I Was Told the Pull Test Was a Good Hair Loss Indicator – Hair Loss Information by Dr. William Rassman

Hi, I’m trying to figure out if I’m balding or not. I’m a 24 year old male (Korean), with thin and straight hair. I recently heard a “good” test is trying to pull on hair and see how many come out. I pulled (relatively hard) on my hair on the top of my scalp and got about 5 hairs to come out. After that, I tried to do it again, and got about 2 hairs to come out, once again, pulling pretty hard, but not ripping it out. I did it again, and got about 2 more hairs to come out.

Is this normal? Did I pull too hard? I still have a little tingly feeling on my scalp from all the hair pulling. I tried searching through your blog, but couldn’t find an answer. Thanks for all your responses.

I realize there is such a thing as a hair pull test, but this is used to identify hairs that have moved out of anagen and into the telogen cycle (read about the hair cycles). When gentle traction is placed on a group of 50 or so hairs (pull test), if more than 10% of the hairs come out then that would indicate there are hairs in telogen, and the condition we call telogen effluvium is present. Genetic balding does not give you a positive pull test.

I generally do not subscribe to the hair pull test for genetic balding. If you pull to the point of pain, you are pulling too hard. Aside from it being variable and not very scientific, the patients would likely be mad at me for pulling out their hair. The “good” test is a microscopic assessment of how each of your hair shafts look under a microscope, and seeing what the variability is around different parts of your scalp. That is in essence a miniaturization study.

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