A simple test where a small group of hairs is gently pulled to assess active shedding.
The hair pull test is used during examination to assess whether shedding is increased. A clinician gently pulls a small bundle of hairs from different scalp areas and counts how many come away. A positive result can support active shedding, such as telogen effluvium or active alopecia areata, but it is not diagnostic on its own. Washing frequency, hair care, recent brushing and technique can affect the result. It is best interpreted alongside the history, pattern of loss, scalp examination, trichoscopy and, when needed, blood tests.
Starace M et al. Female Androgenetic Alopecia: Diagnosis and Management, Am J Clin Dermatol, 2020 — https://doi.org/10.1007/s40257-019-00479-x; DermNet: Trichoscopy of generalised noncicatricial hair loss — https://dermnetnz.org/topics/trichoscopy-of-generalised-noncicatricial-hair-loss; Anastassakis K. Androgenetic Alopecia From A to Z, Vol. 1, Springer, 2022 — https://doi.org/10.1007/978-3-030-76111-0
