Diagnosing most common hair problems is not difficult – you just have to note the pattern of the hair loss and how quickly it is occurring. Diagnosis is only the first step, however; finding (and treating) the underlying cause can be trickier.

Genetic Hair Loss

The most common cause of hair loss in men and women is ‘genetic’ hair loss. It occurs gradually and particularly affects the top and/or front of your scalp, while the hair on the back and sides of the scalp remain intact. It never leads to baldness in women, but can do in men as a result of their higher levels of testosterone.

In men, genetic hair loss usually begins in the late teens or early twenties. In women, traditionally it tends to occur after menopause, but now I am seeing it increasingly in younger women. This change in demographic may be due to the effects of oral contraceptives, as well as lifestyle changes and stress, which can all contribute even when the underlying susceptibility is genetic in origin.

Diffuse Hair Loss (Telogen Effluvium)

Excessive hair loss from the entire scalp is called diffuse hair loss or telogen effluvium. The hair is replaced but the rate of loss is greater than the rate of replacement. If you notice an obvious increase in hair loss in the space of two or three weeks, then think back to what happened about three months before the hair loss started. Did you have an operation, a bad illness, food poisoning, a drastic change in diet, rapid weight loss, a baby, or extreme stress? Stress affects people in very different ways, and what is stressful to one person is not to another – and in some people it leads to hair loss.

When you can identify an obvious cause for your rapid hair loss, you can be pretty sure that it will slow after about three months and then fully recover. On the other hand, if your hair loss began slowly and has continued beyond six months, this suggests an internal imbalance which has to be identified by your trichologist and doctor, working together, often with the help of blood tests. With diffuse hair loss it’s important to test iron levels, ferritin, thyroid hormones, vitamin D, zinc and other routine blood markers. Once you identify and correct the imbalance, your hair should fully recover.

Alopecia Areata

If you suddenly discover one or more circular patches of hair loss on your face or scalp, it is most likely alopecia areata, which is an autoimmune problem. If the hair comes out easily from around the patch when you gently pull it, that means the patch will get worse before it gets better. With alopecia areata sometimes the hair regrows fully without any therapy, but at other times treatment is necessary for the hair to fully recover. It is best you see a trichologist to confirm the diagnosis. The good news is that with this type of alopecia, the hair follicles still exist so your hair can regrow, and the trichologist can easily check the follicles with a microscope.

Frontal Fibrosing Alopecia

The other problem that you can diagnose yourself is frontal fibrosing alopecia (FFA). If you are a female in your 50s or 60s and notice a loss of body hair and/or eyebrows, plus a thinning of hair at the front and sides of your scalp, then it is most likely FFA. This is an autoimmune problem where hair follicles are destroyed, so appropriate therapy must be given to try to halt the process. Unfortunately, once scarring occurs and a hair follicle is destroyed, that particular hair will not return.

Think You Have Your Diagnosis – Now What?

Before trying to treat your hair loss problem it is worth consulting a trichologist, who can also determine if there is inflammation around the hair follicles. One good place to start, however, is by taking a vitamin D supplement – 1000 IU daily – which is generally helpful for hair loss issues.

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