Hair loss: causes, what’s normal and treatments

Hair loss has many causes, and finding the cause is the key: without an accurate diagnosis, treatment often does not work [1]. This page explains how much shedding is normal, the common causes in men and women and how each one looks, when to see a doctor soon, what a doctor checks, and what the treatments can realistically do. Every medical statement links to one of 15 sources (dermatology, NHS and Dutch GP patient pages, a review and two drug labels), quoted at the bottom.

In short: losing 50 to 100 hairs a day is normal (the Dutch GPs’ patient site says 100 to 120). The most common cause of hair loss is hereditary pattern hair loss: in men a hairline receding at the temples and a thinning crown, in women a wider part. Heavy shedding 2 to 4 months after an illness, a fever, an operation, a birth, stress or a crash diet usually settles within 6 to 9 months. Sudden bald patches, a sore, itchy or scaly scalp, or a hairline receding in a band with lost eyebrows need a doctor soon. For pattern hair loss, minoxidil and (for men) finasteride are the main treatments: they help some people, and only while you use them. A transplant needs enough donor hair.

How much hair loss is normal?

Losing hair every day is normal. Dermatologists and the NHS put it at 50 to 100 hairs a day [2][5]; the Dutch GPs’ patient site says 100 to 120 [3]. Because new hairs keep growing, normal shedding does not make the hair thinner [3]. At any moment about 85% of the follicles are growing a hair and about 15% are resting; a hair grows for about 4 years, rests for about 4 months, and is then pushed out by the new one [7]. With age most people notice some thinning, because hair growth slows [1][3].

Shedding or hair loss? Shedding a lot more than normal is called telogen effluvium: the hairs fall out, but new hair keeps growing [2][7]. Hair loss in the strict sense is when something stops the hair from growing [2]. A dermatologist can tell the two apart, and some people have both [2].

The common causes and how each looks

What causes the loss decides whether the hair falls out gradually or suddenly, whether it can regrow on its own, needs treatment, or needs care soon to prevent permanent loss [1].

Pattern hair loss (hereditary hair loss) is the most common cause of hair loss worldwide, in men and in women [1][8]. Inherited genes make the follicles shrink and slowly stop growing hair; it can start in the teens but usually starts later [1]. In men the first sign is often a receding hairline or a bald spot on top [1]: the temples recede, with or without thinning at the crown [8], and a ring of hair at the back always stays [4]. Doctors grade it on the Norwood–Hamilton scale [8] (see the Norwood scale and receding hairline). It is thought to affect 80% of men by the age of 80 [8]; the Dutch GPs say 8 in 10 men aged 70 [4]. It can start before 20 and runs in families [4][5]; anabolic steroids can bring it on [4]. The scalp looks normal and does not itch or hurt [4]. In women it usually shows as overall thinning or a wider part [1], while the front hairline usually stays [3]; it affects about 12% of women aged 20 to 29 and 40% by the age of 50 [8]. More in hair loss in women.
Shedding after a shock to the system (telogen effluvium). Common triggers are an illness with a high fever, an operation, an accident, giving birth, a lot of stress, losing a lot of weight or a crash diet, some medicines, thyroid problems and stopping the pill [2][7]. The extra hair fall is noticed 2 to 4 months after the trigger [7] and can affect up to 50% of the scalp hair, but it does not make you bald [7]. In most cases it tapers back to normal over 6 to 9 months [7][2]. If the stress goes on, so can the shedding, sometimes for years [2][7]. It can also unmask pattern hair loss [7].
Alopecia areata often begins with a round or oval bald patch on the scalp or in the beard [11], sometimes in the eyebrows [3]. It usually starts in children and young adults but can start at any age [11]. Hair may regrow on its own in about a year; there is no cure, but treatment can help it regrow [11]. For a few patches, steroid injections are the most effective treatment: in one study of 127 patients, more than 80% had at least half their hair back within 12 weeks [6].
Tight hairstyles (traction alopecia). Hair pulled tight for a long time, by a bun, braids, extensions or a tight headscarf, can fall out [3][1], and the hairline is one of the first places it shows [12]. If the pulling goes on, the skin turns shiny and bald and the hair cannot grow back [12].
Medicines and cancer treatment. Some medicines cause hair loss, including ones bought without a prescription [3]. Ask the doctor who prescribed it, and do not stop on your own [1]. After chemotherapy or radiation to the head, hair usually starts to regrow within months of finishing [1]. For weight-loss injections, see GLP-1 drugs and hair loss.
Thyroid problems and too little iron or other nutrients. A thyroid problem can thin the hair, and treating it can reverse the loss [1]. Too little iron, protein, zinc or biotin can cause noticeable hair loss, and hair can regrow once the body gets enough [1]. Take supplements only when a blood test shows a shortage: with normal levels they can do harm [6].
A scalp infection. A fungal infection of the scalp (scalp ringworm) gives scaly, sometimes inflamed patches where hairs break off, leaving small black dots and bald spots [1][3]. It needs antifungal medicine [6], after which hair tends to grow back [1]. Untreated syphilis can also cause patchy hair loss [1]. Ordinary dandruff is something else: see does dandruff cause hair loss?.
Pulling out hair (trichotillomania). Some people pull out their hair, often to relieve stress and sometimes without noticing [1]. It usually starts between the ages of 10 and 13, and the bald patches can have an unusual shape, more on one side of the head [14]. It is commonly treated with a form of cognitive behavioural therapy called habit reversal training [14].
Scarring alopecias. Inflammation destroys the follicles, and a destroyed follicle cannot grow hair again, so catching it early matters [1]. One example, frontal fibrosing alopecia, looks like a hairline receding along the front and sides of the head [13], and 80% to 95% of women with it have lost some or all of their eyebrows [13].

What the pattern can point to

A rough guide, not a diagnosis; the sources are in the list above.

What you notice	Often
Hairline receding at the temples, thinner crown, scalp looks normal	Male pattern hair loss
A wider part, thinner on top, front hairline kept	Female pattern hair loss
Much more hair in the brush 2 to 4 months after an illness, a fever, an operation, a birth or a crash diet	Shedding (telogen effluvium)
A round or oval bald patch that appears suddenly	Alopecia areata
Thinning where the hair is pulled tight	Traction alopecia
Scaly patches with broken hairs or black dots	A fungal scalp infection
Odd-shaped patches, more on one side	Hair pulling (trichotillomania)
A band receding along the front and sides, thinning eyebrows, or a sore, itchy scalp	Possibly a scarring alopecia

When to see a doctor

Most hair loss needs no treatment: it is temporary or a normal part of getting older [5]. See your GP or a dermatologist soon if:

the hair loss is sudden or comes in patches [3][10]
the scalp hurts, burns or itches, or the loss is extensive or fast without a clear trigger [8]
the hairline recedes in a band along the front and sides, or your eyebrows are thinning [13]
you see scaly patches or broken hairs [1][6]
you lose much more hair than normal, or your hair is getting thinner and you are worried [3]
you are under 20 and going bald [4]
you, or your child, keep pulling out hair [14]
you do not know the reason, or no one in your family has hair loss (the minoxidil label says not to treat yourself then) [10]
the hair loss makes you insecure, low or unhappy [3]; a GP may be able to help you get counselling [5]

Scarring types are the reason not to wait: they can cause permanent loss and need early referral [8], and early treatment can stop frontal fibrosing alopecia from progressing [13]. The NHS also advises seeing a GP about the cause before going to a commercial hair clinic [5].

What a doctor checks

Often the doctor can tell the cause by looking at your hair [5]. Expect:

Questions: how long you have had hair loss and whether it came on quickly [6].
A close look at the scalp, the nails and any other area with hair loss [6].
A pull test: the doctor gently pulls about 60 hairs; more than 2 coming out counts as positive [8]. Heavy shedding gives a positive test [7]; in pattern hair loss it is negative unless something else is going on too [8].
Blood tests when a disease, a vitamin shortage, a hormone imbalance or an infection is suspected [6]. With heavy shedding, thyroid function, iron, vitamin B12 and folic acid are corrected if they are off [7].
A scalp biopsy only when the diagnosis is unclear [8][6].

There can be more than one cause: a woman may shed after having a baby and have early hereditary thinning at the same time [6].

Treatments: what they can realistically do

Treat the cause first. Shedding after a trigger stops once the body readjusts [2], a scalp infection gets antifungal medicine [6], and a thyroid problem or a shortage is corrected [1][7]. Balding itself does not need treatment and says nothing about your health [4]; lotions, caffeine shampoos, diets and vitamin pills sold against it probably do not help [4]. If you want to treat pattern hair loss, the earlier you start, the better it works, and no treatment is 100% effective [1][5]:

Minoxidil (lotion or foam on the scalp) can help early hair loss but cannot regrow a whole head of hair [6]. The men’s foam is half a capful twice a day; results may show at 2 months, and some men need at least 4 [10]. Dermatologists say results usually take 6 to 12 months [6]. The Dutch GPs say it helps a little in about 1 in 6 people [4]. Stop, and the hair loss begins again [10]. More: how to use minoxidil.
Finasteride (men only) is one 1 mg tablet a day [9][5]. It takes 3 months or more before any benefit shows [9]. In the label’s trials, hair growth increased in 48% of men at 12 months and 66% at 2 years, against 7% on placebo [9]; the Dutch GPs say it helps a little in about 1 in 4 men [4]. Sexual side effects were reported by 3.8% of men on finasteride and 2.1% on placebo [9]; they usually go away after stopping [8], but cases that continued after stopping have been reported [9]. Depression and suicidal thoughts are reported too: then stop at once and see your doctor [9][4]. Stopping reverses the effect within 12 months [9]. More: finasteride and minoxidil vs finasteride.
Dutasteride 0.5 mg a day is used off-label for hair loss in men; it blocks both forms of the enzyme 5-alpha-reductase, finasteride only one [8]. More: dutasteride results and DHT blockers.
For women, minoxidil can be used; finasteride should not [5]. Spironolactone works in about 40% of women with female pattern hair loss [6]; it can cause birth defects, so a birth control pill is prescribed with it [6]. More: spironolactone and hair loss in women.
PRP and laser: PRP injections are repeated, usually once a month for 3 months and then every 3 to 6 months [6]. Laser combs, helmets and caps have shown a variable response, and more research is needed [8].
A hair transplant moves hair from the back of the head to a bald area; it only works if there is enough hair left at the back [4][15], and the thinning area must still be able to grow hair [15]. A fuller head of hair, not a full one, is the realistic goal [15]. Hair loss can continue around the transplant, so medicine still helps [15][4], and young men may be asked to start a medicine first and wait [15]. Reviewers place it after medicines have failed; cost and access can be big barriers [8]. Prices by country: hair transplant cost; surgeons: the doctor directory.

Sources

Source titles and quotes are as published (the two Thuisarts pages in Dutch).

[1] Hair loss: Who gets and causes

American Academy of Dermatology (no named author) · American Academy of Dermatology (aad.org), patient information · A patient information page from the American Academy of Dermatology, the US dermatologists' professional body, listing the common causes of hair loss and whether hair can regrow after each. General guidance, not a study; the archived page states no review date. Copied from the hair-loss-women archive (source 1 there, fetched 2026-10-18).

What causes hair loss decides whether it falls out gradually or suddenly, thins, regrows on its own, needs treatment to regrow, or needs care soon to prevent permanent loss. “Hair loss has many causes. What’s causing your hair loss can determine whether your hair: Falls out gradually or abruptly Thins Can regrow on its own Requires treatment to regrow Needs immediate care to prevent permanent hair loss”
Hereditary hair loss is the most common cause of hair loss worldwide, in both men and women; the medical term is androgenic alopecia. “Both men and women develop this type of hair loss, which is the most common cause of hair loss worldwide. In men, it’s called male pattern hair loss. Women get female pattern hair loss. Regardless of whether it develops in a man or women, the medical term is androgenic alopecia.”
Inherited genes make the follicles shrink and eventually stop growing hair; this can begin in the teens but usually starts later in life. “it means that you’ve inherited genes that cause your hair follicles (what each hair grows out of) to shrink and eventually stop growing hair. Shrinking can begin as early as your teens, but it usually starts later in life.”
In women the first sign is usually overall thinning or a widening part. “In women, the first noticeable sign of hereditary hair loss is usually overall thinning or a widening part.”
In men the first sign is often a receding hairline or a bald spot on top of the head. “When a man has hereditary hair loss, the first sign is often a receding hairline or bald spot at the top of his head.”
Treatment can stop or slow hereditary hair loss and may regrow hair; the earlier it starts, the better it works, and without it the loss continues. “Yes, treatment can help stop or slow hair loss. It may also help regrow hair. The earlier treatment is started, the better it works. Without treatment, you will continue to lose hair.”
Finding the cause is the key: without an accurate diagnosis, treatment is often ineffective. “While many causes of hair loss can be treated successfully, the key to effective treatment is to find out what’s causing the hair loss. Without an accurate diagnosis, treatment is often ineffective.”
Thyroid problems can thin the hair, sometimes in clumps when brushing; treating the thyroid can reverse it. “If you have a problem with your thyroid, you may see thinning hair. Some people notice that their hair comes out in clumps when they brush it. Is regrowth possible? Yes, treating the thyroid disease can reverse the hair loss.”
Too little biotin, iron, protein or zinc can cause noticeable hair loss, and hair can regrow once the body gets enough. “Too little biotin, iron, protein, or zinc If you’re not getting enough of one or more of these, you can have noticeable hair loss. Is regrowth possible? Yes. When your body gets enough of the missing nutrients, hair can regrow.”
Some medicines cause hair loss; ask the prescribing doctor and do not stop the medicine before talking to them. “If you think a medication is causing your hair loss, ask the doctor who prescribed it if hair loss is a possible side effect. It’s essential that you do not stop taking the medication before talking with your doctor.”
After chemotherapy or radiation to the head or neck, hair usually starts to regrow within months of finishing. “Hair usually starts to regrow within months of finishing chemotherapy or radiation treatments to the head or neck.”
Hair worn tightly pulled back can, with continual pulling, lead to permanent hair loss (traction alopecia). “If you often wear your hair tightly pulled back, the continual pulling can lead to permanent hair loss. The medical name for this condition is traction alopecia.”
A scalp infection can cause scaly, sometimes inflamed areas with small black dots (stubs of hair) and bald spots; once treated, hair tends to grow back. “A scalp infection can lead to scaly and sometimes inflamed areas on your scalp. You may see what look like small black dots on your scalp. These are actually stubs of hair. Some people develop a bald spot. Is regrowth possible? Yes, treatment can get rid of the infection. Once the infection clears, hair tends to grow.”
Some people pull out their hair, often to relieve stress and sometimes without noticing (trichotillomania). “Some people pull on their hair, often to relieve stress. They may be unaware that they’re pulling their hair. The medical term for this is trichotillomania.”
Untreated syphilis can cause patchy hair loss on the scalp, eyebrows, beard and elsewhere. “Left untreated, syphilis can cause patchy hair loss on the scalp, eyebrows, beard, and elsewhere.”
In scarring alopecias inflammation destroys the follicles, which then cannot grow hair; catching it early can prevent further loss. “This condition develops when inflammation destroys hair follicles. Once destroyed, a hair follicle cannot grow hair. Diverse conditions can cause this. The medical name for this group of conditions is cicatricial alopecia. Is regrowth possible? Once a hair follicle is destroyed, it cannot regrow a hair. Catching this condition early can prevent further hair loss.”
With age most people notice some hair loss, because hair growth slows. “With age, most people notice some hair loss because hair growth slows.”

[2] Do you have hair loss or hair shedding?

American Academy of Dermatology (no named author) · American Academy of Dermatology (aad.org), patient information · A patient information page from the American Academy of Dermatology on the difference between hair shedding and hair loss. General guidance, not a study; the archived page states no review date. Copied from the hair-loss-women archive (source 2 there, fetched 2026-10-18).

Shedding 50 to 100 hairs a day is normal; shedding much more is excessive shedding (telogen effluvium). “It’s normal to shed between 50 and 100 hairs a day. When the body sheds significantly more hairs every day, a person has excessive hair shedding. The medical term for this condition is telogen effluvium”
Common triggers: losing 20 pounds or more, giving birth, a lot of stress, a high fever, an operation, recovering from an illness, stopping the pill. “Excessive hair shedding is common in people who have experienced one the following stressors: Lost 20 pounds or more Given birth Experiencing lots of stress (caring for a loved one who is sick, going through a divorce, losing a job) Had high fever Undergone an operation Recovering from an illness, especially if it included high fever Stopped taking birth-control pills”
Most people notice the shedding a few months after the stressful event. “Most people notice the excessive hair shedding a few months after the stressful event.”
Once the body readjusts the shedding stops and hair tends to regain its fullness within 6 to 9 months; ongoing stress can keep it going. “As your body readjusts, the excessive shedding stops. Within six to nine months, the hair tends to regains its normal fullness. If the stressor stays with you, however, hair shedding can be long lived.”
Hair loss (as opposed to shedding) is when something stops the hair from growing. “Hair loss occurs when something stops the hair from growing. The medical term for this condition is anagen effluvium . The most common causes of hair loss include:”
A dermatologist can tell hair loss from excessive shedding; some people have both. “A dermatologist can tell you whether you have hair loss or excessive hair shedding. Some people have both.”

[3] Ik heb haaruitval. Wat kan het zijn?

Thuisarts.nl (Nederlands Huisartsen Genootschap; no named author) · Thuisarts.nl, Dutch patient information from the Dutch College of General Practitioners (NHG), last changed 7 Jan 2026, 2026 · The Dutch public patient information site of the Dutch College of General Practitioners (NHG), with the Federation of Medical Specialists and the Dutch Patient Federation, written from the GP guideline on hair loss (alopecia). General guidance in Dutch, not a study.

Everyone loses 100 to 120 hairs a day; new hairs grow back, so the hair does not get thinner. “Haaruitval is normaal. Iedereen verliest 100 tot 120 haren per dag. Elke dag groeien er ook weer weer nieuwe haren bij. Hierdoor wordt het haar op je hoofd niet dunner.”
As you get older you lose more hair and it gets thinner all over; that happens to everyone. “Als je ouder wordt verlies je meer haren. Het haar op je hoofd wordt dan overal dunner. Dit gebeurt bij iedereen.”
Losing more than 120 hairs a day makes the hair thin; it can come from stress, fever, being very thin, too little iron, childbirth, an illness or an operation. “Bij veel haartuitval verlies je meer dan 120 haren per dag en hierdoor wordt je haar dun. Dit kan bijvoorbeeld komen door stress, koorts, erg dun zijn, te weinig ijzer in uw lichaam, een bevalling, een ziekte of een operatie.”
In men the front of the head gets balder, with bald areas at the sides of the forehead and at the crown; in women the hair thins in the middle of the head while the front usually stays, without real bald spots. “Bij mannen wordt de voorkant van het hoofd steeds kaler. Er komen kale plekken aan de zijkant van het voorhoofd. Ook het bovenste deel van het hoofd (de kruin) wordt kaal. Bij vrouwen wordt het haar midden op het hoofd dunner. De haren op de voorkant van het hoofd blijven meestal zitten. Er zijn meestal geen echte kale plekken.”
Men often have this pattern of balding, and so does 1 in 3 women, for example after menopause; balding young often runs in families. “Mannen hebben deze vorm van kaal worden vaak. Maar ook 1 van de 3 vrouwen heeft deze vorm van kaal worden, bijvoorbeeld na de overgang. Al jong kaal worden gebeurt vaak bij meer mensen in dezelfde familie.”
Alopecia areata causes sudden round or oval bald patches, usually on the head, sometimes in the eyebrows, beard or pubic hair. “Je kunt ineens 1 of meer kale plekken krijgen. Meestal op je hoofd, soms in je wenkbrauwen, baard of schaamhaar. De plekken zijn rond of ovaal.”
Medicines can cause hair loss, including ones bought without a prescription. “Je kunt ook haaruitval krijgen door medicijnen. Dit kunnen ook medicijnen zijn die je zelf zonder recept koopt.”
A fungal infection of the scalp gives scaly patches where hair can break off, leaving bald areas. “Bij hoofdschimmel heeft u plekken met schilfers op uw hoofd. Op die plekken kunt u kaal worden doordat uw haren afbreken.”
Tight buns, braids, hairpins, extensions, or a tight headscarf or turban can make hair fall out. “Uw haar kan uitvallen als het heel strak zit. Bijvoorbeeld door een strakke knot of vlecht, een haarspeld of hair-extensions. En ook als er iets straks over uw haren zit, zoals een hoofddoek of tulband.”
See your GP if you lose much more hair than normal, your hair gets thinner, you suddenly get bald patches, you are worried, or the hair loss makes you insecure or low. “Bel je huisarts voor een afspraak als 1 of meer van deze dingen voor jou kloppen: Je verliest veel meer haar dan normaal. Het haar op je hoofd wordt dunner. Je krijgt ineens kale plekken op je hoofd. Je maakt je zorgen over de haaruitval. Je wordt onzeker, somber of ongelukkig door de haaruitval.”

[4] Ik word kaal (man)

Thuisarts.nl (Nederlands Huisartsen Genootschap; no named author) · Thuisarts.nl, Dutch patient information from the Dutch College of General Practitioners (NHG), last changed 26 Aug 2025, 2025 · The Dutch GPs' patient page on balding in men, written from the GP guideline on hair loss (alopecia). General guidance in Dutch, not a study; its success rates for the two medicines are rounded figures without a cited trial.

Balding usually goes: the front gets balder, deeper bald areas at the sides of the forehead (temples), the crown goes bald, the areas grow, and a ring of hair always stays at the back. “De voorkant van je hoofd wordt steeds kaler. Er komen kale plekken aan de zijkanten van je voorhoofd: je krijgt diepere inhammen. Ook het bovenste deel van je hoofd (je kruin) wordt kaal. De kale plekken op je hoofd worden steeds groter. Er blijft altijd een krans van haar op je achterhoofd.”
With balding the scalp looks normal and does not itch or hurt. “Je hoofdhuid ziet er normaal uit. En je hebt geen jeuk of pijn.”
8 in 10 men aged 70 have it; it can start before 20, and early balding often runs in families. “Hoe ouder je bent, hoe groter de kans is dat je kaal wordt. 8 van de 10 mannen van 70 jaar heeft er last van. Je kunt ook al kaal worden voordat je 20 jaar bent. Jong kaal worden gebeurt vaak bij meer mensen in dezelfde familie.”
Balding can come from too many male hormones, for example from anabolic steroids used in bodybuilding. “Soms komt kaal worden door te veel mannelijke hormonen. Dit kan bijvoorbeeld gebeuren als je anabole steroïden gebruikt. Zoals bij bodybuilding.”
Lotions, creams and caffeine shampoos sold against hair loss probably do not help, and neither do diets or vitamin pills. “Er is onderzoek gedaan of deze middelen helpen. En waarschijnlijk helpen ze niet. Ook een dieet of vitaminepillen helpen niet.”
Balding does not need treatment and says nothing about your health. “Kaal worden hoeft niet behandeld te worden. Het zegt niets over hoe gezond of ongezond je bent.”
Only after 6 months can you tell whether a medicine works; after stopping, balding continues and can even go faster. “Pas na 6 maanden kun je goed zien of het medicijn bij jou werkt of niet. Als je met het medicijn stopt, gaat het kaal worden weer verder. Het kan dan zelfs sneller gaan.”
Minoxidil lotion is applied twice a day; it helps a little in about 1 in 6 people. “Je smeert de crème 2 keer op een dag op de plekken op je hoofd die kaal worden. Na 6 maanden is pas te zien of het smeren helpt. Bij ongeveer 1 van de 6 mensen helpt het een beetje.”
Finasteride is one pill a day; it helps a little in about 1 in 4 men. “Je slikt 1 keer op een dag 1 pil. Na 6 maanden is pas te zien of het medicijn helpt. Bij ongeveer 1 van de 4 mannen helpt het een beetje.”
Finasteride can cause erection problems, less sex drive, and depression or suicidal thoughts; then stop at once. “niet of moeilijk een stijve penis krijgen of houden minder zin hebben in seks depressief voelen of denken aan zelfmoord Als dit bij jou zo is, moet je meteen met de pillen stoppen.”
A transplant moves hair from the back of the head to a bald area; it can help some men but only if there is enough hair left at the back. “Dit kan bij sommige mannen helpen. Maar het kan alleen als er nog genoeg haren over zijn achter op je hoofd.”
There is no research on whether transplanted hair still fills the bald areas well after a long time, and you can keep going bald elsewhere after a transplant. “We weten niet of de haren ook na lange tijd nog steeds de kale plekken op je hoofd goed opvullen. Hier is geen onderzoek naar gedaan. En na een haar-transplantatie kun je op andere plekken op je hoofd ook nog steeds kaal worden.”
See the GP if you are under 20 and going bald, or if balding makes you insecure, low or unhappy. “Je bent jonger dan 20 jaar en je wordt kaal. Je bent onzeker, somber of ongelukkig door het kaal worden.”

[5] Hair loss

NHS (no named author) · NHS website (nhs.uk), symptoms A to Z, last reviewed 24 January 2024, 2024 · The UK National Health Service's patient page on hair loss. General guidance, not a study.

Losing 50 to 100 hairs a day is normal, often without noticing. “It's normal to lose hair. We can lose between 50 and 100 hairs a day, often without noticing.”
Male and female pattern baldness is permanent and usually runs in the family. “Some types of hair loss are permanent, like male and female pattern baldness. This type of hair loss usually runs in the family.”
Temporary hair loss can come from an illness, stress, cancer treatment, weight loss or iron deficiency. “Other types of hair loss may be temporary. They can be caused by: an illness stress cancer treatment weight loss iron deficiency”
A GP may be able to tell the cause by looking at your hair. “The GP may be able to tell you what's causing your hair loss by looking at your hair.”
See a GP about the cause before going to a commercial hair clinic. “See a GP to get an idea about what's causing your hair loss before thinking about going to a commercial hair clinic.”
Most hair loss needs no treatment: it is temporary or a normal part of getting older. “Most hair loss does not need treatment and is either: temporary and it'll grow back a normal part of getting older”
Finasteride and minoxidil are the main treatments for male pattern baldness; minoxidil can be used by women, finasteride should not. “Finasteride and minoxidil are the main treatments for male pattern baldness. Minoxidil can also be used to treat female pattern baldness. Women should not use finasteride.”
They do not work for everyone and only work for as long as they are used. “do not work for everyone only work for as long as they're used”
No hair loss treatment is 100% effective. “No treatment is 100% effective.”
If hair loss causes distress, a GP may be able to help you get counselling. “If your hair loss is causing you distress, your GP may be able to help you get some counselling.”

[6] Hair loss: Diagnosis and treatment

American Academy of Dermatology (no named author) · American Academy of Dermatology (aad.org), patient information · A patient information page from the American Academy of Dermatology on how dermatologists diagnose hair loss and the treatments they use, with a reference list. General guidance, not a study; the archived page states no review date.

A dermatologist asks how long you have had hair loss and whether it came on quickly. “Ask questions. It’s important to know how long you’ve had hair loss and whether it came on quickly.”
They look closely at the scalp, nails and any other area with hair loss. “Look closely at your scalp, nails, any other area with hair loss. This exam provides vital clues about what’s happening.”
Gently pulling on the hair (a pull test) shows how it is growing and whether it breaks easily. “Test the health of your hair. Gently pulling on your hair tells your dermatologist a lot about how your hair is growing and whether it’s prone to breaking.”
If a disease, vitamin deficiency, hormone imbalance or infection is suspected, a blood test or scalp biopsy may be needed. “If your dermatologist suspects that the cause of your hair loss could be a disease, vitamin deficiency, hormone imbalance, or infection, you may need a blood test or scalp biopsy.”
There can be more than one cause, for example shedding after a baby on top of early hereditary loss. “This might be the case if someone has more than one cause. For example, a woman may have had a baby a few months ago, and this may be causing obvious hair shedding. She may also have early hereditary loss, which isn’t so obvious.”
Minoxidil can help early hair loss but cannot regrow an entire head of hair. “Minoxidil (Rogaine®): Minoxidil can help early hair loss; it cannot regrow an entire head of hair.”
Minoxidil results usually take about 6 to 12 months, and it has to be used every day to keep them. “Many people see some regrowth when using minoxidil, but it takes time to see results, usually about 6 to 12 months. Should you see regrowth, you will need to keep using it every day.”
Corticosteroid injections are the most effective treatment for a few patches of alopecia areata: in a study of 127 patients, more than 80% had at least half their hair back within 12 weeks. “This is considered the most effective treatment for people who have a few patches of alopecia areata, a condition that causes hair loss. In one study of 127 patients with patchy alopecia areata, more than 80% who were treated with these injections had at least half of their hair regrow within 12 weeks.”
Finasteride usually takes about 4 months to show any improvement, and works better if started when hair loss is first noticed. “It usually takes about 4 months to notice any improvement. Finasteride tends to be more effective if you begin taking it when you first notice hair loss.”
If finasteride works, you have to keep taking it; once you stop, you start losing hair again. “If finasteride works for you, you will need to keep taking it to continue getting results. Once you stop, you’ll start losing hair again.”
Spironolactone is effective in about 40% of women with female pattern hair loss. “Studies indicate that this medication is effective in about 40% for women who have female pattern hair loss.”
Spironolactone can cause birth defects, so women who could get pregnant are also prescribed a birth control pill. “It’s essential that you not become pregnant while taking spironolactone. This medication can cause birth defects. To prevent pregnancy, your dermatologist will also prescribe a birth control pill if it’s possible for you to get pregnant.”
PRP injections are repeated: most patients return once a month for 3 months, then every 3 to 6 months. “You will need to return for repeat injections. Most patients return once a month for 3 months and then once every 3 to 6 months.”
Scalp ringworm, caused by a fungus, needs antifungal medication. “Scalp ringworm, which is caused by a fungus, requires antifungal medication.”
Take biotin, iron or zinc only when a blood test shows a deficiency; with normal levels a supplement can be harmful. “You should only take biotin, iron, or zinc when your blood test shows that you have a deficiency. If your levels are normal, taking a supplement can be harmful.”
If treatment is needed for regrowth, the earlier it starts, the more likely it works. “If you need treatment for regrowth, the earlier you start, the more likely you are to see regrowth.”

[7] Telogen effluvium

Fen-Lan Cherry Chang; Amanda Oakley (DermNet editor in chief) · DermNet (dermnetnz.org), updated November 2019, 2019 · A reference page from DermNet, a dermatology resource written by New Zealand doctors and dermatologists. Clinical information summarising textbooks, not a study.

Telogen effluvium is a common cause of temporary hair loss: too many resting hairs are shed after a shock to the system, and new hair continues to grow. “Telogen effluvium is the name for a common cause of temporary hair loss due to the excessive shedding of resting or telogen hair after some shock to the system. New hair continues to grow.”
On a healthy scalp about 85% of follicles are growing hair and about 15% are resting; a follicle grows hair for about 4 years, then rests for about 4 months, and the new hair pushes the old one out. “In a normal healthy person's scalp, about 85% of the hair follicles are actively growing hair (anagen hair) and about 15% are resting hair (telogen hair). A few hairs may also be in catagen. A hair follicle usually grows anagen hair for 4 years or so, then rests for about 4 months. A new anagen hair begins to grow under the resting telogen hair and pushes it out.”
Losing up to about 100 hairs a day is normal. “Thus, it is normal to lose up to about 100 hairs a day on one's comb, brush, in the basin or on the pillow, as a result of the normal scalp hair cycle.”
After a shock to the system as many as 70% of growing hairs can switch to resting. “If there is some shock to the system, as many as 70% of the anagen hairs can be precipitated into telogen, thus reversing the usual ratio.”
Triggers include childbirth, illness with fever, surgery, an accident, psychological stress, weight loss or crash diets, certain medicines, thyroid disorders and stopping the pill. “Acute or chronic illness, especially if there is fever Surgical operation Accident Psychological stress Weight loss, unusual diet, or nutritional deficiency (eg, iron deficiency/) Certain medications Endocrine disorders (eg, hypothyroidism, hyperthyroidism) Discontinuing the contraceptive pill”
The extra hair fall is noticed 2 to 4 months after the trigger. “The new hairs coming up through the scalp push out the resting club hairs and increased hair fall is noticed 2 to 4 months after the triggering event.”
It can affect up to 50% of the scalp hair, without scarring or inflammation. “Telogen effluvium is a non-scarring form of diffuse hair loss with no clinical or histological evidence of inflammation and can affect up to 50% of the scalp hair.”
The hair fall peaks after several months and tapers back to normal over 6 to 9 months in most cases. “after several months a peak is reached and hair fall begins to lessen, gradually tapering back to normal over 6–9 months in most cases.”
In some people the shedding goes on for long periods, sometimes years (chronic telogen effluvium). “In some patients, hair shedding continues to be intermittently or continuously greater than normal for long periods of time, sometimes for years.”
Telogen effluvium does not cause complete baldness, but it may unmask pattern hair loss. “Telogen effluvium does not cause complete baldness, although it may unmask a genetic tendency to genetic balding i.e. female pattern hair loss, or in men, male pattern hair loss.”
A gentle pull test brings out more hairs than normal. “A gentle hair pull test reveals an increased number of hairs; most are telogen with a typical epithelial sac.”
Thyroid function, iron, vitamin B12 and folic acid are corrected if abnormal. “Correct any abnormality in thyroid function, or levels of iron, vitamin B12 and folic acid.”

[8] Male and female pattern hair loss

Iyengar L, Li J · Australian Prescriber 48(3), 2025 · A practical review for prescribers in Australia (University of Melbourne authors) of diagnosis, other causes to rule out, treatment and when to refer. One author reports payments from Bristol Myers Squibb and CeraVe. Copied from the hair-loss-women archive (source 5 there).

Pattern hair loss is the most common form of hair loss in men and women: progressive thinning in a set pattern, genetically regulated and driven by sensitivity to androgens. “Androgenetic alopecia (AGA), otherwise known as pattern hair loss, is the most common form of hair loss in both men and women. It is characterised by progressive hair thinning in a defined pattern that is genetically regulated, driven by sensitivity to androgens.”
Male pattern hair loss is thought to affect 80% of men by the age of 80. “Male pattern hair loss is thought to affect 80% of males by the age of 80.”
Female pattern hair loss affects about 12% of women aged 20 to 29 and 40% of women by age 50. “Female pattern hair loss affects approximately 12% of women aged between 20 and 29 years to 40% of women by age 50.”
In men there is usually recession at both temples, with or without loss at the crown; the Norwood–Hamilton scale is used for men, Ludwig and Sinclair for women. “In male pattern hair loss, there is usually bitemporal hairline recession with or without scalp vertex hair loss. Commonly used classification scales include the Norwood–Hamilton scale for male pattern hair loss, and the Ludwig scale and Sinclair scale for female pattern hair loss.”
Alopecia areata shows as well-circumscribed patches, in adults or children; pattern loss can occur together with telogen effluvium. “Alopecia areata presents as well-circumscribed patches of hair loss in adults or children; trichoscopy may reveal black dots and exclamation mark hairs. AGA can present simultaneously with other forms of hair loss, such as telogen effluvium.”
Scalp pain, itch or burning, extensive hair loss, or rapid hair loss without a trigger warrant urgent referral to a dermatologist. “Symptoms such as scalp pain, itch or burning, extensive hair loss, or rapid hair loss in the absence of a preceding trigger, warrant urgent escalation of care to a dermatologist.”
Scarring alopecias need early referral because they can lead to permanent hair loss. “It is important that the primary care physician is able to identify scarring alopecias to allow early referral to a dermatologist for treatment, as these can lead to permanent hair loss.”
In the pull test about 60 hairs are pulled gently; more than 2 coming out is positive. “The hair pull test involves holding approximately 60 hairs between the index finger and thumb and pulling these hairs away from the vertex, parietal and occipital areas of the scalp. A positive hair pull test is defined when more than 2 hairs are removed from the scalp.”
In pattern hair loss the pull test is negative unless other conditions are present. “In AGA, the hair pull test is negative, unless other conditions are also present.”
Scalp biopsies are not routine, only when the diagnosis is uncertain. “Scalp biopsies are not routinely performed; however, they may be used if there is diagnostic uncertainty.”
Most drug treatments take at least 6 months to show a response and may need to continue long term. “Most pharmacological treatments take at least 6 months to show a response and may need to be continued long term.”
Stopping treatment leads to progression of pattern hair loss. “Stopping treatment leads to progression of AGA.”
For men: finasteride 1 mg once daily for at least 2 years; dutasteride 0.5 mg once daily, used off-label for hair loss. “Finasteride: 1 mg orally once daily for at least 2 years Dutasteride: 0.5 mg orally once daily; used off label for hair loss [NB1]”
Finasteride blocks the type II form of 5-alpha-reductase, dutasteride types I and II; blocking it prevents DHT, which improves growth and slows loss. “Therefore, inhibition of 5-alpha-reductase prevents the formation of dihydrotestosterone, which improves hair growth and slows hair loss. Finasteride inhibits the type II isoform of 5-alpha-reductase while dutasteride inhibits type I and type II.”
Side effects are mainly sexual (erectile dysfunction, low libido), breast enlargement and lower blood pressure; they rarely persist and usually reverse on stopping. “Adverse effects mainly relate to sexual dysfunction (e.g. erectile dysfunction, low libido, anorgasmia), gynaecomastia and lower blood pressure. These rarely persist and are generally reversible with discontinuation of the medication.”
Laser combs, helmets and caps have shown a variable response; more research is needed. “Results to date have shown a variable response and further research is needed to ascertain the efficacy of this treatment.”
When medical therapy has failed, a hair transplant gives permanent hair restoration. “Patients in whom medical therapy has failed may consider surgical management, which involves hair transplantation and results in permanent hair restoration.”
Transplants can be combined with medicines, but cost and access can be major barriers. “Patients may choose to combine transplantation with medical therapy for improved cosmesis; however, cost and access can be major barriers.”

[9] PROPECIA (finasteride) 1 mg tablets: US prescribing information

Organon · DailyMed (US National Library of Medicine), label version 9, Oct 2024, 2024 · The official US label of the original finasteride brand for hair loss. Its trial figures come from the manufacturer's own studies in men aged 18 to 41. Archived as the full label text from the DailyMed XML (copied from the finasteride-guide archive, source 1 there).

The dose is one 1 mg tablet once a day. “The recommended dose of PROPECIA is one tablet (1 mg) taken once daily.”
Daily use for three months or more is needed before benefit shows. “In general, daily use for three months or more is necessary before benefit is observed.”
Stopping treatment reverses the effect within 12 months. “Withdrawal of treatment leads to reversal of effect within 12 months.”
In the label's trials, hair growth increased in 48% of men on finasteride at 12 months and 66% at 2 years, against 7% on placebo. “At 12 months, 48% of men treated with PROPECIA had an increase as compared with 7% of men treated with placebo. At 2 years, an increase in hair growth was demonstrated in 66% of men treated with PROPECIA, compared with 7% of men treated with placebo.”
Sexual side effects were reported by 3.8% of men on finasteride and 2.1% on placebo. “Integrated analysis of clinical adverse experiences showed that during treatment with PROPECIA, 36 (3.8%) of 945 men had reported one or more of these adverse experiences as compared to 20 (2.1%) of 934 men treated with placebo (p=0.04).”
Reports after approval include sexual problems that continued after stopping treatment. “sexual dysfunction that continued after discontinuation of treatment, including erectile dysfunction, libido disorders, ejaculation disorders, and orgasm disorders”
Reported after approval: depression, suicidal thoughts and behaviour. “Nervous System/Psychiatric: depression, suicidal ideation and behavior.”
Finasteride for hair loss is for men only. “PROPECIA® is indicated for the treatment of male pattern hair loss (androgenetic alopecia) in MEN ONLY.”

[10] MINOXIDIL 5% (FOR MEN) minoxidil aerosol, foam: Drug Facts label

Sun Pharmaceutical Industries (distributed by Ohm Laboratories) · DailyMed (US National Library of Medicine), label version 9, Sep 2026, 2026 · The US over-the-counter Drug Facts label of a generic 5% minoxidil foam for men, as published on DailyMed. A label states the approved directions and warnings; it is not a study. Archived as the DailyMed page text on 2026-10-16 (copied from the minoxidil-guide archive, source 1 there).

Do not use it if there is no hair loss in your family, if the loss is sudden or patchy, if you do not know the reason, or under 18. “you have no family history of hair loss your hair loss is sudden and/or patchy you do not know the reason for your hair loss you are under 18 years of age”
Half a capful twice a day on the scalp in the hair loss area. “apply half a capful 2 times a day to the scalp in the hair loss area”
Results may show at 2 months; some men need at least 4 months. “Results may occur at 2 months with twice a day usage. For some men, you may need to use this product for at least 4 months before you see results.”
Continued use is needed to keep the regrowth, or hair loss begins again. “continued use is necessary to increase and keep your hair regrowth or hair loss will begin again”

[11] Alopecia areata: Overview

American Academy of Dermatology (no named author) · American Academy of Dermatology (aad.org), patient information · A patient information page from the American Academy of Dermatology on alopecia areata. General guidance, not a study; the archived page states no review date. Copied from the hair-loss-women archive (source 11 there).

Alopecia areata often begins with a round or oval bald patch on the scalp or beard. “This type of hair loss often begins with a round or oval bald patch on the scalp or beard, which may be small and hidden or noticeable.”
It usually begins in children and young adults but can start at any age. “This type of hair loss usually begins in children and young adults, but it can start at any age.”
Hair may regrow on its own in about a year. “Hair may regrow on its own in about a year, and some people never have another episode of hair loss.”
There is no cure, but treatment can help hair regrow. “At this time, alopecia areata cannot be cured. However, treatment can help people regrow their hair.”

[12] Hairstyles that pull can cause hair loss

American Academy of Dermatology (no named author) · American Academy of Dermatology (aad.org), patient information · A patient information page from the American Academy of Dermatology on traction alopecia. General guidance, not a study; the archived page states no review date. Copied from the hair-loss-women archive (source 10 there).

The hairline is one of the first places traction alopecia shows. “Your hairline is one of the first places you can see traction alopecia.”
If the pulling continues, the skin turns shiny and bald and the hair cannot grow back. “When the pulling continues, most people eventually notice that their hair stops growing. Where you once had hair, you’ll see shiny, bald skin. When traction alopecia advances to this stage, your hair cannot grow back.”

[13] Hair loss types: Frontal fibrosing alopecia overview

American Academy of Dermatology (no named author) · American Academy of Dermatology (aad.org), patient information · A patient information page from the American Academy of Dermatology on frontal fibrosing alopecia, a scarring hair loss. General guidance, not a study; the archived page states no review date. Copied from the hair-loss-women archive (source 12 there).

Frontal fibrosing alopecia destroys follicles and causes permanent loss; early diagnosis and treatment can stop it progressing. “It destroys the hair follicles (openings from which hair grows), causing permanent hair loss. With an early diagnosis and medical treatment from a board-certified dermatologist, it’s possible to stop the disease from progressing and causing further permanent hair loss.”
It often looks like a receding hairline along the front and sides of the head. “This type of hair loss often looks like a receding hairline that runs along the front and sides of your head.”
80% to 95% of women with it have lost some or all of their eyebrows. “Between 80% and 95% of women diagnosed with FFA have lost some (or all) of their eyebrows.”

[14] Trichotillomania (hair pulling disorder)

NHS (no named author) · NHS website (nhs.uk), mental health conditions, last reviewed 5 February 2024, 2024 · The UK National Health Service's patient page on trichotillomania. General guidance, not a study.

Trichotillomania usually starts between the ages of 10 and 13. “Trich usually starts between the ages of 10 and 13 years old.”
Bald patches can have an unusual shape and affect one side of the head more than the other. “Bald patches on the head may have an unusual shape and affect 1 side of the head more than the other.”
It is commonly treated with a type of cognitive behavioural therapy called habit reversal training. “Trich is commonly treated using a type of CBT called habit reversal training.”
See a GP if you are pulling your hair out, or notice that your child is. “See your GP if you're pulling your hair out or if you notice that your child is.”

[15] A hair transplant can give you permanent, natural-looking results

American Academy of Dermatology (no named author) · American Academy of Dermatology (aad.org), patient information · A patient information page from the American Academy of Dermatology on hair transplants. General guidance, not a study; the archived page states no review date. Copied from the hair-transplant-women archive (source 10 there).

A man in his 20s may be asked to wait and start a hair loss medicine first. “Are you a man in your 20s, who is experiencing hair loss? For best results, you may be asked to wait to have a hair transplant and start treating with a hair loss medicine.”
A transplant needs enough healthy hair to move, and an area that can still grow hair. “To be considered for a hair transplant, you need two things: Enough healthy hair on your scalp that can be transplanted to the area that needs hair The ability to grow hair on the thinning area of your scalp”
A full head of hair may be unrealistic; a fuller head of hair can be the goal. “A full head of hair may be unrealistic, but a fuller head of hair can be the goal.”
Medicine helps after a transplant because hair loss can continue. “Medicine helps because hair loss and thinning can continue, even after a hair transplant.”

How this page was made

We read each source in full, archived the text and quote it word for word: a build check fails if any quote is not in the archived text. The sentences on this page are our short summaries; the quotes under each source show exactly what it says. Where sources give different numbers (normal shedding, how many men go bald), we show both. This page has no reddit data. Sources checked October 2026. This is not medical advice: tests and prescription treatments are for you and your doctor.

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