Hair loss: finding the cause before buying the treatment
Shedding, thinning and patches are different problems with different treatments. Here is how each one is diagnosed and managed.
Hair loss is rarely one condition. Sudden diffuse shedding, slow thinning over the crown, and smooth round bald patches all look alarming, but each has a different cause and a different treatment. Buying a serum before knowing which one you have is the most common mistake.
Key points
- Shedding, thinning and patches are three different diagnoses
- Dermatoscopy separates scarring from non-scarring loss
- Ferritin and thyroid testing changes management often
- Minoxidil needs six months and an early shedding phase is normal
- Supplements without deficiency do not help
The three patterns seen most often
Telogen effluvium is a sudden increase in shedding two to three months after a trigger: fever, surgery, severe illness, childbirth, crash dieting or major stress. Hair comes out from all over the scalp and regrows once the trigger passes.
Androgenetic hair loss is gradual, with widening of the parting in women and recession plus crown thinning in men. Alopecia areata produces smooth, well defined patches and is an immune condition that often responds well to treatment.
What a proper assessment includes
The scalp is examined with a dermatoscope to look at the follicles themselves, which separates scarring from non-scarring loss. Scarring conditions need urgent treatment because lost follicles do not return.
Blood tests are targeted, not scattershot: iron studies with ferritin, thyroid function, vitamin D, full blood count, and hormonal tests for women with irregular cycles or excess hair growth. Low ferritin is very common and treatable.
Treatments that have evidence
Topical minoxidil remains the first line for pattern hair loss and needs at least six months of daily use, with a temporary shedding phase in the first weeks. Oral options, including low dose oral minoxidil and hormonal treatments for suitable patients, are prescribed and monitored by a dermatologist.
Platelet rich plasma and microneedling can support results in selected cases. Alopecia areata is treated with topical or injected steroids and, in extensive disease, newer systemic options. Correcting iron and thyroid problems supports every other treatment.
What does not work
Multivitamins in someone who is not deficient do nothing for hair, and high dose biotin can distort thyroid and cardiac blood tests. Heavy oils left overnight can worsen seborrhoeic dermatitis and itching. Frequent tight styles, hair pulling and strong chemical straightening cause traction loss that becomes permanent if it continues.
Frequently asked questions
Is hair loss reversible?
Telogen effluvium and alopecia areata usually regrow. Pattern hair loss can be slowed and partially reversed but needs ongoing treatment. Scarring hair loss is permanent, which is why early diagnosis matters.
Can hair loss be assessed online?
Yes, with good photographs of the parting, crown and hairline plus recent blood results. Where dermatoscopy or a scalp biopsy is needed, an in-person visit is arranged.
Need advice for your own skin?
Book a video consultation from anywhere in Iraq, or a clinic visit in Baghdad or Karbala.
