Hair Loss

Hair loss, or alopecia, is a symptom with many causes. It may be gradual thinning, sudden shedding or distinct bald patches, and it may affect the scalp alone or the eyebrows, beard and body hair as well.

Losing 50 to 100 hairs a day is normal. The important step is to find the type of hair loss, because some forms recover on their own, some respond to medicine, some are suitable for a transplant and a few scar the scalp permanently if they are not treated early.

Symptoms

• Gradual thinning at the temples and crown in men, or a widening parting in women
• Sudden heavy shedding when washing or brushing, often 2 to 3 months after an illness or stress
• Round, smooth bald patches
• Broken hairs with scaling or itch, especially in children
• Patches with redness, pain, pustules or shiny scarred skin
• Loss of eyebrows, lashes or body hair

Causes and risk factors

The commonest cause is androgenetic alopecia, an inherited sensitivity of hair follicles to androgens. Telogen effluvium is diffuse shedding triggered by fever, surgery, childbirth, crash dieting, major stress or a new medicine. Alopecia areata is an autoimmune attack on follicles. Other causes include iron deficiency, thyroid disease, polycystic ovary syndrome, fungal scalp infection, tight hairstyles (traction), hair pulling, chemotherapy and scarring conditions such as lichen planopilaris and frontal fibrosing alopecia.

How it is diagnosed

• History and scalp examination: The pattern, speed and timing of loss usually point to the cause.
• Trichoscopy: A magnified view of the scalp shows miniaturised hairs, exclamation mark hairs, scaling or loss of follicle openings.
• Pull test: Gentle traction on a group of hairs shows whether active shedding is under way.
• Blood tests: Ferritin, thyroid function, vitamin D, and in women with irregular periods or excess hair, androgen hormones.
• Scalp biopsy: Used when a scarring alopecia is suspected or the diagnosis is unclear.
• Fungal scraping: Confirms tinea capitis, mainly in children.

Treatment options

• Treating the trigger: Correcting iron deficiency or thyroid disease, or simply waiting after an illness. Telogen effluvium usually recovers within 6 to 9 months.
• Topical or low dose oral minoxidil: Slows loss and thickens existing hair in pattern hair loss. It must be continued to keep the benefit.
• Finasteride or dutasteride: Tablets for male pattern loss that block the hormone driving it. Sexual side effects occur in a small minority.
• Steroid injections and JAK inhibitors: For alopecia areata: injections for small patches, newer tablets for severe disease under specialist supervision.
• Anti-inflammatory treatment: Scarring alopecias need prompt medical treatment to save the remaining follicles. Transplants are unsuitable while the disease is active.
• Hair transplant: Moves permanent follicles from the back of the scalp to thin areas. Appropriate only for stable pattern loss or healed scars with a good donor area.
• PRP and low level laser: Evidence is modest and results vary. Treat them as optional extras, not as replacements for proven medicine.

When it is urgent

Hair loss is almost never an emergency. See a doctor promptly, locally, if loss is sudden and accompanied by a painful, boggy or pus-filled scalp, if a child has scaly bald patches, or if shedding comes with marked weight change, fatigue or other signs of general illness.

Travelling to Türkiye for treatment

A trip makes sense once the diagnosis is clear and the answer is a transplant: typically 3 to 4 days in Istanbul. It does not make sense to fly for shedding that has not been investigated, for active alopecia areata or for scarring alopecia. Medical treatment runs for years and is best prescribed and monitored by a doctor near you. Send clear photographs and any blood results first so that an honest opinion can be given before you book.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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