{"id":1775,"date":"2026-01-13T17:59:16","date_gmt":"2026-01-13T10:59:16","guid":{"rendered":"https:\/\/www.piyawatclinic.com\/?p=1775"},"modified":"2026-01-13T18:32:28","modified_gmt":"2026-01-13T11:32:28","slug":"the-secret-beneath-your-scalp-you-never-knew-trichoscopy","status":"publish","type":"post","link":"https:\/\/www.piyawatclinic.com\/en\/the-secret-beneath-your-scalp-you-never-knew-trichoscopy\/","title":{"rendered":"The Secret Beneath Your Scalp You Never Knew: Trichoscopy"},"content":{"rendered":"<pre>Article by Dr. Piyawat POOMSUWAN<\/pre>\n<p><a href=\"https:\/\/www.piyawatclinic.com\/en\/%e0%b8%84%e0%b8%a7%e0%b8%b2%e0%b8%a1%e0%b8%a5%e0%b8%b1%e0%b8%9a%e0%b9%83%e0%b8%95%e0%b9%89%e0%b8%ab%e0%b8%99%e0%b8%b1%e0%b8%87%e0%b8%a8%e0%b8%b5%e0%b8%a3%e0%b8%a9%e0%b8%b0%e0%b8%97%e0%b8%b5%e0%b9%88\/\"><img decoding=\"async\" class=\"alignnone  wp-image-1616\" src=\"https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/Thai-Flag-300x300.png\" alt=\"\" width=\"35\" height=\"35\" srcset=\"https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/Thai-Flag-300x300.png 300w, https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/Thai-Flag-150x150.png 150w, https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/Thai-Flag.png 512w\" sizes=\"(max-width: 35px) 100vw, 35px\" \/><\/a> <a href=\"https:\/\/www.piyawatclinic.com\/en\/%e9%a0%ad%e7%9a%ae%e3%81%ae%e4%b8%8b%e3%81%ab%e9%9a%a0%e3%81%95%e3%82%8c%e3%81%9f%e7%9c%9f%e5%ae%9f%ef%bc%9atrichoscopy\/\"><img decoding=\"async\" class=\"alignnone  wp-image-1640\" src=\"https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/japan-300x300.png\" alt=\"\" width=\"35\" height=\"35\" srcset=\"https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/japan-300x300.png 300w, https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/japan-150x150.png 150w, https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/japan.png 512w\" sizes=\"(max-width: 35px) 100vw, 35px\" \/><\/a> <a href=\"https:\/\/www.piyawatclinic.com\/en\/%e6%82%a8%e4%b8%8d%e4%b8%ba%e4%ba%ba%e7%9f%a5%e7%9a%84%e5%a4%b4%e7%9a%ae%e7%a7%98%e5%af%86%ef%bc%9atrichoscopy\/\"><img decoding=\"async\" class=\"alignnone  wp-image-1642\" src=\"https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/china-300x300.png\" alt=\"\" width=\"35\" height=\"35\" srcset=\"https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/china-300x300.png 300w, https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/china-150x150.png 150w, https:\/\/www.piyawatclinic.com\/wp-content\/uploads\/2025\/02\/china.png 512w\" sizes=\"(max-width: 35px) 100vw, 35px\" \/><\/a><\/p>\n<p><strong>The Secret Beneath Your Scalp You Never Knew: When \u201cThinning Hair\u201d in Women Isn&#8217;t Just Hormones, but \u201cInflammation and Fibrosis\u201d<\/strong><\/p>\n<p>\u200bWhen we talk about <strong>Female Pattern Hair Loss (FPHL)<\/strong>, we often picture mothers or grandmothers whose hair thins with age. We tend to blame hormones or genetics and simply accept it. However, data from recent research has completely shifted the perspective on treating this condition.<\/p>\n<p>\u200bToday, I\u2019m going to digest a deep-dive research paper (a Cross-sectional Observational Study) involving 90 female patients to help you understand why <strong>\u201cwaiting\u201d<\/strong> is your hair&#8217;s worst enemy.<\/p>\n<p><strong>\u200b<\/strong><strong>\ud83d\udd0d<\/strong><strong> Looking for Truth through the Lens (Trichoscopy)<\/strong><\/p>\n<p>\u200bIn the past, we might have just looked with the naked eye to make a diagnosis. But today, we have <strong>\u201cTrichoscopy\u201d<\/strong>\u2014a dermoscope for the scalp\u2014which acts like a <strong>\u201cdetective\u2019s magnifying glass.\u201d<\/strong> This research confirms that what we cannot see with the naked eye, but the camera can reveal, is the key:<\/p>\n<ul>\n<li>\u200b\ud83d\udea9 <strong>Anisotrichosis (Variable Hair Diameter):<\/strong> A mix of thick and thin hairs. This is the earliest warning sign that your hair roots are becoming weak.<\/li>\n<\/ul>\n<ul>\n<li>\u200b\ud83d\udea9 <strong>Dartboard Sign:<\/strong> Concentric rings of different colors around the hair follicle, indicating the severity of the disease.<\/li>\n<\/ul>\n<p><strong>\u200b<\/strong><strong>\ud83d\udd25<\/strong><strong> The Silent Danger: Inflammation<\/strong><\/p>\n<p>\u200bShockingly, biopsy results from this research found that <strong>over 73% of patients had inflammation hidden beneath the skin<\/strong>. When viewed through the scope, we see this as a <strong>\u201cBrown Peripilar Sign\u201d<\/strong> around the follicle.<\/p>\n<p>\u200bThis is the <strong>\u201cGolden Period.\u201d<\/strong> Inflammation means the hair root is currently under attack. If we treat it during this stage\u2014using topical meds, oral medication, medicated shampoos, or treatments to reduce inflammation\u2014we can stop the damage in time.<\/p>\n<p><strong>\u200b<\/strong><strong>\ud83d\udea8<\/strong><strong> The Scary Turning Point: Fibrosis<\/strong><\/p>\n<p>\u200bIf inflammation is left untreated for a long time, or treated incorrectly, the consequence is the <strong>\u201cWhite Peripilar Sign\u201d<\/strong>. The research clearly indicates this is associated with the duration of the condition. When a biopsy is performed, <strong>\u201cPerifollicular fibrosis\u201d<\/strong> (scarring around the hair root) is found.<\/p>\n<p>\u200bSimply put, the living hair root is replaced by scar tissue, making it impossible for new hair to grow, or causing the hair to become so thin it is barely visible. The research found that nearly 1 in 3 patients with severe thinning already had this fibrosis. This has led doctors to view Female Pattern Hair Loss as a condition that can actually become <strong>\u201cMicro-cicatricial alopecia\u201d<\/strong> (tiny scarring hair loss).<\/p>\n<p><strong>\u200b<\/strong><strong>\ud83d\udca1<\/strong><strong> Conclusion and Self-Care<\/strong><\/p>\n<p>\u200bWhat I want to leave you with from this research data is:<\/p>\n<ul>\n<li>\u200b\u2705 <strong>Don\u2019t wait until friends comment:<\/strong> 90% of patients in this research came to see the doctor when their symptoms were already severe (Severity score \u226510), which is difficult to reverse.<\/li>\n<\/ul>\n<ul>\n<li>\u200b\u2705 <strong>Observe yourself:<\/strong> If your hair part widens by more than 1 cm or the hair at the front becomes thinner, consult a doctor immediately.<\/li>\n<\/ul>\n<ul>\n<li>\u200b\u2666\ufe0f <strong>Treatment must be targeted:<\/strong> If inflammation is detected, the doctor may need to prescribe medication or perform treatments to reduce inflammation as well, not just prescribe hair growth stimulants alone, to prevent future fibrosis.<\/li>\n<\/ul>\n<p>\u200b\u2665\ufe0f <strong>Thinning hair is treatable, but \u201cTime\u201d is the most critical factor.<\/strong> \u2665\ufe0f<\/p>\n<p>\u200b\u201cAt <strong>Piyawat Clinic<\/strong>, we realize that <strong>\u2018Precision\u2019<\/strong> is the heart of treatment and prevention to stop thinning hair from becoming a permanent problem. We have established a standard to analyze scalp conditions using high-magnification cameras (<strong>Trichoscopy<\/strong>) for <strong>\u2018every\u2019<\/strong> patient and <strong>\u2018every time\u2019<\/strong> they come for a consultation or treatment. Because we believe that seeing microscopic signs of abnormality\u2014whether it\u2019s slightly shrinking hair diameter or hidden traces of inflammation\u2014allows us to plan targeted treatments and stop the problem in time. If you want confidence and care that pays attention to every detail for long-term hair health, stop by for a consultation and treatment plan at Piyawat Clinic.\u201d<\/p>\n<p>\u00a0<\/p>\n<p>\u200b<strong>\ud83d\udcda<\/strong><strong> References<\/strong><\/p>\n<p>Singh S, Makhecha MB, Rambhia KD. A cross-sectional observational study to correlate the trichoscopic findings of female pattern hair loss with the disease severity and underlying histopathological changes. International Journal of Trichology. 2023;15:221-230.<\/p>\n<p>\u00a0<\/p>","protected":false},"excerpt":{"rendered":"<p>Article by Dr. Piyawat POOMSUWAN The Secret Beneath Your Scalp You Never Knew: When \u201cThinning Hair\u201d in Women Isn&#8217;t Just Hormones, but \u201cInflammation and Fibrosis\u201d \u200bWhen we talk about Female Pattern Hair Loss (FPHL), we often picture mothers or grandmothers whose hair thins with age. We tend to blame hormones or genetics and simply accept [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1776,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[487,486,700,701,522,495,704,496,497,485,702,703,483],"yst_prominent_words":[435,431,427,429,433,428,34],"class_list":["post-1775","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-dr-piyawat-poomsuwan","tag-dr-piywat","tag-female-pattern-hair-loss","tag-fphl","tag-hair-laser","tag-hair-loss","tag-hair-matters","tag-hair-transplant","tag-meso-hair","tag-piyawat-clinic","tag-thinning-hair","tag-trichoscopy","tag-483"],"_links":{"self":[{"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/posts\/1775","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/comments?post=1775"}],"version-history":[{"count":3,"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/posts\/1775\/revisions"}],"predecessor-version":[{"id":1796,"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/posts\/1775\/revisions\/1796"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/media\/1776"}],"wp:attachment":[{"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/media?parent=1775"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/categories?post=1775"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/tags?post=1775"},{"taxonomy":"yst_prominent_words","embeddable":true,"href":"https:\/\/www.piyawatclinic.com\/en\/wp-json\/wp\/v2\/yst_prominent_words?post=1775"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}