A clinical dermatologist diagnosis uses physical examination, trichoscopy, and sometimes blood tests to confirm male pattern baldness, while at-home diagnosis relies on self-assessment tools, AI analysis, and pattern matching against the Norwood scale. Both approaches have clear strengths and limitations, and for most men, the best path involves starting with a home assessment and following up with clinical confirmation before committing to treatment.
This article is for informational purposes only and does not constitute medical advice.
Clinical Diagnosis: What It Involves
A clinical diagnosis of androgenetic alopecia takes place in a dermatologist's or hair restoration surgeon's office and typically includes several components.
Physical Examination
The doctor visually examines your scalp, noting the pattern of thinning, the quality of existing hair, and the degree of miniaturization. An experienced dermatologist can often classify your Norwood stage on sight by observing temple recession, crown thinning, and the overall distribution of loss.
Trichoscopy (Dermoscopy of the Scalp)
Trichoscopy uses a handheld dermatoscope or digital microscope to examine hair follicles at 20x to 70x magnification. This reveals:
- Hair shaft diameter variation: A hallmark of androgenetic alopecia is the coexistence of thick terminal hairs and thin miniaturized hairs in the same area. A ratio of more than 20% miniaturized hairs in the frontal scalp is diagnostic.
- Follicular unit density: Normal density ranges from 120 to 230 follicular units per cm2 depending on ethnicity (Caucasian: 170 to 230, Asian: 140 to 200, African: 120 to 180).
- Perifollicular signs: Brown halos around follicles (perifollicular pigmentation) are characteristic of early androgenetic alopecia.
- Yellow dots: Indicate empty follicles filled with sebum, common in both alopecia areata and advanced pattern baldness.
Pull Test
The dermatologist gently tugs on 40 to 60 hairs in different scalp regions. In stable androgenetic alopecia, the pull test is typically negative (fewer than 6 hairs come out). A positive pull test may indicate active shedding from telogen effluvium or another condition occurring alongside pattern baldness.
Blood Tests
When the diagnosis is not entirely clear or when contributing factors are suspected, the doctor may order blood work including thyroid panel, ferritin, testosterone, DHT, vitamin D, and CBC. These tests help rule out conditions that can mimic or worsen androgenetic alopecia.
Scalp Biopsy (Rare)
A 4mm punch biopsy is occasionally performed when the clinical picture is ambiguous. Histology can definitively distinguish androgenetic alopecia from conditions like alopecia areata or scarring alopecia by showing the ratio of terminal to vellus hairs and any inflammatory patterns.
At-Home Diagnosis: What It Involves
At-home assessment methods range from simple self-checks to AI-powered photo analysis.
Self-Assessment Against the Norwood Scale
The most basic approach is comparing your current hair loss pattern to the Norwood-Hamilton scale:
| Norwood Stage | Visual Pattern | Grafts If Treated |
|---|---|---|
| N1 | No significant recession | None needed |
| N2 | Slight temple recession | 800 to 1,500 |
| N3 | Deep M-shaped recession | 1,500 to 2,200 |
| N3V | Recession plus vertex thinning | 2,000 to 2,800 |
| N4 | Enlarged vertex area | 2,500 to 3,500 |
| N5 | Front and vertex nearly merging | 3,000 to 4,500 |
| N6 | Bridge lost, horseshoe forming | 4,000 to 6,000 |
| N7 | Extensive loss, narrow band | 5,500 to 7,500 |
This method is reasonably accurate for men with clear pattern recession (Norwood 3 and above) but less reliable for early or diffuse loss.
AI Photo Analysis
AI-powered tools like myhairline.ai analyze uploaded photos to estimate Norwood stage, graft requirements, and potential treatment paths. These tools use computer vision trained on clinical datasets and provide results in seconds.
Hair Count Tracking
Counting hairs lost during washing or on your pillow over time can reveal trends. Normal shedding is 50 to 100 hairs per day. Consistently losing more than 150 per day may indicate active miniaturization or telogen effluvium.
At-Home Trichoscopy Devices
Consumer-grade USB microscopes (50x to 200x magnification) can capture close-up images of your scalp, allowing you to observe miniaturized hairs and follicular unit density. While not as precise as clinical dermoscopy, these devices cost $20 to $80 and can track changes over months.
Head-to-Head Comparison
| Factor | Clinical Diagnosis | At-Home Diagnosis |
|---|---|---|
| Cost | $100 to $300 per visit | Free to $80 (AI tools or USB microscope) |
| Time to results | 1 to 3 weeks (scheduling + appointment) | Minutes |
| Norwood staging accuracy | 95%+ | 80 to 90% for clear patterns |
| Can detect miniaturization | Yes (trichoscopy) | Limited (USB microscope offers some visibility) |
| Can rule out other conditions | Yes (blood tests, biopsy) | No |
| Donor area evaluation | Yes (density per cm2, elasticity, caliber) | No |
| Identifies contributing factors | Yes (thyroid, iron, hormones) | No |
| Treatment plan specificity | Personalized surgical plan | General treatment guidelines |
| Accessibility | Requires specialist availability | Available anywhere, anytime |
| Repeat tracking | Needs new appointments | Easy to repeat regularly |
When At-Home Diagnosis Is Sufficient
At-home assessment is a good starting point when:
- You have clear, classic pattern recession at the temples or thinning at the crown (Norwood 2 to 5)
- You have a family history of male pattern baldness and your pattern matches
- You want a preliminary understanding before deciding whether to book a consultation
- You are tracking progression over time to see if treatment is working
- You are in an area without easy access to a dermatologist or trichologist
An AI assessment can give you a Norwood stage estimate and approximate graft count, which helps you estimate costs (for example, Norwood 4 at 3,000 grafts costs $12,000 to $18,000 in the USA or $3,000 to $6,000 in Turkey) and have more informed conversations with surgeons.
When Clinical Diagnosis Is Essential
You need a clinical evaluation when:
- Your hair loss is diffuse rather than following a clear Norwood pattern
- Onset was sudden (weeks rather than months), which may indicate telogen effluvium or alopecia areata
- You are under 20 and experiencing rapid loss, which may warrant blood work to rule out hormonal or nutritional causes
- Your scalp shows redness, scaling, or scarring, which could indicate a different condition entirely
- You have patches of smooth, complete hair loss (suggesting alopecia areata rather than pattern baldness)
- Treatment is not working after 12 months of finasteride and minoxidil, and you need a reassessment
- You are considering surgery, as a transplant surgeon needs to evaluate donor density, hair caliber, skin laxity, and overall candidacy in person
Misdiagnosis of hair loss type leads to wrong treatment in roughly 28% of cases. The conditions most commonly confused with androgenetic alopecia are telogen effluvium (stress-related shedding), diffuse alopecia areata (autoimmune), and early scarring alopecia. Clinical evaluation is the only way to reliably distinguish between these.
The Recommended Path
For most men, the optimal diagnostic pathway combines both approaches:
- Start with AI assessment at myhairline.ai/analyze to get your estimated Norwood stage and graft requirements
- Track with photos every 3 months to document any progression
- Get clinical confirmation from a dermatologist before starting medication (finasteride requires a prescription)
- Consult a surgeon if you are considering transplant surgery, bringing your AI assessment data and photos
This layered approach gives you early awareness through at-home tools and clinical precision when it matters most. Understanding the causes behind your pattern helps you make better treatment decisions, and checking your hair transplant candidacy ensures you are a good fit before committing to surgery.