“Hair building” fibers through the dermoscope

In 2017, a 40-year-old female patient with hair loss and thinning hair used a commercially available "hair-building" fiber to increase hair density. Trichoscopy revealed signs of female pattern hair loss, but not enough to make a definitive diagnosis. The trichoscopy also showed multiple short, black, hair-like fibers scattered over the scalp, even after cleaning with alcohol gel. These fibers resembled hair fragments, some with a bent appearance similar to that seen in alopecia areata. The study highlighted the need to consider artifacts like artificial hair building fibers when performing trichoscopy. It also emphasized the usefulness of trichoscopy in differentiating between such artifacts and other elements like textile fibers, dirty dots, leftover hair dye, and makeup foundation.