There are often several different factors driving hair loss, and it can sometimes need help from a specialist to help you to understand what is causing it and the range of options you have to treat it.
Hair loss cannot be cured, but it can be treated and this means long term commitment to a plan that is right for you.
It can be tempting to self diagnose and to get medication from the internet which may not be right for the type of hair loss you have. Often these treatments are provided without a detailed one to one assessment. Hair transplant surgery is only a temporary solution if the underlying cause of hair loss is not dealt with. If done on the wrong patient it can actually accelerate hair loss. It is now being recognised that additional medical and non-surgical treatments are needed to support the results of hair transplantation.
This clinic complements rather than replaces what is available in the NHS as more time and a wider range of treatment options are available. This includes lifestyle changes, medications, DNA testing for personalising topical medications and supplement and treatments in the clinic or at home.
Whenever it is appropriate the opportunities for using Regenerative Aesthetics are recommended.
What to expect from your medical trichology consultation
You will have a consultation with a practising doctor who has had additional trichology training. In the UK this is unusual because the majority of UK Trichologists do not have a medical background and cannot prescribe. The approach to treatment is to offer evidence based advice and treatment recommendations. This includes medical options, lifestyle tweaks and aesthetic treatments. Where this is not available, the approach will be guided by the approach taken by reputable clinicians. If you are thinking about having a hair transplant this service will be useful to help you to help you to optimise your results.
The initial consultation is to assess and receive an initial opinion and basic treatment plan. The plan will depend on which hair, scalp or beard condition has been identified as being the likely cause for the hair loss. Eyebrow loss can herald scalp hair loss in some conditions such as Frontal Fibrosing Alopecia.
The most important aspect of the consultation is to understand whether you have a scarring (permanent) or non-scarring form of hair loss. If a scarring form of hair loss is suspected, you will be advised to seek a referral to a dermatologist who specialises in hair loss. This is because they can do a scalp biopsy if necessary and prescribe more potent medications. The consultation process will equip you with information by email to discuss with your GP to assist with a referral. It is important to note that the majority of GPs will not have received more than a few hours of training in hair loss before they qualify, so this may impact on the response to requests for further investigation or referral.
The Approach
- Inclusive. This is a service specialising in non-surgical hair restoration for all hair types including afro-textured hair.
- Time. Clients have reported that private dermatology appointments tend to be around 20-30 minutes. This clinic offers more time to thoroughly assess you and explain your options.
- Detail. The initial consultation can be virtual or face to face. Face to face assessments are encouraged and will include the TrichoLab report.
Personalizing your treatment options using DNA testing
The same medication will have different effectiveness in different people. For example, Regaine, which is topical minoxidil is only thought to work in 40% of some populations with balding. Your response to it can be predicted based on your genetic profile.
Topical minoxidil is licensed for balding, but is also widely used for a variety of hair loss conditions. To help stop you wasting time on treatments that are not likely to work, it can be worthwhile to have a TrichoTest DNA test which will help to personalise your treatment options. It is however likely that you will need to use a combination of approaches to tackle hair loss.
This is most useful if you are experiencing early Male or Female Pattern Hair Loss, Telogen Effluvium (Hair Shedding) or early Alopecia Areata (an autoimmune condition). The clinic will be able to prescribe the necessary medications if you have had a diagnostic hair loss consultation.
Before the first consultation
- When your appointment is confirmed you will be sent a Typeform link to complete an online questionnaire before the consultation. This helps to make the best use of the time available. This is an online form which should take around 8 minutes to complete. Please be open and honest about what treatments you have tried before. There is no judgement here, and the aim is to get the best outcome for you.
- It is also helpful if you are able to share important medical information including any important diagnoses and investigations such as blood tests before the consultation. You may not think it is relevant, but it can help to see all the investigations you have had so far. It is now easier to access this information from your GP using an App. This could be Evergreen Life PHR, Patient Access or the NHS App. If you are unable to manage that technology you could alternatively request a Summary Printout from your GP via email which includes the results of recent blood tests that would be ideal. You are entitled to this information free of charge under the General Data Protection regulations. Even if the blood tests have been reported as normal it is helpful to have this information.
- It is essential to have good quality photographs of your hair loss/scalp condition before the consultation. Photographs of the scalp from the front, side, top and back views showing the condition that you are concerned about should be be emailed to info@crewehairandskinclinic.uk.
Blood Tests
If you have not had any blood tests for your hair loss, you may wish to wait until the appointment to get advice about which blood tests to ask for. Some types of hair loss can be made worse by biochemical imbalances so you may be advised to have a blood test.
At the moment due to the pressure on General Practice an alternative way to access routine blood tests would be to access them privately. This clinic will not directly communicate with GPs to request blood tests, however you are welcome to forward the email from this clinic (which will be sent to you within 2 weeks of the consultation) to your GP which should help to explain why the suggestion has been made.
Please ensure that you have stopped taking any supplements containing Biotin at least 48 hours before the test as this can interfere with the results.
- Advanced Hair Loss Blood Test To Investigate Hair Loss (medichecks.com) needs to be done at a clinic which is part of the Medichecks network for an additional charge, or a nurse can visit you to take your blood at home (not currently available in 2023) or
- Ultimate performance blood test. This includes most tests except for a lupus screen
The initial consultation
You will be asked for proof of identity. It is really important that you are open and honest about what products you are using and what treatments you have had from other hair loss establishments. There is no judgement and the process is confidential.
30 – 60 minutes will be spent finding out about your hair loss/scalp concern, its effect on you, your past medical history, medication history, hair care practices history, family history, nutrition and lifestyle.
Some of the questions may seem unnecessary and personal, but they are asked to ensure that as much information relevant to your hair loss or scalp problem is obtained.
If you attend the consultation face to face, your scalp will be examined at high magnification and your hair and scalp will be examined. Photographs will be taken. It is a condition of using this service that you agree to images being held in your client record. This is for insurance purposes. Your images will not be shared elsewhere without your express permission.
The TrichoLab image taken at the appointment is a highly specialised form of imaging of the hair and scalp. It uses polarised light at high magnification, and there is the added benefit of a second opinion from specialist hair loss doctors based in Europe.
Can I bring someone with me to the appointment?
You are encouraged to attend alone, but if you would like to bring someone with you, you are requested to let the clinic know in advance.
Sometimes a family member may have paid for the appointment. All communications are with you as the client, and questions and queries must come through you. You must therefore ensure that the contact details you provide are for you, and not someone else.
Can you look at my skin?
The aesthetics/skin care consultation service is a separate service. All skin care consultations begin online through the Get Harley Service. Follow up appointments for skin care are also arranged through the Get Harley service. Once progress has been made on agreeing a skin care plan, you will then be invited to the clinic for Observ images and the opportunity to sample some skin care products.
After the consultation
At the end of the consultation you will be given a verbal opinion of the condition and recommendations as to what needs to be done next. This could include:
- In clinic treatments available from this clinic
- Suggested blood tests to discuss with GP (These can be arranged via the clinic if needed)
- For some hair loss or scalp conditions it may be more cost effective for you to seek a prescription from your GP. The clinic does not communicate directly with your doctor, but you can use the email communications from the clinic to help inform your discussion.
- TrichoTest may be advised to personalise which can be prescribed treatment
- If there is a possibility of a scarring form of hair loss a referral to a dermatologist will be recommended
- Possible medical treatments which could be topical or oral medications, cosmetic treatments for home use or in clinic treatments. Low Dose Oral Minoxidil and Spironolactone is available via this clinic.
- Suggested haircare products. These personalised recommendations will be uploaded to the Get Harley portal. A member of the team will get in touch with you via email/WhatsApp/Phone call/text. The products can then be sent to your home.
- Dietary tweaks for hair and scalp health
- Scalp camouflage methods including wigs, hair pieces and scalp concealers
Why does it take up to 2 weeks to get an outcome email?
The main reasons are because:
- The evidence base around the management of hair loss and scalp disorders evolving rapidly, so the effort is made to ensure that resources are checked to ensure that you have up-to-date recommendations
- It can take up to 2 weeks for the TrichoLab report to be reported on
- Personalising your plan takes time and consideration.
Follow up appointments - 2 x 30 minutes in year 1
This is a journey, so you are encouraged to touch base with during first year.
You will usually be emailed a written summary of the consultation and initial advice within 7 -14 days.
Everyone is different, and will want to take a personalised approach which takes into account treatment preferences and budget.
The purpose of the second appointment is to address any issues which there may not have been time to cover in the first appointment and to discuss your personalised management plan.
The package includes a third follow up consultation within the first year.
If you do not use your 2 follow up appointments within 12 months of the initial consultation you will need to book a 30 minute follow up appointment for which a fee applies. This will usually be done virtually.
Once you have had the 3 appointments in the consultation and follow up package, then a fee will apply for subsequent advice appointments which will be charged by the half hour.
You may wish to book a follow up TrichoLab image to assess how your hair and scalp are progressing.
What if I need advice again after the first year?
You are encouraged to stay on the clinic mailing list so that you can be made aware of information that could be relevant to you.
If more than 12 months have passed since the first appointment consultations are charged per half hour whether in person or online. You may wish to have a follow up TrichoLab image to quantify what is happening with your hair.
From January 2025, if more than 1 year has passed since the last follow up consultation, the process begins again with a new consultation.
Can I claim back the cost of the consultation?
Some clients have been able to claim back some of the cost of the initial consultation with their insurer. Payments have been discretionary and are not guaranteed. They have been based on the fact that Dr Wilson is on the Specialist Register for Public Health Medicine and General Practice (not dermatology).
If your insurer requires further information, please ensure that when you ask for a tailored receipt that you provide all the necessary information.
1. Original electronic receipt received by email (this will help to identify the route of payment)
2. Your proof of address and date of birth.
Will the clinic write to my GP or a dermatologist?
The email you receive approximately 14 days after the consultation will explain the opinion about what is likely to be going on with your hair and scalp. It will contain a copy of your TrichoLab report and information leaflets.
You will be advised about what further investigations may be helpful. You can share this information with you GP or dermatologist, but the service does not include further communication with your GP or dermatologist. Their decision to investigate further, or whether to refer is at their clinical discretion. If you are thought to have a scarring alopecia, your GP should be willing to promptly refer you to a dermatologist to prevent chances of future permanent hair loss.
Can I get advice on camouflaging my hair loss?
Yes – please do ask as there is not always the time to cover this in the initial consultation. There is also a selection of wigs, head coverings and hair pieces that can be purchased.
This clinic recommends MS Hair fibres (discount code INGRW90) for people with curly/coily hair and Toppik hair fibres (Discount code Crewe1) for people with straighter hair
What should I do if I don't want a consultation, and just want a treatment?
This clinic will only offer treatments to clients who have had a diagnostic hair loss consultation with this clinic. This is because clients may have seen other hair loss practitioners and received a diagnosis, but their approach to management will be different, and the hair loss condition could have changed.
The hair loss treatments available at this clinic have different indications, different price points and different time commitments:
- Regenera Activa – the preferred Regenerative treatment for earlier male and female pattern hair loss. This can be an ideal preparation for hair transplant if done 6 months before the surgery. Treatment can be repeated every 1-2 years if needed
- Polynucleotide – another Regenerative Treatment which is trending in the aesthetics arena. 4 treatments are initially recommended repeated in 7- 14 days (different intervals for skin). After that a further 4 treatments are recommended every 3 weeks. Maintenance treatments are recommended every 6 months.
- Pharma Hermetic Hair Recovery Programme – A peptide treatment with a wide variety of indications. 1 treatment is usually done every 10 weeks for a total of 6 treatments
- Calecim professional advanced hair system treatment – home based treatment programme
- WOW fusion hair loss treatment – Good for sweaty scalps “Scalp Botox”. Treatments are done 12 weeks apart with Botulinum Toxin, 6 weekly treatments without Botulinum Toxin
- Platelet Rich Plasma treatment – monthly for the first 6 months then every 3-6 months thereafter. This is a well known treatment.
- Purasomes – Exosome treatment. One treatment a month for 3 months, which can be repeated if results are seen.
- Low Level Laser Light Treatment. – 20 minutes twice a week ongoing. It is recommended that if suitable the device is purchased from either Theradome using this link https://www.theradomeforhairloss.co.uk/?affiliates=9 (Discount code CREW50) or a lower cost version on the following link https://www.lifestylepharmacy.co.uk/partner/crewe-hair-and-skin-clinic/?afid=gosussc9 (Discount code Crewe1)
- Skingenuity Hair Restoration will hopefully be returning to the clinic menu in the future Every 2 weeks for a total of 12 weeks
- XL Hair – 1 treatment every 1-2 weeks for one month repeated every 6 weeks. Best for those with hair thinning and dry scalps