Hair loss treatment

Hair loss (జుట్టు రాలడం) is one of the most common reasons people come to the clinic, and one of the most commonly self-treated for years with oils, shampoos and supplements before anyone examines the scalp.

First: is it actually abnormal?

Shedding around 50 to 100 hairs a day is normal. Far more informative than counting hairs is whether your parting is widening or your scalp is becoming more visible over a period of months. That indicates genuine thinning; the hairs on your pillow may not.

The main types

• Androgenetic alopecia (pattern hair loss) — gradual thinning at the crown and temples in men, and diffuse widening of the parting in women. Genetic and hormonal. The most common type by a wide margin.
• Telogen effluvium — sudden, heavy, diffuse shedding two to three months after a trigger: fever, typhoid, dengue, surgery, childbirth, crash dieting, severe stress or significant illness. Usually recovers once the trigger is addressed.
• Alopecia areata — well-defined smooth bald patches, sometimes in the beard or eyebrows. An autoimmune condition; often responds well to treatment.
• Nutritional and hormonal causes — iron deficiency, thyroid disease, vitamin D deficiency and PCOS are genuinely common in this region and are all correctable.
• Scarring alopecia — permanent follicle loss with visible scalp change. Diagnosing this early matters most, because lost follicles cannot be recovered.
• Traction alopecia — from tightly tied hair over years, typically at the hairline. Reversible early; permanent if left.

How we diagnose it

Assessment at the clinic includes:

• History — when it started, how fast, any illness, medicines, family pattern
• Examination of the scalp and the pattern of loss
• Hair pull test to gauge active shedding
• Trichoscopy — magnified examination of follicles, which distinguishes pattern loss, alopecia areata and scarring alopecia from one another
• Blood tests where indicated — haemoglobin and ferritin, thyroid function, vitamin D, and hormonal tests in women with irregular periods

This is the step most often skipped. Treating pattern hair loss and alopecia areata identically will fail for one of them.

Treatment options

Treatment depends entirely on the diagnosis:

• Topical minoxidil — the mainstay for pattern hair loss in men and women
• Oral therapy — anti-androgen treatment for selected patients, discussed with its effects and side effects explained clearly before starting
• Intralesional steroid injections — for alopecia areata patches, usually with good response
• Correcting the underlying cause — iron, thyroid or hormonal treatment where tests show a deficiency or disorder
• PRP (platelet-rich plasma) — an adjunct for pattern hair loss, in a course of sessions, alongside medical treatment rather than instead of it
• Treating the trigger — for telogen effluvium, reassurance and time are often the correct treatment; it typically settles in three to six months

A realistic timeline

Expect three to six months before meaningful regrowth is visible. Reduced shedding comes first, usually at around two months.

Minoxidil commonly causes a temporary increase in shedding in the first four to six weeks. This is expected — it reflects follicles moving into a new growth cycle — and is not a reason to stop, though it is the point at which most people do.

The honest part

Pattern hair loss is controlled, not cured. Treatment slows the loss and regrows some hair, but the benefit lasts only while treatment continues. Starting earlier gives a considerably better result, because a follicle that has already scarred over cannot be brought back.

Anyone offering a guaranteed permanent cure for pattern hair loss — particularly without examining your scalp — is worth being sceptical about.