Hair loss
Investigating hair loss: scalp examination, blood tests where needed, and medical treatment of androgenetic alopecia and other causes.
Diagnosis first
«My hair is falling out» isn't a diagnosis. Behind it there could be androgenetic alopecia — the most common type, with a recognisable pattern in both men and women — a telogen effluvium after childbirth, an illness or a strict diet, alopecia areata, a thyroid problem, an iron deficiency, or a condition of the scalp itself. Each is treated differently, and several resolve on their own once the cause is corrected.
When to book an appointment
- Thinning at the crown or a receding hairline that's progressing.
- Sudden, heavy shedding, with hair coming out when washing or brushing.
- Well-defined bald patches that appear quickly.
- Itching, flaking, redness or pain on the scalp.
- Hair loss along with tiredness, heavy periods or weight changes.
How we investigate it
With your history — how long it's been happening, how it started, family history, medication, diets — and a scalp examination, backed up by trichoscopy where needed. If there's reason to suspect a cause, it's completed with blood tests: iron and ferritin, thyroid and hormone panel.
What can be done
Treatment depends on the diagnosis: topical or oral treatment for androgenetic alopecia, correcting a deficiency where there is one, anti-inflammatory treatment for the types of alopecia that need it. Two honest points: results take months — hair grows slowly — and the realistic goal is usually to slow the loss and regain density, not go back to the hair you had at twenty. When the case calls for it, referral to specific units is considered.
Frequently asked questions
How much hair is it normal to lose in a day?
Losing around a hundred hairs a day falls within the normal range, and there are times of year when it is more noticeable. What does warrant an appointment is sudden, heavy shedding, loss of density at the crown or the hairline, or clearly defined bald patches.
Will I be asked to have blood tests?
Often yes, when the history warrants it: iron and ferritin, thyroid and hormone panels explain a good number of cases of hair loss, especially after childbirth, a strict diet or an illness. Correcting a deficiency can solve the problem with no need for any hair treatment at all.
When do the results of the treatment become noticeable?
Hair grows slowly: you have to count in months, and the first change is usually that it stops falling out before you see any extra density. The realistic goal in androgenetic alopecia is to halt the loss and recover part of the thickness, not to go back to the hair you had at twenty.
Which vitamin am I lacking if my hair is falling out?
Rather than one particular vitamin, what is usually found is low iron —with low ferritin—, vitamin D deficiency or thyroid abnormalities. Taking supplements without blood tests does not help, and some, such as excess vitamin A, can make the hair loss worse. First you measure, then you correct.
Which conditions can cause hair loss?
Thyroid problems, iron-deficiency anaemia, autoimmune diseases such as alopecia areata or lupus, hormonal disorders such as polycystic ovary syndrome, scalp infections and also acute events —surgery, an infection or childbirth— that trigger shedding months later.