Hair loss
Losing 50 to 100 hairs a day is normal: hair is constantly renewed. The problem starts when density visibly decreases, when the scalp starts to show, or when…
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Medicines commonly prescribed for Hair loss
For informational purposes only. Always consult a doctor before taking any medication.
Dosage form: TOPICAL SOLUTION, 20 mg/mlActive substance: minoxidilManufacturer: Laboratorios Normon S.A.Prescription not requiredDosage form: TOPICAL SOLUTION, 50 mg/mlActive substance: minoxidilManufacturer: Mibe Pharma Espana S.L.Prescription not requiredDosage form: TOPICAL SOLUTION, 50 mg/mlActive substance: minoxidilManufacturer: Galenicum Derma S.L.U.Prescription not required
Losing 50 to 100 hairs a day is normal: hair is constantly renewed. The problem starts when density visibly decreases, when the scalp starts to show, or when shedding suddenly increases. The good news is that most causes are treatable, and the key is working out which type of hair loss it is, because the treatments are not interchangeable.
The main types
Telogen effluvium
- diffuse, heavy shedding without bald patches; hairs come out with the root on washing or brushing;
- it begins 2–4 months after the trigger: that delay is the key to identifying it;
- causes: a febrile illness, surgery, childbirth, rapid weight loss, a very restrictive diet, severe stress, iron deficiency, thyroid disturbance, medication;
- it is reversible: hair recovers over 6–12 months once the cause is corrected.
Androgenetic alopecia
- the commonest cause of reduced density in both sexes;
- in men: receding temples and crown;
- in women: widening of the central parting with the frontal hairline preserved;
- hairs progressively thin before ceasing to grow;
- it is progressive and needs ongoing treatment.
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Alopecia areata
- round, well-defined patches of complete hair loss;
- autoimmune in origin;
- it can also affect the beard, eyebrows and eyelashes;
- it often recovers spontaneously, though it can recur.
Scarring alopecias
- lichen planopilaris, lupus, folliculitis decalvans;
- there is redness, scaling or pain around the follicles;
- the follicle is destroyed and the hair does not return, so speed is critical here: every week of delay counts.
Others
- traction alopecia: from tight hairstyles, extensions and braids; recession of the frontal hairline and temples. Reversible at first, scarring if maintained for years;
- trichotillomania: compulsive pulling, with hairs broken at different lengths;
- scalp ringworm: mainly in children, with scaling and broken hairs.
Causes always worth excluding
- iron deficiency and low ferritin, very common in women;
- thyroid disorders;
- vitamin D and B12 deficiency;
- polycystic ovary syndrome;
- coeliac disease;
- medication: anticoagulants, retinoids, lithium, beta blockers, chemotherapy, some antidepressants;
- very low-protein diets;
- childbirth and stopping hormonal contraception;
- the menopause.
When to see a doctor
- shedding has lasted more than three months;
- the scalp is becoming visible;
- round bald patches have appeared;
- there is redness, scaling, pain or itching of the scalp: this may be a scarring alopecia and should not wait;
- the hair loss comes with tiredness, weight gain, irregular periods or increased facial hair;
- it started after beginning a medicine;
- it is a child with broken hairs and scaling;
- it is affecting your mood: a valid reason to attend.
How it is assessed
The doctor examines the scalp with a dermatoscope, assesses the pattern of loss and performs a gentle pull test. Usual blood tests: full blood count, ferritin — not just iron — thyroid function, vitamin D, B12, zinc and, in women with hormonal features, androgens. Where a scarring alopecia is suspected, a biopsy is done.
It is useful to bring photographs from one or two years ago: the pattern of change is the most informative thing.
Treatment
- correct the cause: replace iron, adjust thyroid function, review medication; in telogen effluvium that is the whole treatment;
- topical minoxidil for androgenetic alopecia, and low-dose oral minoxidil in selected cases;
- finasteride or dutasteride in men, and anti-androgens in women where indicated;
- topical or injected corticosteroids for alopecia areata;
- JAK inhibitors for extensive alopecia areata;
- intensive anti-inflammatory treatment for scarring alopecias, to halt follicle destruction;
- oral antifungals for scalp ringworm;
- platelet-rich plasma and mesotherapy: as adjuncts, with variable evidence;
- hair transplantation once the process has stabilised.
Any hair treatment needs 4–6 months before it can be judged. Before that you cannot say it has not worked.
What you can do
- a diet with enough protein, iron and zinc;
- avoid very restrictive diets;
- wash your hair as often as you need: washing does not cause hair loss;
- avoid tight hairstyles, extensions and tight braids;
- go easy on heat from dryers and straighteners;
- space out bleaching and chemical straightening;
- do not take hair supplements blindly: without a deficiency they add nothing, and excess zinc or selenium can worsen shedding;
- manage stress and sleep enough.
Common questions
Does washing make it worse? No. Washing simply collects hairs that had already detached.
How long does recovery take? Telogen effluvium, 6–12 months. Androgenetic alopecia does not recover on its own: it is slowed with treatment.
Do anti-hair-loss shampoos work? They look after the scalp but do not treat the cause.
Is it inherited only from the mother's side? No: genes from both parents are involved.
Should I take biotin? Only if deficient, which is rare. It also interferes with some blood tests, including thyroid ones.
Online consultation
In an online consultation the doctor reviews photographs and the pattern of loss, distinguishes telogen effluvium from androgenetic alopecia and recognises the signs of scarring alopecia — where time is decisive — arranges the right tests including ferritin, and sets out treatment with realistic timescales.
This material is for information only and does not replace a medical consultation.
Medically reviewed by
Reviewed on Jul 9, 2026
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