Microscopic examination of hairs plucked or clipped by the examiner (excluding hair collected by the patient) to determine telogen and anagen counts, or structural hair shaft abnormality
CPT4 code
Name of the Procedure
Microscopic Examination of Hairs (Trichogram)
Summary
This procedure involves the detailed examination of hair samples plucked or clipped by a healthcare professional. It helps determine the growth phase of hair (telogen and anagen counts) or identify structural abnormalities in the hair shaft.
Purpose
Primarily, the microscopic examination of hair is used to diagnose hair loss conditions or structural hair diseases. The goal is to understand the underlying causes of hair loss, whether due to the hair growth cycle or structural defects.
Indications
- Unexplained hair loss or thinning
- Assessment of hair disorders such as alopecia
- Diagnosis of structural abnormalities of the hair shaft
- Evaluation of scalp conditions
Patient factors that make the procedure appropriate:
- Persistent or progressive hair loss
- Visible changes in hair texture or strength
- Scalp health concerns
Preparation
- Patients should avoid washing their hair for at least 24 hours before the procedure.
- Refrain from applying any hair products like gels, sprays, or conditioners.
- No special fasting or medication adjustments are usually necessary.
Procedure Description
- The healthcare professional identifies the specific area of the scalp for sampling.
- Hairs are either carefully plucked using tweezers or clipped close to the scalp with sterile scissors.
- The collected hair samples are placed on a glass slide.
- Microscope examination is performed to observe hair characteristics.
Typically, no anesthesia or sedation is required.
Duration
The procedure generally takes about 10-15 minutes.
Setting
The procedure is usually performed in an outpatient clinic or a dermatology office.
Personnel
- Dermatologist or trained healthcare professional
- Medical assistant (if needed)
Risks and Complications
- Minor discomfort during hair plucking
- Potential for slight redness or irritation at the sampling site
- Rare risk of minor infection if not properly sterilized
Benefits
- Accurate diagnosis of hair growth issues or structural abnormalities
- Targeted treatment planning based on specific findings
- Non-invasive and straightforward procedure with quick results
Recovery
- No significant recovery time is required.
- Patients can resume their normal activities immediately.
- Minimal post-procedure care; simply keep the sampling area clean.
Alternatives
- Scalp biopsy: More invasive, may provide more comprehensive information but can cause scarring.
- Blood tests: Can identify underlying conditions affecting hair health but may not reveal specific hair shaft issues.
- Observation and wait-and-see approach: Requires longer period to monitor changes without immediate diagnosis.
Patient Experience
- Slight discomfort may be felt during hair plucking, similar to a minor pull.
- Post-procedure, the scalp may feel slightly sensitive but this typically resolves quickly.
- Pain is minimal and usually does not require pain management.
Comfort measures include:
- Ensuring the procedure is performed by experienced personnel.
- Providing reassurance and explaining each step to reduce anxiety.