What is alopecia?
Alopecia simply means hair loss, but it covers a range of quite different conditions with different causes, patterns, and treatments. Getting the type right is the key first step, since management varies significantly between them.
The most common types we see are androgenetic (pattern) alopecia — the gradual, genetically driven thinning seen in both men and women — telogen effluvium, a temporary, diffuse shedding triggered by illness, stress, or hormonal change, and alopecia areata, an autoimmune condition causing patchy hair loss.
Common causes
- Genetics — the main driver of male and female pattern hair loss.
- Telogen effluvium — triggered by illness, surgery, significant weight loss, childbirth, or major stress, usually 2–3 months beforehand.
- Alopecia areata — an autoimmune condition where the immune system attacks hair follicles.
- Thyroid disorders, iron deficiency, and other medical conditions.
- Traction alopecia — from tightly pulled hairstyles over time.
- Certain medications, including some chemotherapy agents.
Recognising the pattern
- Pattern hair loss: gradual thinning at the crown/temples (men) or a widening part (women).
- Telogen effluvium: diffuse, all-over shedding, often noticed as increased hair in the shower or on the pillow.
- Alopecia areata: well-defined, coin-shaped bald patches, sometimes with a tingling sensation beforehand.
Diagnosis
We take a history of onset, pattern, and any recent illness, medication changes, or family history, examine the scalp and hair pattern, and where needed, arrange blood tests (iron studies, thyroid function) to look for an underlying medical cause.
Treatment options
Topical minoxidil
An evidence-based first-line treatment for pattern hair loss in both men and women.
Oral medication
Prescription options for male pattern hair loss, discussed with your doctor based on suitability.
Addressing the underlying cause
Correcting iron deficiency, thyroid dysfunction, or reducing a triggering stressor for telogen effluvium.
Specialist referral
For alopecia areata or complex cases, referral for treatments such as PRP or specialist-directed therapy.
Living with hair loss
- Gentle hair care — avoid tight hairstyles and harsh chemical treatments where hair loss is active.
- A balanced diet, adequate protein and iron intake.
- Early treatment generally gives better results — don't wait years before seeking assessment.
Frequently asked questions
Is hair loss always permanent?
No. Telogen effluvium and many cases of alopecia areata are reversible with time and appropriate management. Pattern hair loss is progressive but can often be slowed or partially reversed with treatment.
Can stress really cause hair loss?
Yes — significant physical or emotional stress can push hair follicles into a resting phase, causing noticeable shedding around two to three months later. It's usually temporary.
When should I see a doctor about hair loss?
If shedding is sudden, patchy, or accompanied by scalp symptoms like itching or scarring, it's worth an assessment rather than waiting — some causes respond much better to early treatment.