- Best Results4-8 months
- Treatment Recovery0
- Procedure Time2-3 minutes per day @home
- Skin SpecialistYou, with help from us
- Duration of ResultsDepends
- Back to WorkNA
Hair Loss Guide; Self Diagnosis
Not all cases of hair loss require dermatological management. Telogen effluvium is most commonly seen in women. This is self-limiting. For males, the most common cause of hair loss is androgenic alopecia or male pattern baldness. Early & effective management can halt the progression of baldness in over 90% of cases. Be guided by your dermatologist.
FactsFacts on Hair Loss. How to self-diagnose?
- Telogen hair fall is commonly seen after pregnancy
- The most common cause of hair loss in adult males is patterned baldness
- Most cases of acute hair loss will self-resolve
- Simple over the counter lotions & foams can slow down hair loss
- Some cases of hair loss can be diagnosed by yourself with some simple prompts & detective work
- Sensible home microneedling can stimulate hair growth
How many strands of hair are normally shed in one day?
Between 100 to 150. The number is arbitrary as if you generate an equal number of new follicles your net loss will be zero. The flipside is that if you lose 25 a day, but don’t regenerate any new follicles, your net loss will be nearly 10,000 in just over a year.
Lesson number one- do not count strands of hair. For an objective measurement, take accurate photos of the hairline, temples, sides & top (crown).
How do you detect the early signs of balding in men?
Hair loss in men is often insidious. Early signs include thinning of the vertex (top), the frontal hairline & temples. Most but not all balding males will have a family history of hair loss.
How to detect the signs of female pattern hair loss?
Female pattern hair loss is different from men. Hair loss can be from the top or vertex as well as thinning of the front, & or it can be diffuse (all over). One of the most common ways to detect hair loss is to measure the circumference of hair tied up in a ponytail. Another way to measure the extent of hair loss is to measure the diameter of your hair part.
Hair loss in females is harder to diagnose compared to men. In many cases there are two conditions contributing to hair loss. For example, telogen effluvium or chronic TE coupled with patterned baldness.
What is a simple & effective way to treat hair loss at home?
It really depends on the diagnosis. For the most part, common causes of acute hair loss will self-resolve without any special treatment.
Male & female pattern baldness/hair loss can be managed with pharmacy sourced lotions & supplements.
View our Treatment Gallery
What is the most likely diagnosis if I am losing hair all over?
Most common conditions include telogen effluvium and or concurrent AGA, especially in females. Your dermatologist will also consider drug induced causes, endocrine (thyroid), chronic TE, diffuse alopecia areata, as well as inflammatory causes.
What is the most likely diagnosis if I am losing hair in patches?
Probably alopecia areata. If you have OCD, it could be you ripping out your hair (trichotillomania). Syphilis can cause patchy hair loss as well. Tinea is common in children.
This pattern of hair loss can be tricky to manage, you should see a medical dermatologist ASAP. Disclaimer- I do not treat nor manage medical cases of hair loss.
What is the most likely diagnosis if I am losing hair in temples, the front & eyebrows?
If you are female, it is probably Frontal Fibrosing Alopecia or FFA. This is a rare condition however most dermatologists will see one or two cases every few weeks to months. The diagnosis is straightforward in most cases.
Pattern: Hair loss in the front hairline & brows, usually over the age of 50, female.
Symptoms: Can be itchy in some.Action: See a medical dermatologist ASAP. They need to preserve your remaining hair follicles.
Treatment: Topical anti-inflammatory, minoxidil, systemic medications. Adjunctive FUE, PRP in some cases.
What is the cause if I braid my hair for many years?
If you tie your hair with super tight braids, chances are you have traction alopecia. This is more common in ethnic women. This is due to tractioning of hair shafts that pull the follicles, leading to destruction.
Pattern: Hair loss in the front hairline, with sparing of the fringe. Pimple-like areas in some.
Symptoms: Often asymptomatic.
Action: See a medical dermatologist ASAP. They need to preserve your remaining hair follicles.
Treatment: Topical anti-inflammatory, minoxidil, try another hair style. Some patients will benefit from FUE hair transplant.
What drugs can cause hair loss?
Lots. The most drastic is with chemotherapy, the most common is with the oral contraceptive pill & Accutane.
Pattern: Generalised hair loss
Symptoms: Often asymptomatic.
Action: See a medical dermatologist to confirm.
Treatment: Most will self-resolve. PRP & oral minoxidil can increase the anagen cycle of hair.
What are common causes of hair loss in children?
Tinea, alopecia areata, & trichotillomania. Tinea (esp. if you have guinea pigs, cats or puppies), is pretty easy to diagnose. Trichotillomania is due to habitual hair pulling. In kids it is usually self-limiting.
For complex cases, see either a hair specialist or a paediatric dermatologist as there are rare cases such as genetic disorders of hair growth as well as structure.
Pattern: Variable. Often patchy.
Symptoms: Often asymptomatic, can be inflammatory if tinea.
Action: See a medical dermatologist ASAP.
Treatment: Treat the cause.
What is telogen effluvium?
This is probably the second most common cause of hair loss after androgenetic alopecia. The majority of women will experience telogen effluvium at some point in their lives, the most common is 2-4 months after childbirth.
Pattern: Hair loss globally following stress, pregnancy, surgery, trauma.
Symptoms: No symptoms (except stress)
Action: See a GP, or dermatologist if it last longer than 6 months (Chronic TE)
Treatment: Reassurance, support growth of new hair with supplements. Exclude concurrent AGA.
What simple tests can you do at home?
Clinical testing ranges from hair microscopy, biopsy, culture, fluorescence as well as many more including DNA. There are, however, simple DIY tests you can do. Be careful with interpretation as most non-dermatologists may still get the diagnosis wrong.
A hair pull test can determine how active your hair loss can be. 6 or more strands may possibly indicate hair loss disorders such as telogen effluvium (most common), early patterned hair loss, Chronic TE, loose anagen syndrome, & anagen effluvium.
*Though these tests can easily be performed at home, interpretation is contextual. As the normal human scalp can shed up to 150-160 strands per day, you may get excessively stressed or paranoid with your own subjective interpretations of testing. Ideally, visit a dermatologist with a special interest in hair.
Can Accutane cause hair loss?
Yes. In most cases it is reversible when you stop this tablet. Discuss this with your treating dermatologist. See the section on Accutane Hair Loss to understand more about this common condition.
Which lotion is best for hair loss?
If you have male or female pattern hair loss, the most effective over the counter lotion is minoxidil. Choose the 5% strength. It comes in either a lotion or a foam solution. Foam is less irritating.
Minoxidil is a life-long treatment, if you stop it your hair will regress back within 4-6 months. For more on how to use this lotion refer to the dedicated page on this website.
Do shampoos make a difference?
If hair loss is secondary to inflammation (seb dermatitis, psoriasis) shampoos make a difference. If it is due to male or female pattern hair loss, it doesn’t.
There are reports of ketoconazole shampoo inhibiting the enzyme 5 alpha reductase which is responsible for male & female pattern hair loss. If you would like to try it, buy some Nizoral, for 10 bucks it is worth a go. Placebo works 20% of the time.
Do vitamins help with hair loss?
Yes if you are deficient in the first place. The most common deficiency is iron followed by folate & B12 (vitamin D if you are photo protected). Vitamin C or ascorbic acid can also present as hair fall, however if you are deficient in C, namely scurvy, you have much bigger problems than hair loss. Like bleeding in your gums, joint & extensive bruising of your skin.
Patients who are iron deficient may have telogen effluvium (especially if blood loss occurred 2-4 months ago). Be guided by your physician based upon iron studies.
Supplementation is banal hence you can go on a hair support formulation of vitamin B complex, biotin, folate, zinc, & iron. Found in all pharmacies.
Does home microneedling work?
Yes, however for home use, most dermatologists recommend 0.2 to 0.25 mm rollers or stampers. If you bleed, the needles are too deep. These can be purchased from Amazon or ebay for a few dollars. See the section on microneedling for instructions. This is very different from clinical microneedling as we use 1.5 mm to 2.0 mm needles.
A sensible guide is –
- Home microneedling 0.25 mm, every 7 to 14 days.
- Application of minoxidil 5% foam 15 to 30 minutes after
Microneedling has been shown to be beneficial for male & female pattern baldness, telogen effluvium, lichenoid disorders as well as alopecia areata (controversial). It works by increasing absorption of topicals & stimulation of stem cells in the dormant hair follicles.
Do home laser devices work?
Hard to say. I am currently trialling a few LLLT or low-level laser therapy home devices at Cutis. This is to compare with our much more powerful clinical LEDs. Home devices cost between 800 to 1500 dollars. They may work. Be careful of advertising that promises results too good to be true. Lights & lasers are not fertilizers for your scalp.
What can a dermatologist do?
Lots. We approach hair loss from a medical POV, namely diagnose, then manage. Dermatologists spend an average of 6 additional years of study on top of a 6 year medical degree. This study involves disorders of the skin & hair.
Dermatologists treat common hair loss disorders such as male and female pattern hair loss, as well as rarer conditions such as alopecia areata, discoid lupus, lichen planopilaris, frontal fibrosing alopecia & traction alopecia. We also manage super rare cases of hair loss including genetic disorders of hair loss. We are the pointy end of the hair industry.
We can arrange formal hair microscopy (not fuzzy in office ones) as well as genetic markers for genodermatoses. Cutis Clinic has two hair experts, Dr Esh & Dr Heba who have had extensive training in medical management of hair loss disorders.
Disclaimer: I am a procedural dermatologist. I do not practice medical dermatology. I do not treat hair loss disorders, but I may give a second option in complex cases of hair loss.
Davin’s Viewpoint on Hair Loss & self-diagnosis
As with everything, common things occur commonly, & self-diagnosis is never 100% accurate (neither is a clinical diagnosis). As a disclaimer you should see a medical dermatologist for confirmation (or a real diagnosis, it is probably more accurate than most).
The hair loss industry is huge, many clinics & experts out there, with optimistic claims. The majority of hair loss lotions, pills & procedures can be purchased in a pharmacy for literally a fifth of the costs from chain clinics. This includes lotions like minoxidil & supplements like biotin, B12, iron & folate. Safe microneedling can be done at the comfort of your own bathroom using 0.2 to 0.25 needles. They cost 4 to 5 dollars on eBay or Amazon.
Many cases of acute hair loss, namely telogen effluvium will self-resolve in 3-6 months. For complex cases, a medical dermatologist can shed some light, & in most cases treat accordingly.
Disclaimer: I am a procedural dermatologist. I do not get involved in medical management of hair loss disorders. For hair loss diagnosis, please book with one of my colleagues at Clinic Cutis.
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