Identifying hair loss and initial considerations

Author: Dr Dilan Fernando, Hair Transplant Surgeon, The Treatment Rooms London

Identifying hair loss and initial considerations

Our hair is one of the best ways to express identity. We often cut, colour and style it in ways that improve our appearance, but on a deeper level we change our hair to reflect mood, personality and even career. Suffering from hair loss can therefore be a devastating prospect and with up to 50% of both men and women being affected by the age of 50, the issue is a common one.

The start of our hair loss journey is usually a very personal experience. We may notice hairs falling out in the shower or stuck to the comb when grooming our hair. Some people are unable to style their hair in the way they used to. Others don’t notice hair loss at all, whereby it is brought to their attention by a comment from a loved one or a photograph taken from an unsuspecting angle where hair loss is evident.

Whichever way it happens, it is important that we start our hair loss journey on the correct path. After establishing whether it is an issue in the first place, all possible causes of hair loss need to be considered, this will guide our decision in seeking treatments, professional advice, or even choosing to do nothing at all.

When is our hair loss an issue?

Hair loss is a normal part of healthy hair growth. In fact, we lose up to 100 hairs per day because of a hair’s normal growth cycle. If we lose significantly more than 100 hairs per day, then this is where active hair loss takes over from healthy hair growth, also known as alopecia.

How do we know if we have hair loss?

Hair loss can present itself in different ways- sometimes hair is lost quickly with changes seen in a few months. In other cases, hair loss can be slower and the change happens over years.

It may be helpful to look back at old photographs to see how hairline or density has changed with time. If hair loss is a concern, it is also a good idea to take some photos now, to keep as a baseline for comparison down the line.

Why do we lose our hair?

There are many different factors which can contribute to hair loss for example:

  • Lifestyle factors (such as diet, smoking or stress)
  • Hormonal and genetic factors
  • Medication or medical conditions (e.g. Systemic lupus erythematosus, hyperthyroidism)

How do we get to a diagnosis?

To work out which of the above factors is causing hair loss, here are some questions to consider:

  1. Is the hair loss all over the scalp or in a specific area?  
  2. Does the hair loss follow a specific pattern?
  3. Is there any scarring or inflammation to the scalp?

Do I need to see a hair loss specialist?

When we consider the questions above, it may be the case that hair is lost in a specific pattern. (male or female pattern baldness). However, finding out whether hair loss has occurred in combination with scarred or inflamed skin can be more challenging and may require a specialist eye. In these circumstances it would be beneficial to seek professional help. If hair loss is thought to be associated with other medical symptoms or medication, then it may be necessary to discuss this with the general practitioner.

At this stage there may have been enough information to seek specialist advice for hair loss. If not, some of our next blogs explore in more detail how certain patterns of balding associated with different symptoms can help lead to a diagnosis for hair loss. Although many conditions are shared between men and women, we hope that having a separate 'female hair loss' and 'male hair loss' blog will help focus the path to treatment.

Please note: Blog content represents the views of the author and not necessarily the BAHRS

This article has been written for people concerned about their own hair loss. Clinicians looking to find out more about hair loss should refer to the BAHRS professional articles.