When Thick Hair Turns Thin: My Alopecia Journey and the Importance of Trichoscopy in Vietnam

I've always taken my thick, long hair for granted. It's been a part of me for as long as I can remember, and I've never really had any issues with it. Sure, I'd notice a few stray hairs falling out here and there, but it was nothing to worry about. I'd read stories about women with alopecia and think, 'That'll never happen to me – I've got a mane going on!'

But life had other plans. It started about four months ago, after I moved to Vietnam. My hair started falling out in big chunks. I brushed it off, thinking it would sort out on its own. I was busy with work, my kid's education, and getting settled in Vietnam. Losing my hair seemed like a minor issue, not worth worrying about.

It wasn't until I was cleaning the house that I realized something was up. I was mopping the floors and noticed my hair all over the stairs – not just the long bits, but the short ones too! I took a closer look in the mirror and was shocked. My hairline had receded, and my scalp was visible. My hair was thinning, and it was weak and brittle. I'd never seen it like that before. How had I missed it?

I was in a panic. What do I do? Where do I go? I knew I needed to see a dermatologist, but I'm not in Moscow. It's hard to find specialists like that here in Vietnam. Locals seem to take alopecia in stride – I've seen young women in Nha Trang with barely any hair and big bald spots. They're not ashamed of it, and they're not trying to hide it.

First things first, I decided to consult with a dermatologist online. I reached out to a specialist from a clinic in Rostov-on-Don. She was a nice woman in her 40s who listened carefully and suggested I might have difuse telogen effluvium and androgenetic alopecia.

Diffuse telogen effluvium in women is a condition where there's a uniform thinning of hair all over the scalp, triggered by a disruption in the natural hair growth cycle. Essentially, a large number of hair follicles prematurely transition from the active growth phase (anagen) to the shedding phase (telogen).

Androgenetic alopecia is a chronic condition where there's a gradual thinning and shedding of hair due to increased sensitivity of hair follicles to androgens – male sex hormones.

At that point, it was just a hunch. The doc told me I needed to run a bunch of tests to get an accurate diagnosis – a general blood test, biochemistry, thyroid hormones, and sex hormones, plus a computerized scalp examination, or trichoscopy. I'd never heard of trichoscopy before, so I started researching it as soon as the online consultation was over.

What is trichoscopy, and what was my experience like?

Trichoscopy is a diagnostic tool that helps a dermatologist assess the health of your hair and scalp. It's done using a special device called a trichoscope. This little gadget gives you a magnified view of your hair and scalp, allowing the dermatologist to take a close look. The trichoscope can be handheld, offering 10 times magnification and is often used for a quick initial assessment to get a sense of the overall condition.

I have to admit, one of the first questions that came to mind when I was considering getting a trichoscopy was whether it's really necessary, or if I could just get a diagnosis based on some blood tests. After doing my research on trichoscopy, I realized that it actually complements blood tests by providing a more detailed picture of my scalp and hair health. The benefits of computer-assisted hair diagnosis are that it can timely detect pathology, capture minimal changes in hair and scalp structure that signal the onset of disease, and identify different types of alopecia, making it an essential tool for accurate diagnosis. On top of that, trichoscopy helps monitor treatment and track treatment outcomes.

I have to admit, I was starting to lose hope of finding trichoscopy services in Nha Trang. I even considered traveling to Ho Chi Minh or Hanoi to look for a clinic that offered this procedure. But then I stumbled upon a post in a local expat chat group about a Russian-speaking trichologist who occasionally visits Nha Trang to perform trichoscopy and consultations. I messaged the trichologist on Telegram, and to my surprise, they got back to me quickly. Unfortunately, they weren't available to visit Nha Trang at the time, but they had an assistant who could perform the trichoscopy, record it, and send it to them. After that, I would receive treatment recommendations, and I could schedule a follow-up consultation three months later to assess the effectiveness of the treatment and get additional advice. The trichoscopy and two consultations cost $120.

At the time of my conversation with the trichologist, I already had my blood tests ready: hormone tests, a general blood analysis, and biochemistry. I also needed to get a biochemistry test for my liver.

I booked an appointment with the trichologist's assistant for the trichoscopy. The procedure was conducted in a specially equipped room in the center of Nha Trang.

Getting a scalp analysis was a breeze – no prior prep was needed. All I had to do was sit down with a comb with fine teeth, and the technician used a trichoscope (basically a mini-microscope) to take a closer look at my scalp. My hair was displayed on a screen, and the technician asked me to record the video on my phone. The whole process took around 20-25 minutes. She sent the video straight to the trichologist.

The next evening, the trichologist called me with the results. It turned out I had differential telogen effluvium, and he also detected androgenetic alopecia that had been dormant for a while. Hearing the diagnosis wasn't a shock – I was expecting it. Now that I know the AGA is on pause, I can take steps to prevent it from coming back.

The next day, I received a detailed report from the trichologist, explaining the causes of my telogen effluvium and outlining a treatment plan.

The causes were:

Iron deficiency;Vitamin D deficiency;Copper level on the borderline;Low protein levels;Chronic stress.The trichologist prescribed me a treatment plan:

Ferrovit;Vitamins B + C + biotin;Vitamin D;Zinc Picolinate;Omega-3.Along with my vitamin and supplement regimen, my doctor prescribed a capixyl-based lotion called "MUST HAIR", a peptide lotion (I'm currently using a multi-peptide serum from The Ordinary), and a ketoconazole shampoo called Nizoral (I use it once a week as a scalp treatment). Before I started treatment, I was already using a scalp detoxifying shampoo called Ducray Anaphase+. I really like this shampoo - it's great at cleaning both my hair and scalp, so my doctor said I can keep using it.

My doctor recommended waiting to start using a dihydrotestosterone blocker, which is used to treat androgenetic alopecia, for at least three months. Once I've been using it for that long, we'll reassess.

Although I've only just started treatment, I've already noticed some positive changes: my hair looks healthier and shiny, and it's falling out less. Of course, it'll take at least three to four months to see any real results.

I've spent a pretty penny on hair analyses, trichoscopy, doctor consultations, vitamins, supplements, lotions, and shampoos, but I don't regret it. Let's face it - treating hair loss can be pricey.

My Verdict

I think trichoscopy is an incredibly valuable and essential diagnostic method that helps you understand the root causes of hair and scalp problems. Thanks to this method, I finally diagnosed my long-standing androgenetic alopecia. I'm glad I went through trichoscopy and found a knowledgeable specialist who performed it and prescribed the right treatment. I highly recommend computerized hair diagnostics (trichoscopy) to anyone experiencing hair loss!

Thanks for reading! Wishing you all good health!