The Last Word: Trichologist

By Iain Sallis / 07 Feb 2017

Consultant trichologist Iain Sallis argues the reasons why aesthetic practitioners and trichologists need to build more of a rapport

If you were to lose every single hair on your head and body, it would not have an impact on your physiological health. Yet, there are very few other aesthetic issues that can be as psychologically and emotionally devastating as hair loss.

Broadly speaking, many aesthetic practitioners do not have a vast knowledge of the causes and treatment of hair loss and the appropriate training needed. Yet, patients may open up to an aesthetic practitioner, as hair is still classed as ‘cosmetic’.

There are many reasons for hair loss, such as lifestyle, diet, hormones, medication, auto-immune or genetic conditions (or a mixture of any of the above),1 and to add to this, the reasons for losing hair has many ‘myths’ attached to it, meaning it would be easy for someone without the required expertise to give the wrong advice. Everything from sea kelp to stimulating the scalp with magnets to improve blood circulation to the hair follicles has been reported as a ‘cure’ for hair loss, with no or extremely limited scientific evidence to support their efficacy.2,3

Unfortunately advising your patient to go directly to their GP usually achieves very little, as they typically have little training regarding general thinning hair. Is it time aesthetic practitioners turned to trichologists to begin a new working partnership that could be beneficial for patients?

Acknowledging the issue

Hair loss is a common aesthetic concern for both men and women. At my hair loss clinic, approximately 75% of my patient-base is female, which may be of surprise to many, who would presume it is a male-dominated sector. The majority of my patients are suffering from general diffuse, thinning hair.

Once patients have reached the point where they know they have a hair loss problem they may turn to an aesthetic practitioner, before or after seeing a GP to no avail. However, I have seen many patients that have been to aesthetic practitioners and not been given the most appropriate treatment for their condition and, instead, appear to be given the currently ‘popular’ hair treatment or the only one that is available at that clinic.

Aesthetics clinic who specialise in mesotherapy will likely swear that this is the best treatment for hair loss, and those clinics that specialise in PRP will likely say that that is the best course of therapy. These treatments may very well work, however, if treatment is undertaken without proper investigation, it could likely be the wrong treatment for that patient, may not work, and will lead to dissatisfied patients. Hair loss is not one single problem with one single treatment option.

Why may some aesthetic practitioners be wary?

Aesthetic practitioners may not consider approaching trichologists if they are not fully aware of our expertise. Hair loss is a big issue and a big business. Hair loss clinics can be set up by people without any qualification and can promise the earth at a costly price. But this is not the case with ethical and appropriately qualified trichologists.

Qualified trichologists, from the Institute of Trichologists, are trained in a plethora of subjects over a two to three year period. They are not medically qualified but are medically trained in areas pertaining to the health of the hair and scalp. General chemistry, biology and genetics underpin more detailed subjects about diseases and disorders of the hair and scalp as well as its pathology, anatomy and physiology.4

It is important for qualified trichologists to set the bar, earn a good reputation and earn the respect of clinical and medical practitioners.

Why it’s time to come together

An aesthetic practitioner does not always have the in-depth training of the issues that can affect hair, as a trichologist could not do an aesthetic practitioner’s job.

Many forms of hair loss are caused either by underlying medical issues, which, first and foremost, need to be investigated in a medical/evidence based-way such as using blood tests. In some cases, blood tests have been performed by a concerned GP/ aesthetic practitioner but misinterpreted, simply because they lack the specialist knowledge to realise what is affecting the hair. In many cases, aesthetic practitioners are looking for deficiencies rather than insufficiencies. There is a great opportunity for aesthetic specialists to team up with a local qualified trichologist, to ensure the correct bloods are taken and help with interpreting the results afterwards.

How it should work

Trichologists can sift through the small detail of the patient’s problem, taking into consideration lifestyle, diet, medication and blood results. After we have investigated the issue, we can diagnose it and either help the aesthetic practitioner correct the long term medical issue, help the patient directly, correct simple vitamin/mineral disorders or refer the patient to a general practitioner if the problem is serious and requires specialist medical assistance. Local qualified trichologists can be found through the Institute of Trichologists website and practitioners can call them directly to discuss setting up a referral system.


It is in everyone’s best interest that qualified trichologists and medical professionals start working more closely together to overcome what is a huge problem for men and women alike. Hair loss is a taboo subject; it is difficult for patients to talk about it and even harder to find the right person to talk to. If aesthetic practitioners and trichologists could build more of a closer working relationship with each other where they can advise one another, then hair loss can be treated much more effectively. 

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