clinician may discuss patch testing. Fragrance mix, linalool and limonene hydroperoxides, and certain preservatives are frequent culprits, which is why label photos matter.⁵ ⁶

Step 7: Pack a small visit kit so you feel comfortable

• Hair clips or soft scrunchies to section hair during the exam.

• A gentle brush or comb if the exam changes your part.

• A list of your current hair routine in order.

• A small notebook or notes app to record instructions.

These simple items reduce stress and help you leave with clear next steps.

Step 8: Choose gentle at-home care before and after your visit

Fragrance-free basics: Many sensitive scalps improve when you reduce potential irritants and allergens in your wash routine. If you are looking for a fragrance-free option, consider The Better Scalp Company Sensitive Scalp Shampoo and Sensitive Scalp Conditioner. Use them as your baseline between medicated washes unless your clinician advises otherwise.

Medicated shampoos wisely: If your clinician suspects seborrheic dermatitis, they may recommend rotating medicated dandruff shampoos that contain zinc pyrithione, selenium sulfide, ketoconazole, or salicylic acid. The AAD notes that dandruff shampoos can treat mild to moderate scalp seborrheic dermatitis, sometimes as the only therapy needed.⁸

Styling with care: Avoid tight hairstyles, high heat, and heavy resins during active flares. If you use camouflage fibers or powders, wash them out before follow-up exams to keep the scalp easy to evaluate.¹⁰

Step 9: Plan your next steps and follow-up

Make a follow-up plan before you leave:

• How long to try the regimen before reassessing.

• What improvement looks like. For example, 50% less flaking or itch within four weeks.

• Which signs mean you should contact the clinic sooner. For example, pain, pus, or rapidly spreading hair loss.

Track changes: Use a simple weekly note or two photos per week with the same lighting and parting. Consistent documentation helps your clinician fine-tune the plan quickly.

Step 10: Your quick checklist to print or save

One week before:

• Write your symptom timeline and triggers.

• List every medication and supplement.¹ ⁷

• Photograph product labels and past prescriptions.⁹

Two days before:

• Wash hair and let it dry naturally.

• Pause heavy styling products until after the visit.¹⁰

• Gather prior labs or biopsy reports.⁷

Day of visit:

• Do not wear makeup or nail polish.²

• Bring your visit kit and questions.

• Bring or upload photos of flares and products.¹ ⁹

After the visit:

• Start the agreed regimen.

• Use a gentle baseline wash like The Better Scalp Company Sensitive Scalp Shampoo and Sensitive Scalp Conditioner unless instructed otherwise.

• Set a reminder for follow-up photos and the next appointment.

Gentle myths and truths for sensitive scalps

If it burns, it means it is working. No. Stinging or burning can signal irritation or allergy, especially with fragrance or preservatives. Fragrance allergy is not rare and deserves attention.⁵

Dandruff means poor hygiene. No. Seborrheic dermatitis is an inflammatory condition that often benefits from medicated shampoos and routine care, not scrubbing harder.⁸

Trichoscopy hurts. No. Trichoscopy uses a light and magnifier to look at scalp and hair patterns. It is painless and often avoids a biopsy.³

When to seek care sooner

Book or message your clinic promptly if you develop scalp pain, pus, rapidly expanding bald patches, hair that breaks off at the roots, fevers, or a new rash that spreads quickly. Early evaluation protects hair follicles and reduces scarring risk.

Encouragement for the road

You are not alone if you feel frustrated by itchy, flaky, sore, or reactive skin. Many people carry similar stories, and there are clear, gentle steps to help. Good preparation turns one appointment into a plan that respects your skin, your schedule, and your peace of mind.

Glossary

Trichoscopy: A close-up exam of the scalp and hair using a dermatoscope to identify diagnostic patterns without a biopsy.

Seborrheic dermatitis: An inflammatory condition causing redness and flaking on oily areas such as the scalp and face.

Contact allergy: A delayed immune reaction to a substance touching the skin, often fragrances or preservatives.

Patch testing: Applying small amounts of allergens to the skin for 48 hours to identify contact allergies.

Fragrance-free: Products formulated without added perfumes. Still verify ingredient lists for botanical extracts that can act as fragrances.

Medicated shampoo rotation: Alternating active ingredients across the week to reduce yeast, scale, and itch while limiting irritation.

Non-scarring alopecia: Hair loss where follicles remain intact and regrowth is possible.

Scarring alopecia: Hair loss where inflammation destroys follicles. Early diagnosis is critical to preserve hair.

Emollient: A moisturizing agent that softens and soothes skin.

Trigger diary: A simple log of exposures or events that precede flares, used to spot patterns.

Claims Registry

Citation #	Claim(s) supported	Source title + authors + year + venue	Accessed date (America/Toronto)	Anchor extract	Notes
1	AAD provides guidance for taking clear, well-lit skin photos and removing makeup or nail polish for teledermatology.	How to take pictures of your skin for your dermatologist. American Academy of Dermatology. 2023. Web.	2025-11-20	“These five steps can help you take pictures… Remove any makeup or nail polish…”	Authoritative patient guidance from AAD.
2	AAD advises not to wear makeup, nail polish, or heavy moisturizers so clinicians can see skin and nails.	How to select a dermatologist. American Academy of Dermatology. 2022. Web.	2025-11-20	“Do not wear makeup, nail polish, heavy amounts of moisturizer…”	AAD public education page.
3	Trichoscopy is a noninvasive, low-cost technique helpful in diagnosing most hair and scalp diseases.	Trichoscopy. DermNet NZ. Year not stated. Web.	2025-11-20	“Trichoscopy represents a valuable, non-invasive and low-cost technique… diagnosis of most hair and scalp diseases.”	DermNet is a respected dermatology reference.
4	Adult seborrheic dermatitis prevalence about 5.64% globally.	Global Prevalence of Seborrheic Dermatitis. Polaskey MT et al. 2024. JAMA Dermatology.	2025-11-20	“The seborrheic dermatitis prevalence in adults… 5.64%.”	High-quality peer-reviewed meta-analysis.
5	Up to 4.5% of adults have fragrance allergy. Rates reach 20 to 25% in patch-tested populations.	Fragrances: Contact Allergy and Other Adverse Effects. de Groot AC. 2020. American Contact Dermatitis Society monograph.	2025-11-20	“In the general adult population, up to 4.5%… in consecutive patients patch tested… 20% to 25%.”	Standard reference in contact dermatitis.
6	Recent NACDG data track contemporary patch-test results and common allergens.	North American Contact Dermatitis Group Patch Test Results 2021–2022. Houle MC et al. 2024. PubMed record.	2025-11-20	“This study documents the NACDG patch testing results from 2021 to 2022.”	Premier surveillance dataset for North America.
7	Patient prep with brief history, medication list, and prior results is recommended for dermatology visits.	How to Prepare for Your Doctor Appointment. National Eczema Association. Web.	2025-11-20	“Prepare a brief history… make a list of all your current and previous medications… Provide previous biopsy and lab work results.”	Patient-focused nonprofit with clinical advisory.
8	Dandruff shampoo can treat mild to moderate scalp seborrheic dermatitis and may be sufficient for some.	Seborrheic dermatitis: Diagnosis and treatment. AAD. 2024. Web.	2025-11-20	“A dandruff shampoo can treat mild to moderate seborrheic dermatitis… for some people, that may be all the treatment they need.”	AAD treatment guidance.
9	Bringing actual medicines or clear photos helps dermatologists assess usage and details.	You and Your Derm. Canadian Skin Patient Alliance. 2023. PDF.	2025-11-20	“Please bring your medicines or a good quality photo of them…”	Patient advocacy group with clinician input.
10	Heavy hairspray and scalp powders can hinder thorough scalp examination.	How To Prep For A Full Body Skin Cancer Exam. Henry Ford Health. 2023. Web.	2025-11-20	“Heavy hairspray makes it difficult to thoroughly check your scalp… scalp powder makes it harder to examine the scalp.”	Large academic health system guidance.