The pictures we see most often
People rarely arrive with a single textbook pattern. A post-partum shed can sit on top of an older family hairline. Heat breakage can hide a thinning vertex. The assessment is how we separate what the fibre is doing from what the follicle is doing. The notes here are a map of the territory, not a substitute for sitting under the camera.
Androgenetic (pattern) thinning
On trichoscopy we look for hairs of mixed calibre in the same field, a falling follicular-unit count toward the vertex or mid-scalp, and a relatively spared occipital control. The cosmetic work is density and calibre tracking over 12 to 24 weeks, barrier care, and in-clinic sessions that the baseline can justify. We cannot reverse a long-established pattern, and we do not promise restoration of a hairline. Medicines that act on this picture belong with a doctor; we will write the images so that conversation is shorter.
Telogen effluvium
The history usually contains a date: illness, surgery, a sharp change in diet, a new medicine, or a period of marked stress some two to three months earlier. The trichoscope may show empty openings and a high shed on the pull of a gentle test, with calibre still relatively even. A phototrichogram is sometimes the cleaner way to read the anagen share. Cosmetic work is gentle, and we wait out the wave rather than inventing aggressive treatment. Loss with systemic symptoms is a GP matter first.
Post-partum shedding
Many people notice a heavier shed between three and six months after birth, when hairs that stayed in anagen during pregnancy enter telogen together. We treat this as a Recovery-length picture once a midwife or GP has no outstanding medical concern. Imaging gives a baseline so that “still shedding” at month seven can be distinguished from a second process. We do not ask anyone to start a 24-week Density block on a scalp that is still emptying a pregnancy wave.
Traction change at the hairline
Tight styles, extensions and daily tension leave a characteristic frontal or temporal recession, often with broken hairs of even calibre and a rim of retained miniaturised follicles. The first cosmetic act is to stop the pull. We document the hairline, settle the skin if it is sore, and write a protocol that does not rely on another tight style to “hide” the change. If we see a scarring edge, we stop and refer.
Seborrhoeic dermatitis and scaling
Yellow or white scale, itch, and perifollicular erythema are the usual trichoscopic cluster. We can lift scale, reset the barrier, and write a shampoo frequency that the scalp will actually tolerate. We cannot treat an infected or eroded field, and we will not keep exfoliating a scalp that needs a medical anti-inflammatory. If the pattern looks more like psoriasis or an untreated infection, the images go to your GP.
Scalp folliculitis
Punctate pustules, crust and tender follicular openings are a reason to pause cosmetic needling and most leave-on actives. We can photograph the field, keep the area clean in a limited way, and write what we see. Active, spreading or painful folliculitis is referred. We will not sell a program across an infection we are not licensed to treat.
Breakage from heat, bleach and chemical services
Broken shafts of irregular length, weathered cuticle and a history of bleach, straightening or high heat point to a fibre problem more than a follicle problem. Density on trichoscopy may be preserved while the pony feels thinner in the hand. The plan is rest from the insult, a short home protocol, and a later image to confirm the follicles were not also changing underneath. We do not colour, tone or reconstruct hair in this clinic.
Menopausal thinning
Calibre drop and a wider part often arrive with other menopausal change. We record the same four markers and write a program only if the picture is stable enough to compare at 12 weeks. Hormone treatment, if it is being considered, is a conversation with your GP. Our job is to keep the cosmetic record honest so that any later medical decision has a before-image.
Sensitive and reactive scalp
Burning, tightness and a low threshold for product are common, and they do not always travel with visible disease. Trichoscopy helps us see whether there is hidden scale or erythema, or whether the skin looks quiet and the problem is load — too many acids, too many fragrance steps, too little interval between washes. We subtract before we add. A reactive scalp that also shows ulceration or marked swelling is referred the same day.
Jinfujeos provides cosmetic trichology services. We do not diagnose medical conditions and do not prescribe medicines. Where findings suggest a medical cause, we recommend review by your GP or a dermatologist.