Hair scalp biopsy, help for diagnosis

During the initial consultation, Dr. Espinosa Custodio performs a comprehensive assessment to determine the type of hair loss affecting each patient and whether they are a suitable candidate for hair transplantation.

In the vast majority of cases, patients are diagnosed with androgenetic alopecia, which can usually be identified through a detailed clinical examination and advanced scalp imaging. However, some patients present with less common forms of hair loss that require additional investigation.

In these situations, Dr. Espinosa Custodio may recommend a scalp biopsy, a procedure that can provide a definitive diagnosis and guide the most appropriate treatment plan.

What is a scalp biopsy?

A scalp biopsy is a minor medical procedure in which a very small sample of scalp tissue is removed for examination under a microscope by a specialist dermatopathology laboratory.

This analysis allows the physician to identify inflammatory, autoimmune, or scarring conditions that cannot always be distinguished through clinical examination alone.

The procedure is performed under local anaesthesia, making it quick, safe, and generally painless.

Scalp biopsies at Instituto Médico del Prado

At Instituto Médico del Prado, the biopsy is performed personally by Dr. Espinosa Custodio.

Once collected, the tissue sample is sent to a specialist pathology laboratory with extensive experience in diagnosing hair and scalp disorders. Results are typically available within approximately one week.

After receiving the pathology report, Dr. Espinosa Custodio reviews the findings with the patient and recommends the most appropriate treatment based on the confirmed diagnosis.

Although scalp biopsy is an extremely valuable diagnostic tool, it is not routinely required. Most patients with androgenetic alopecia can be accurately diagnosed using advanced digital trichoscopy with HairMetrix® by Canfield, which provides detailed information about hair density, follicular miniaturization, and scalp health without the need for tissue sampling.

A biopsy is generally reserved for cases in which a scarring alopecia or another uncommon hair disorder is suspected.

Conditions that may require a scalp biopsy include:

• Lichen planopilaris
• Frontal fibrosing alopecia
• Folliculitis decalvans
• Cutaneous lupus erythematosus
• Alopecia mucinosa
• Graham-Little syndrome
• Pseudopelade of Brocq
• Keratosis follicularis spinulosa decalvans

Frequently Asked Questions

Does every patient need a scalp biopsy?

No. Only a small proportion of patients require a scalp biopsy. Most cases of androgenetic alopecia can be accurately diagnosed through clinical examination and advanced dermoscopic assessment without the need for tissue sampling.

Is a scalp biopsy painful?

No. The procedure is performed under local anaesthesia, so the area is completely numb during the biopsy. Patients generally experience little or no discomfort, similar to other minor dermatological procedures.

How long does it take to receive the results?

Biopsy results are usually available within approximately one week. Once the pathology report has been received, the clinic will contact the patient to arrange a follow-up consultation, during which Dr. Espinosa Custodio will explain the findings and discuss the recommended treatment plan.sta.

Dr. Espinosa Custodio works at Instituto Médico del Prado, his hair clinic in Madrid, and performs hair transplants in Mexico, twice a year. If you would like to make an appointment, you can contact us on +34 912 468 664, on WhatsApp +34 627 396 322 or on the contact page of our website. From Mexico you can contact us at +52 55 4590 9909.