Hair Pull Test: Evidence-Based Update and Revision of Guidelines

    Katherine McDonald, Amanda Shelley, Sophia Colantonio, Jennifer Beecker
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    TLDR The normal range for the hair pull test is 2 hairs or fewer, and washing or brushing hair before the test does not affect the results.
    The study "Hair pull test: Evidence-based update and revision of guidelines" involved 181 participants and aimed to establish normal values for the hair pull test, a diagnostic tool for hair loss. The researchers concluded that the normal range for the hair pull test is 2 hairs or fewer removed per pull, which is a revision from the previously suggested value of less than 5 to 6 hairs. The study also found that pretest hair washing and brushing did not significantly affect the results, allowing these activities to be performed at any time before the test. The findings indicated no significant difference in test results based on sex, hair texture, or use of oral contraceptives. The updated guidelines suggest that ≤2 hairs removed is normal, and pretest hair washing and brushing are permissible at any time. Further research is needed, particularly for Afro-textured hair and in individuals with hair loss disorders.
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