Dermatologist, Hair Specialist, or Surgeon: Optimize Hair Loss Care

Disclaimer: This guide is for general information and is not medical advice. It does not replace an in person evaluation by a qualified clinician.

Which clinician should I see first for itching, shedding, or scarring hair loss?

First, a quick promise

I will help you choose the right professional for your exact scalp or hair concern, so you do not waste time, money, or hope. I will also show you what to bring, what to expect, and what you can try at home while you wait for care.

What is each clinician, exactly?

General dermatologist. A dermatologist is a medical doctor who diagnoses and treats conditions of the skin, hair, and nails. Board-certified dermatologists complete medical school, residency, and rigorous exams to demonstrate competence across these areas.¹²

Hair-focused dermatologist. This is still a board-certified dermatologist, but with extra focus on hair and scalp disorders. Some run dedicated hair loss or scalp disease clinics and use tools like trichoscopy, which is dermoscopy for hair and scalp, to map patterns and decide on tests. Trichoscopy is now considered a core diagnostic tool in alopecia care.⁷

Hair transplant surgeon. This is a physician trained and qualified to perform hair restoration surgery. Professional societies advise that only licensed physicians with appropriate training perform the incision and other surgical steps of hair restoration.¹⁰

Trichologist. Trichologists are hair and scalp practitioners who are not medical doctors. They can advise on gentle routines and hair care but cannot diagnose medical disease, order prescriptions, or perform medical procedures. If a trichologist suspects disease, they should direct you to a physician.

Who should I see first for my symptoms?

What is the fastest safe starting point?

Start with a board-certified dermatologist for any new, worsening, painful, or scarring scalp or hair change. Dermatologists evaluate medical causes, perform tests, and begin treatment when timing matters for regrowth.¹²

When do I choose a hair-focused dermatologist?

Choose a hair-focused dermatologist when you notice patterned thinning, chronic shedding, scalp tenderness, patchy loss, or when first-line treatments have not worked. Trichoscopy findings, standardized photos, and targeted tests can shorten the path to the right plan.⁷

When do I go straight to a surgeon?

Go straight to a hair restoration surgeon when you already have a medical diagnosis of stable pattern hair loss and you want to explore surgical density restoration. A surgeon still screens for active disease and builds a long-term plan that includes medical therapy before and after surgery. Professional guidance is clear that hair restoration surgery belongs in trained physician hands.¹⁰

How common are these problems?

Pattern hair loss, also called androgenetic alopecia, affects an estimated 50 million men and 30 million women in the United States.³ Alopecia areata, an autoimmune type, affects roughly 0.2 percent of insured adults at a given time in large U.S. datasets.⁴ These numbers explain why you see so many products, and why a precise diagnosis matters.³⁴

Comparison table: who does what, and when

Your situation	Best first stop	Key reasons	Typical tests or tools	First-line treatments	When a surgeon becomes relevant
New patch of smooth bare skin, eyebrows or beard involved	Dermatologist or hair-focused dermatologist	Autoimmune alopecia areata is common and treatable	Scalp exam, trichoscopy; sometimes blood tests	Corticosteroids, immunotherapy; for severe disease, FDA-approved baricitinib for adults	Surgery is not first-line for active areata. Medical control comes first
Gradual widening part or receding temples with family history	Hair-focused dermatologist	Androgenetic alopecia is highly prevalent and responds best to early treatment³	Trichoscopy, baseline photos	Minoxidil, finasteride for eligible men. Routine care plan⁸¹¹	Consider surgery after medical therapy stabilizes loss. Only with trained physician¹⁰
Burning scalp, scale, or pustules with broken hairs	Dermatologist	Possible infection or inflammatory scarring needs urgent care	KOH microscopy, cultures, trichoscopy	Antifungals, antibiotics, anti-inflammatories	Surgery only after disease is quiet and scarring is stable
Years of shedding after illness, stress, or childbirth	Dermatologist	Telogen effluvium usually self-limited once triggers addressed	History, exam, trichoscopy	Time, nutrition review, gentle care. Sometimes minoxidil	Surgery is not helpful for temporary shedding
Unclear diagnosis after first visit	Hair-focused dermatologist	Advanced tools and pattern analysis improve accuracy⁷	Trichoscopy, targeted labs, possible biopsy	Tailored medical plan	Surgery only after diagnosis and stability are confirmed
You want density in a stable area despite good medical care	Hair transplant surgeon	Surgical redistribution can improve coverage	Surgical planning, donor assessment	Pre and post op medical therapy	Physician performed procedure with informed expectations¹⁰

How does the diagnostic workflow actually look?

Dermatologist evaluates. We start with history, examine your scalp, and use trichoscopy to see miniaturization, broken hairs, exclamation point hairs, and scale patterns that differentiate common diagnoses. Trichoscopy is now second only to cancer work in dermoscopy’s clinical impact, which is why many clinics use it routinely.⁷

We test when the diagnosis is unclear. A scalp biopsy answers whether loss is scarring or non scarring and narrows the cause. Expert guidance recommends doing a 4 mm punch biopsy, often sectioned horizontally, when diagnosis is in doubt.⁶

We treat and then measure. We begin evidence based therapy, document photos, and reassess shedding, density, and symptoms at set intervals so you see progress or we pivot quickly.

What treatments belong with which clinician?

Medical therapies most people hear about

• Minoxidil topical. Minoxidil foam or solution is FDA approved for androgenetic alopecia and can help men and women increase hair growth.⁸

• Finasteride oral for men. Finasteride 1 mg is FDA approved for male pattern hair loss. Clinicians screen for side effects and set expectations.¹¹

• Baricitinib for severe alopecia areata in adults. This oral JAK inhibitor is FDA approved for severe alopecia areata in adults and is managed by dermatology with safety monitoring.⁵

In office options you may be offered

• Platelet rich plasma. Meta analysis data show PRP can increase hair density in androgenetic alopecia, although protocols vary.⁹

• Injections and targeted therapies. Corticosteroid injections for alopecia areata or inflammatory scalp disease are office procedures guided by diagnosis.

When surgery makes sense

• Hair transplantation. Appropriately trained physicians assess donor supply, pattern stability, and goals, and they perform key surgical steps. The professional standard is that physicians, not unqualified personnel, perform incisions and surgical components.¹⁰

Safety notes you deserve to know

Compounded topical finasteride is not FDA approved. The FDA has warned of serious potential risks with compounded topical finasteride products marketed online, including sexual and mood side effects similar to the oral form. These compounded combinations, including finasteride with minoxidil, do not have FDA approved labeling.¹²

Biopsy is small but important. A small 4 mm punch can prevent months of trial and error by confirming scarring conditions early, which changes treatment and protects remaining follicles.⁶

PRP is not one size fits all. Results vary with technique, dosing, and your underlying diagnosis. Discuss expectations before starting.⁹

Gentle at home care while you seek an appointment

• Use a fragrance free shampoo and conditioner to reduce irritation. The Better Scalp Company Sensitive Scalp Shampoo and Sensitive Scalp Conditioner are designed for reactive scalps and pair well with medical plans.

• Avoid tight styles and harsh treatments. Give breakage a chance to improve.

• Photograph your part, temples, and crown monthly in the same lighting so you and your clinician can measure change.

• Bring a list of all products and supplements to your visit. This shortens the path to a clear plan.

What to bring and what to expect at each visit

Dermatologist or hair focused dermatologist

• Bring symptom timeline, photos, medication list, and family history.

• Expect a scalp exam, trichoscopy, and a plan that may include labs or biopsy if needed.⁶⁷

• Ask how to monitor progress and when to follow up.

Hair transplant surgeon

• Bring your diagnosis, treatment history, and stabilization steps you already take.

• Expect donor density measurement, hairline planning, and a discussion of medical maintenance before and after surgery. Only trained physicians should perform surgical steps.¹⁰

Quick decision guide

• Choose a dermatologist for anything new, painful, scarring, or unclear.¹²

• Choose a hair focused dermatologist for persistent or patterned loss, or when first steps fail. Trichoscopy speeds clarity.⁷

• Choose a surgeon when your diagnosis is stable and you want density improvement with a physician performed procedure.¹⁰

FAQs in plain language

Is pattern hair loss really that common? Yes. Tens of millions of Americans live with it, and early treatment preserves more hair.³

Do I always need a biopsy? No. But when the diagnosis is uncertain, a 4 mm punch biopsy can save time and hair.⁶

Is PRP right for me? It can help some people with pattern hair loss. Evidence shows gains in density, but techniques differ and expectations should be realistic.⁹

Can a trichologist manage medical disease? No. They can support gentle care, but only physicians diagnose and prescribe.

Encouragement you can keep

You are not behind. The right clinician and an evidence based plan will meet you where you are. Early evaluation protects follicles, and compassionate care protects peace of mind. If you are unsure where to start, book the first available appointment with a board certified dermatologist and bring this guide.¹²

Glossary

• Androgenetic alopecia: Pattern hair loss due to genetic and hormonal factors.

• Alopecia areata: Autoimmune hair loss that causes round patches or total loss.

• Board certified dermatologist: A physician who passed specialty exams and maintains ongoing certification in dermatology.²

• Trichoscopy: Dermoscopy applied to hair and scalp to visualize diagnostic patterns.⁷

• Scalp biopsy: A small 4 mm punch of skin to diagnose hair disorders under the microscope.⁶

• PRP: Platelet rich plasma, a concentration of your platelets injected into the scalp to stimulate growth.⁹

• Hair transplant: Surgical redistribution of hair follicles from donor to thinning areas.¹⁰

• Minoxidil: Topical medication that promotes hair growth, FDA approved for pattern loss.⁸

• Finasteride: Oral medication for male pattern hair loss, FDA approved at 1 mg.¹¹

• Baricitinib: Oral JAK inhibitor FDA approved for severe alopecia areata in adults.⁵

Claims Registry

Citation #	Claim(s) supported	Source title + authors + year + venue	Accessed date (America/New_York)	Anchor extract	Notes
1	A dermatologist is a medical doctor who treats skin, hair, and nails.	What is a dermatologist? American Academy of Dermatology, 2022	2025 12 02	A dermatologist is a medical doctor who specializes in treating the skin, hair, and nails.	Authoritative public explainer from AAD.
2	Board certification affirms high standards and lifelong learning.	American Board of Dermatology. What does it mean to be Board Certified, 2024	2025 12 02	Certification by the American Board of Dermatology affirms knowledge, experience, and lifelong learning.	Primary certifying body statement.
3	Pattern hair loss affects about 50M men and 30M women in the U.S.	MedlinePlus Genetics. Androgenetic alopecia, 2023	2025 12 02	Androgenetic alopecia affects an estimated 50 million men and 30 million women in the United States.	NIH hosted consumer genetics reference.
4	Alopecia areata prevalence about 0.2 percent in a large U.S. population.	Mostaghimi A. Trends in Prevalence and Incidence of Alopecia Areata. 2023. JAMA Network Open	2025 12 02	Prevalence was 0.199 percent to 0.222 percent.	Peer reviewed large cohort analysis.
5	Baricitinib is FDA approved for severe alopecia areata in adults.	OLUMIANT baricitinib label. FDA, 2022	2025 12 02	OLUMIANT is indicated for the treatment of adult patients with severe alopecia areata.	Official FDA label.
6	A biopsy should be performed when diagnosis is in doubt. 4 mm punch.	The role of the scalp biopsy in the evaluation of alopecia. JAAD, 2023	2025 12 02	A biopsy should be performed whenever the diagnosis is in doubt. A 4 mm punch biopsy is best.	Specialty journal guidance.
7	Trichoscopy has become a key diagnostic tool in alopecia care.	Three Step Diagnostic Algorithm for Alopecia. Katoulis AC, 2025. Journal of Clinical Medicine	2025 12 02	Trichoscopy has emerged as a significant application of dermoscopy, second in importance only to dermato oncology.	Recent peer reviewed review.
8	Topical minoxidil is FDA approved for pattern hair loss in men and women.	Minoxidil. A comprehensive review. Gupta AK, 2022	2025 12 02	Topical minoxidil is FDA approved for androgenetic alopecia in men and women.	Scholarly review summarizing FDA status.
9	PRP increases hair density in AGA in meta analysis.	Platelet Rich Plasma for Androgenetic Alopecia. Zhang XX, 2023	2025 12 02	PRP increased hair density at 3 and 6 months compared with placebo.	Meta analysis across randomized studies.
10	Hair restoration surgery should be performed by trained physicians.	ISHRS Position Statement on Qualifications for Scalp Surgery, 2017	2025 12 02	Physicians who perform hair restoration surgery must possess the education and training.	Global specialty society guidance.
11	Finasteride 1 mg is FDA approved for male pattern hair loss.	Finasteride. StatPearls. 2024	2025 12 02	In 1997, finasteride received approval to treat male pattern hair loss at 1 mg.	Evidence review with regulatory history.
12	FDA warns of risks with compounded topical finasteride and notes lack of FDA approved labeling.	FDA alert on compounded topical finasteride, 2025	2025 12 02	Currently, there is no FDA approved topical finasteride. Potential serious risks associated.	Primary federal safety communication.