Hair loss is a common dermatologic concern that can affect women and men at any age and has many possible causes.

Shedding approximately 50–100 hairs a day can be part of the normal hair growth cycle. However, a noticeable increase in shedding, thinning hair, or bald patches may indicate an underlying condition.

Not all hair loss is permanent. With an accurate diagnosis and appropriate treatment, many patients can experience reduced hair loss and regrowth.

What Causes Hair Loss?

Possible causes include:

• Genetic predisposition and hormonal influences
• Iron deficiency and certain nutritional deficiencies
• Thyroid disorders
• Serious illness, surgery, and rapid weight loss
• Hormonal changes after childbirth
• Certain medications
• Autoimmune conditions
• Inflammatory scalp conditions

Identifying the cause is essential to selecting appropriate treatment.

Main Types of Hair Loss

1. Androgenetic Alopecia (Male and Female Pattern Hair Loss)

This is the most common type of hair loss.

Men typically develop a receding hairline at the temples and thinning at the crown. Women more often notice a widening part and reduced hair density over the top of the scalp.

Genetic predisposition and hair follicle sensitivity to androgens play important roles.

Early treatment can help preserve existing hair.

2. Telogen Effluvium (Diffuse Hair Shedding)

Telogen effluvium causes more shedding than usual.

It may develop after a serious illness, fever, surgery, childbirth, rapid weight loss, or significant physiological stress.

Shedding usually becomes noticeable 2–3 months after the triggering event.

Once the cause is addressed, hair can gradually regrow in many patients.

3. Alopecia Areata

Alopecia areata occurs when the immune system targets hair follicles, usually causing round or oval patches of hair loss.

It can affect the scalp, beard, eyebrows, and eyelashes.

Depending on severity, treatment may include local therapies or newer systemic medications.

4. Scarring Alopecias

Certain inflammatory conditions can permanently damage hair follicles.

Symptoms may include scalp redness, burning, pain, crusting, or permanent patches of hair loss.

Early diagnosis is particularly important in these conditions. Treatment can help prevent further progression, but follicles that have been destroyed cannot always be restored.

How Is Hair Loss Diagnosed?

Diagnosis is based on a dermatologic examination and the patient’s medical history.

The scalp and hair shafts may be examined using a dermatoscope, a technique known as trichoscopy.

Tests such as a complete blood count, ferritin, and thyroid function tests may be requested when needed. Additional tests are selected according to the patient’s symptoms.

Extensive hormone and vitamin testing is not necessary for everyone with hair loss.

Current Hair Loss Treatments

Treatment is planned according to the type and cause of hair loss.

Minoxidil

Minoxidil can support hair growth and is used particularly for androgenetic alopecia.

Topical minoxidil is applied to the scalp. Low-dose oral minoxidil may also be considered for selected patients under medical supervision.

A response generally takes several months. Oral treatment requires assessment of blood pressure, heart rate, swelling, and other potential side effects.

Finasteride and Dutasteride

These medications reduce the effects of dihydrotestosterone (DHT) and are used particularly for male pattern hair loss.

In suitable patients, they may slow hair loss and improve hair density.

Medical assessment is important to discuss sexual side effects, possible effects on mood, and pregnancy-related risks.

Hormonal Treatments for Women

Antiandrogen medications such as spironolactone may be considered for some women.

These medications are not appropriate during pregnancy and are not recommended for everyone.

PRP Treatment

PRP, or platelet-rich plasma, involves applying a platelet-rich portion of the patient’s own blood to the scalp.

It may improve hair density and thickness in some patients, particularly those with androgenetic alopecia.

However, results vary. PRP is not effective for every type of hair loss and should not automatically replace established treatments.

Scalp Mesotherapy and Supportive Procedures

Scalp mesotherapy may involve the administration of various substances into the scalp.

Their effectiveness and supporting scientific evidence differ. It cannot therefore be assumed that every mesotherapy treatment produces hair regrowth.

Treatment should be selected according to the diagnosis and available scientific evidence.

Newer Treatments for Alopecia Areata

Local corticosteroid treatments and injections into affected areas may be used for alopecia areata in suitable patients.

Targeted medications called JAK inhibitors have been developed in recent years, particularly for severe alopecia areata.

Baricitinib and ritlecitinib are notable examples.

Their suitability depends on the patient’s age, disease severity, safety assessment, and local regulatory approval.

How Long Does Hair Loss Treatment Take?

Hair growth is a slow process.

Many treatments require at least 3–6 months before the initial response can be assessed. More noticeable changes may take 6–12 months.

With hereditary hair loss, the benefits of treatment may gradually diminish after treatment is stopped.

Daily Tips to Help Reduce Hair Loss

• Avoid hairstyles that keep the hair under constant tension.
• Limit practices that irritate the scalp.
• Eat a balanced diet with adequate protein.
• Avoid rapid, unsupervised weight-loss diets.
• Take iron and vitamin supplements only when needed.
• See a dermatologist if you develop scalp redness, pain, crusting, or sudden patches of hair loss.
• Taking photographs at regular intervals under the same conditions may help track treatment progress.

Dermatologic Evaluation and Follow-Up

An accurate diagnosis is the first step toward effective hair loss treatment.

At Dr. Armin Müştak’s private dermatology practice, hair and scalp concerns are assessed through a dermatologic examination. When needed, trichoscopy and appropriate laboratory tests help investigate the cause.

A treatment and follow-up plan is developed based on the type of hair loss, clinical findings, and previous treatments.

Early evaluation is important for preserving hair follicles and starting appropriate treatment promptly.