Androgenetic alopecia
Genetically susceptible follicles gradually miniaturise under the influence of DHT. Progressive, permanent once the follicle is lost, and by far the most common cause in both sexes.
Understanding why you're losing hair
Most hair loss is androgenetic – pattern loss driven by genetics and DHT – but not all of it is, and the difference decides everything that follows. Thyroid problems, iron deficiency, autoimmune conditions and simple mechanical tension all cause hair loss that responds to treatment rather than surgery. Diagnosis comes first here, always.
A transplant redistributes the hair you still have. It does not stop the loss continuing around it. So the sequence here is diagnosis, then stabilising what is happening – and in many cases that is the whole treatment.
Where to start
Hair loss in men
Androgenetic alopecia accounts for the large majority of male hair loss. What the pattern tells you, and what can be done at each stage.
Read more →Hair loss in women
Diffuse thinning rather than a receding hairline, and a much wider list of possible causes – which is why diagnosis matters more here.
Read more →Diagnosis
Trichoscopy, pull testing and blood work. What actually happens at a consultation and what we are looking for.
Read more →Treatment
Minoxidil, finasteride, mesotherapy, PRP and laser therapy – what each does, what it does not do, and who it suits.
Read more →New to the topic? Start with how the hair growth cycle works →
The main causes, and what separates them
These behave differently, respond to different things, and carry very different prognoses. Telling them apart is the entire purpose of a consultation.
Telogen effluvium
A larger-than-normal share of follicles shift into the resting phase after illness, surgery, childbirth, crash dieting or severe stress. Usually temporary, and usually recovers once the trigger passes.
Alopecia areata
The immune system attacks follicles, producing sharply defined round patches. It can regrow spontaneously and it needs medical treatment, not surgery.
Traction alopecia
Sustained tension from tight styling gradually damages follicles, typically along the hairline and temples. Reversible early, permanent if the tension continues.
Scarring alopecia
Inflammation destroys the follicle and replaces it with scar tissue. The underlying condition has to be brought under control before any surgery can be considered.
Nutritional and hormonal causes
Thyroid disorders, iron deficiency and certain medications all affect hair. These are found with blood work, not by looking at the scalp – and treating them is what fixes the hair.
The thing people get wrong
Acting early is about diagnosis, not surgery
Once a follicle has miniaturised past the point of recovery it is gone, and no treatment brings it back. Everything medicine can do for hair loss works on follicles that are still alive – which means the earlier you know what you are dealing with, the more options you still have.
That is not an argument for operating early. It is an argument for finding out early, and then doing whatever the diagnosis actually calls for.
What diagnosis involves →Common questions
How much hair loss is normal?
Shedding 50 to 100 hairs a day is normal – hair grows in cycles and a proportion is always in the resting phase. What matters is not the number on the pillow but whether density is visibly reducing over months, whether the pattern is diffuse or localised, and whether the hairline is moving.
Can hair loss be reversed?
It depends on the cause. Telogen effluvium, traction alopecia caught early, and hair loss from thyroid or iron problems usually recover once the cause is addressed. Androgenetic alopecia can be slowed and partially reversed while it is still miniaturising, but a follicle that has been lost does not come back – which is why timing matters so much.
Should I start treatment or go straight to a transplant?
Almost always treatment first, and often treatment instead. A transplant redistributes hair you still have; it does not stop the loss continuing around the transplanted area. If your loss is active and early, operating now risks an unnatural result in five years. The sequence is to stabilise it first and reassess.
At what age should I do something about it?
As soon as you notice a change is the right time to get diagnosed – not necessarily to get treated. Early diagnosis tells you what pattern you are dealing with and how fast it is moving, which is the information every later decision depends on.