Hair loss consultation preparation guide: get ready
A useful hair loss consultation begins with a timeline, not a sales pitch. The clinician needs to know what changed, when it changed and what was happening with your health, medicines and hair care before the loss became visible.
You do not need to diagnose yourself or arrange every possible blood test. Bring accurate information, arrive with the scalp visible and write down the questions you want answered. The clinician's job is to connect that information with the examination.
What to bring
- A short timeline of when the change began and how it progressed
- A complete list of prescription medicines, over-the-counter products and supplements
- Relevant diagnoses, operations, recent illness and allergies
- Family history of scalp or eyebrow hair loss
- Details of major weight change, restrictive dieting or significant stress
- Recent blood results you already have
- Monthly photographs taken under consistent conditions
- Details of previous hair-loss treatments, doses, dates and side effects
- Information about chemical processing, extensions or tight hairstyles
- A written list of questions
Use exact medicine and supplement names where possible. “A vitamin” is less useful than the product, strength and frequency. If a medicine changed near the time shedding began, record both the start date and the date on which hair loss became noticeable.
Build a six-to-twelve-month timeline
Hair loss can appear weeks or months after a trigger. Record significant illness, surgery, fever, pregnancy, major emotional stress, rapid weight loss, dietary restriction and medicine changes from the preceding year. The event may be unrelated, but leaving it out can hide a useful clue.
Describe the pattern rather than only saying that “a lot” is falling out. Note whether loss is diffuse, patchy, focused at the temples, centred on the crown, widening a parting or affecting brows, beard or body hair. Record itching, burning, pain, scale, redness, pustules or a shiny area of skin.
Do not count every shed hair. Hair length and wash frequency make counts unreliable. A short dated record of wash-day shedding and monthly photographs is usually more practical.
Take photographs that can be compared
- Photograph dry hair before applying fibres, concealer or styling product.
- Use the same room, lighting and camera distance each month.
- Take the front, both temples, top, crown and donor area.
- Keep the parting and hairstyle consistent.
- Do not use filters, portrait blur or edited contrast.
Older photographs from before the change are useful even when the lighting is imperfect. Bring them alongside, not instead of, a consistent new baseline.
Prepare the hair and scalp for an in-person examination
Follow any instructions given by the clinic. Unless told otherwise, wash normally and attend with dry hair. Avoid heavy oils, fibres, sprays and concealers that cover the scalp or glue hairs together. Do not create soreness by scrubbing aggressively on the morning of the appointment.
Wear the hair in its usual style so the clinician understands what you see day to day, but be prepared to move or part it for examination. If extensions, a hair system or a tightly fixed style cannot be removed, tell the clinic beforehand because the scalp and donor area may not be fully assessable.
What happens during the consultation?
The clinician usually starts with the history, then examines the pattern, scalp skin, hair calibre and areas of breakage or inflammation. Magnification may help identify miniaturisation, variation in shaft diameter, broken hairs, scale and follicle openings.
Blood tests are selected when the history or pattern suggests a medical cause. Iron studies, thyroid function or other tests may be appropriate for some patients, but arranging them without clinical direction can waste time and money. The NHS advises seeing a GP to understand the cause of hair loss before approaching a commercial clinic.
If surgery is being considered, the assessment also covers donor density, hair calibre, scalp laxity where relevant, likely graft requirements and the pattern that future loss may follow. A stage number or photograph alone cannot establish surgical suitability.
Questions worth asking
About the diagnosis
- What diagnosis best fits the pattern and history?
- Are there signs of inflammation, infection or scarring?
- Do I need GP or dermatology review before cosmetic treatment?
- Would any targeted tests change the plan?
About treatment
- What is the aim: stopping inflammation, reducing shedding, protecting native hair or adding coverage?
- What evidence supports the option being recommended?
- What side effects, contraindications and monitoring apply?
- How long should treatment be used before a fair review?
- What happens if I stop?
About surgery
- Why is surgery suitable now, and what are the non-surgical alternatives?
- Who will perform extraction, recipient-site creation and graft placement?
- How was the graft range estimated?
- How has future loss and the finite donor supply been allowed for?
- What complications, scars, aftercare and follow-up should I expect?
- What is included in the written price?
The GMC's cosmetic interventions guidance requires doctors to discuss outcomes, benefits and risks, obtain consent themselves and give patients time to reflect. A consultation is not informed consent when the risks, alternatives or person performing the procedure remain unclear.
Treatments that may be discussed
Minoxidil and finasteride
Topical minoxidil is available in licensed products for pattern hair loss. Finasteride is prescription-only and licensed for male pattern hair loss. Neither works for everyone, and benefit generally depends on continued use.
Finasteride requires a clear discussion of sexual and psychiatric side effects. The MHRA safety warning says men taking finasteride 1 mg for hair loss should stop and seek medical advice if depression or suicidal thoughts develop. Anyone at immediate risk should call 999.
PRP and scalp micropigmentation
PRP uses a processed concentration of the patient's own platelets and is offered privately. Evidence and protocols vary, so it should be described as an optional supporting treatment rather than guaranteed regrowth. Scalp micropigmentation creates the visual impression of closely cut hair or reduced contrast; it does not grow hair.
FUE, FUT and DHI
FUE removes individual follicular units. FUT removes a donor strip that is dissected into grafts. DHI generally refers to graft placement with an implanter after donor follicles have been obtained; it is not a separate diagnosis or cure. The clinic's FUE and DHI pages explain the terminology.
Surgery may address the hairline, temples, mid-scalp, crown, beard or eyebrows when the diagnosis and donor supply make it appropriate. The clinic's eyebrow-transplant page explains the additional direction and grooming considerations for brow grafts.
After the appointment
Write down the working diagnosis, proposed treatment, dose or procedure, review date and symptoms that should prompt earlier contact. Ask for written information when a prescription or procedure has material risks.
Continue monthly photographs and take medicines exactly as prescribed. Do not add several new products at the same time; it becomes difficult to identify which caused benefit or irritation. Seek prompt medical advice for sudden new patches, scalp pain, marked redness, burning, pustules or rapidly increasing loss.
Check the named doctor on the GMC register and the treating provider and operating location with the regulator for the country where surgery will take place. In England, check the CQC.
Consultations with Dr Harpreet Kalra
Dr Harpreet Kalra's consultation begins with the diagnosis, pattern and likely progression before a transplant is discussed. For surgical planning, he assesses the recipient area alongside donor density and the amount of hair that may need to be reserved for future loss.
Online consultation is useful for an initial history and photographic review, but some findings and donor measurements require an in-person examination. You can request a consultation and bring the checklist above.
Clinical sources
- NHS: Hair loss
- NHS: Hair transplant
- GMC: Cosmetic interventions guidance
- MHRA: Finasteride safety warning
This guide is general preparation information. Follow the instructions of the clinician or clinic arranging your appointment.
Dr Harpreet Kalra is a GP and hair-transplant surgeon at Manchester Hair Transplant Clinic. His consultations examine the diagnosis, donor area and likely future pattern before treatment is planned.
Speak with the Manchester clinic
Manchester Hair Transplant Clinic is at 82 King Street, Manchester, M2 4WQ. Arrange a consultation or call 0161 410 0113. Confirm your appointment location before travelling.
