Taula de Continguts
- Why start with the diagnosis and not the treatment
- The types of hair loss distinguished in the consultation
- What the assessment involves: medical history, examination and trichoscopy
- The blood test: when the physician may request one and what it usually checks
- When it is not the time for an aesthetic treatment
- From diagnosis to plan: hair mesotherapy, PRP and exosomes
- How we work at Santé Madrid
- Frequently asked questions
A hair consultation in Madrid is there to answer one question first: why your hair is falling out. Only with that diagnosis does it make sense to choose a treatment, and in some cases the physician may request a blood test before deciding. In this guide we explain which types of hair loss are distinguished, what the assessment involves, when a blood test is usually indicated and which values are checked, when it is better to see a dermatologist first, and how hair mesotherapy, PRP or hair exosomes fit in afterwards.
Key points
- Hair loss has different causes, and each is managed differently: that is why diagnosis comes before treatment.
- The medical history and a scalp examination are usually enough to point to a diagnosis; trichoscopy is a common supporting tool.
- A blood test is not automatic: the physician may request one when the history or examination makes it advisable, for example with diffuse hair loss.
- Some alopecias, such as scarring ones or those suggesting an infection, need assessment by a dermatologist.
- At Santé Madrid the hair consultation is a medical consultation costing €50. Results of any treatment vary from person to person.
Why start with the diagnosis and not the treatment
Losing some hair every day is normal. Hair grows in cycles: an active growth phase (anagen), a short transition phase (catagen) and a resting phase (telogen), at the end of which the hair is shed (American Family Physician, 2017). A review in the same journal puts usual shedding at an average of around 100 hairs a day (American Family Physician, 2009), although every person is different.
When shedding increases or hair looks thinner, the cause can be very different from one case to another: a hereditary and hormonal factor, an episode of physical or emotional stress, a nutritional deficiency, a thyroid problem, a styling habit or a scalp condition. One treatment does not work for all of them.
That is why, before talking about mesotherapy, PRP or exosomes, the hair consultation aims to identify the type of hair loss. If the cause is temporary, no aesthetic treatment may be needed; if it is an alopecia that a dermatologist should treat, the right step is to refer you; and if it is a pattern that may benefit from a local treatment, the plan is built on that diagnosis.
The types of hair loss distinguished in the consultation
A practical way to organise the diagnosis is to separate diffuse hair loss, which affects the whole scalp, from patchy hair loss, and to distinguish non-scarring alopecias, which are generally reversible, from scarring ones, which are permanent (American Family Physician, 2017). This table summarises the most common forms according to that review.
| Type of hair loss | How it usually presents | What guides the assessment |
|---|---|---|
| Androgenetic alopecia | Progressive; in men, receding temples and crown; in women, thinner hair on top with the frontal hairline preserved | Family history and a characteristic pattern |
| Telogen effluvium | Diffuse shedding with a relatively sudden onset, sometimes in clumps in the shower or the brush | A prior trigger: illness with fever, stress, recent pregnancy, a very restrictive diet |
| Alopecia areata | Bald patches that appear quickly | Appearance of the patches on examination |
| Tinea capitis | Patches with or without scaling | Examination and culture; requires systemic treatment |
| Hair shaft breakage from traction or products | Dry hair that breaks | Tight hairstyles, heat, straightening treatments |
| Scarring alopecia | Areas where the follicle openings cannot be seen | Referral to dermatology |
According to the same review, telogen effluvium usually resolves on its own within two to six months once the cause is removed. In androgenetic alopecia, by contrast, the course is slow and progressive. Knowing which of the two scenarios you are in completely changes the conversation about treatments.
What the assessment involves: medical history, examination and trichoscopy
According to the American Family Physician review, the medical history and physical examination are often enough to point to the cause of hair loss. In the consultation, the physician will ask you things like these:
- How long you have noticed the hair loss and whether it started suddenly or gradually.
- Whether there is a family history of hair loss.
- Whether in the previous months you have had an illness with fever, surgery, childbirth, a very stressful period or a very restrictive diet.
- What medication you take and whether you have recently started or changed any.
- Whether you have tiredness, weight changes, irregular periods or other general symptoms.
- Which products, hairstyles and heat tools you use.
The examination focuses on the hair and scalp: the pattern of hair loss, whether there are patches, scaling, redness or pustules, and whether the follicle openings are preserved. One simple test is the pull test, in which a lock of hair is gently pulled to see whether more hair comes out than expected; the review notes that it is hard to standardise and that a negative result does not rule out active shedding (American Family Physician, 2017).
Trichoscopy, that is, dermoscopy of the scalp, is a common tool in hair medicine. A systematic review on androgenetic alopecia concludes that in many men the history and examination may be enough for the diagnosis, while in women they should be supplemented with trichoscopy; the most frequent findings were variability in hair thickness and the presence of fine vellus-type hairs (Kuczara et al., 2024).
The blood test: when the physician may request one and what it usually checks
A blood test is not an automatic part of every hair consultation. The 2017 American Family Physician review states that laboratory tests depend on what the history and examination show: if a general condition is suspected, such as hypothyroidism, iron deficiency or another nutritional deficiency, a complete blood count and thyroid-stimulating hormone, TSH, may be requested (American Family Physician, 2017).
The 2009 review in the same journal recommends ordering ferritin and thyroid function tests for diffuse hair loss, and a targeted hormonal work-up (testosterone, DHEA-S and prolactin) in women with hair loss who also have irregular periods, fertility problems, excess body hair, acne that does not respond or nipple discharge. It also notes that most of these women have normal androgen levels (American Family Physician, 2009).
A retrospective study of 467 patients with non-scarring alopecia found that abnormalities in ferritin, haemoglobin and vitamin B12 were more frequent in the telogen effluvium group, and more frequent in women than in men. The authors suggest prioritising blood tests in those cases and not running them straight away in every patient with non-specific hair loss (Öner and Akdeniz, 2022). It is a single-centre study, but it illustrates the idea: a blood test is requested when it adds information.
There is another reason the physician may want to see a recent blood test: anaemia or a low platelet count are among the relative contraindications to PRP described in the literature (Paichitrojjana and Paichitrojjana, 2022).
When it is not the time for an aesthetic treatment
Part of the value of a hair consultation is being able to say no, or not yet. There are situations in which a local scalp treatment is not the first step, and others in which it is better for a dermatologist to see you before anything is planned.
In these cases, the medical team will explain why that prior assessment is advisable. If the cause is temporary, such as telogen effluvium after a clear trigger, sometimes the most reasonable option is to wait and monitor how it evolves before starting a treatment.
From diagnosis to plan: hair mesotherapy, PRP and exosomes
When the diagnosis points to hair loss that may benefit from a local treatment, such as androgenetic alopecia, the medical team may suggest one of these options. None of them replaces the diagnosis or the treatments a dermatologist may prescribe, and the available evidence has limits worth knowing.
Hair mesotherapy. It consists of micro-injections of medicines or vitamins into the middle layer of the scalp skin. A systematic review of 11 studies describes favourable results in androgenetic alopecia, with uncommon local adverse effects (Aledani et al., 2024). You can see how we approach it on the hair mesotherapy page.
Hair PRP. Platelet-rich plasma is obtained from a sample of your own blood. A review of the evidence from 2020 to 2025 identifies it as the most studied regenerative therapy in androgenetic alopecia, although with limitations: poorly standardised composition, short follow-up and little comparative data between protocols. The most common adverse effects are local: redness, swelling, tenderness, itching, pain or bruising (Gupta et al., 2025). More detail on hair PRP.
Hair exosomes. A systematic review of 11 clinical studies found improvements in at least one hair parameter with no serious adverse effects, but with small samples, very different designs and variable follow-up; the authors call for higher-quality trials (Al Ameer et al., 2025). You can read more on hair exosomes.
In all cases, results vary from person to person, and the number of sessions is decided after the assessment.
How we work at Santé Madrid
Santé Clinics Madrid is at C. de Amador de los Ríos, 1, Chamberí, 28010 Madrid. We are open Monday to Friday from 9:00 to 21:00 and on Saturdays from 10:00 to 15:00; the clinic is closed on Sundays.
At Santé Madrid, the hair consultation is a medical consultation costing €50. In it, the Santé Madrid medical team reviews your history, examines your scalp and explains which type of hair loss they suspect. If they consider that a blood test would add information, they will tell you which values are worth checking. If you already have a recent blood test or reports from other specialists, bring them: they can save steps.
Once the diagnosis is clear, we suggest a plan. It may include hair mesotherapy, PRP or exosomes, or the right step may be to wait, adjust habits or see a dermatologist first. At Santé we do not perform hair surgery. If you are concerned about nutrition, keep in mind that supplements do not replace a diagnosis; we explain this in our article on biotin and hair growth.
We make no promises about results. We prefer to explain calmly what is reasonable to expect in your case before starting.
Frequently asked questions
How much does the hair consultation cost at Santé Madrid?
The hair consultation is a medical consultation and costs €50. It assesses the cause of the hair loss and, where appropriate, a treatment plan is proposed.
Is a blood test always needed to treat hair loss?
No. The physician requests one when the history or examination makes it advisable, for example with diffuse hair loss or if there are symptoms suggesting a thyroid problem, iron deficiency or a hormonal imbalance.
Which values are usually checked in a blood test for hair loss?
According to the medical literature, the complete blood count, ferritin and thyroid function are often checked; in some women with hormonal signs, testosterone, DHEA-S and prolactin as well. What to request depends on each case.
Can I bring a blood test I already have?
Yes, bring it to the consultation together with any recent medical report. The medical team will assess whether it is enough or whether another value should be checked.
How do I know whether my hair loss is temporary or androgenetic?
Diffuse shedding with a sudden onset after a trigger usually points to telogen effluvium, which often resolves within months. Slow, progressive loss with a family history points to androgenetic alopecia. The distinction is made in the consultation.
Which hair treatments do you offer at Santé Madrid?
Hair mesotherapy, hair PRP and hair exosomes, always after a medical assessment. We do not perform hair surgery. Results vary from person to person.
When should I see a dermatologist first?
If there are areas that look scarred, patches with scaling or pustules, rapid patchy hair loss or general symptoms. In those cases a dermatology assessment is advisable before any aesthetic treatment.
If you notice you are losing more hair or that it looks thinner, a hair consultation at Santé Madrid will help you understand the cause before choosing a treatment. We will explain calmly which options make sense in your case and which do not.
