a defect of telogen, anagen, or systemic disease. telogen hairs have tiny bulbs without sheaths at their roots. telogen effluvium shows an increased percentage of hairs upon examination. anagen hairs have sheaths attached to their roots. anagen effluvium shows a decrease in telogen-phase hairs and an increased number of broken hairs. scalp biopsy is used when the diagnosis is unsure; a biopsy allows for differing between scarring and nonscarring forms. hair samples are taken from areas of inflammation, usually around the border of the bald patch. daily hair counts are normally done when the pull test is negative. it is done by counting the number of hairs lost. the hair from the first morning combing or during washing should be counted. the hair is collected in a clear plastic bag for 14 days. the strands are recorded. if the hair count is >100/day, it is considered abnormal except after shampooing, where hair counts will be up to 250 and be normal. trichoscopy is a noninvasive method of examining hair and scalp. the test may be performed with the use of a handheld dermoscope or a video dermoscope. it allows differential diagnosis of hair loss in most cases. there are two types of identification tests for female pattern baldness: the ludwig scale and the savin scale. both track the progress of diffused thinning, which typically begins on the crown of the head behind the hairline, and becomes gradually more pronounced. for male pattern baldness, the hamilton–norwood scale tracks the progress of a receding hairline and/or a thinning crown, through to a horseshoe-shaped ring of hair around the head and on to total baldness. in almost all cases of thinning, and especially in cases of severe hair loss, it is recommended to seek advice from a doctor or dermatologist. many types of thinning have an underlying genetic or health-related cause, which a qualified professional will be able to diagnose. management