Medical Dermatology

Hair Loss

Hair loss creeps up quietly, and by the time most people seek help they have often lost time to shampoos and tonics that were never going to work. The single most useful thing to know is that acting early, with a real diagnosis, beats almost everything else.

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At a glance

What it is: Loss or thinning of scalp hair, with several distinct causes that are treated differently.
Who it affects: Very common. Pattern hair loss affects a majority of men and many women over a lifetime; other types can occur at any age.
Main types: Pattern (genetic) hair loss, temporary shedding (telogen effluvium), patchy loss (alopecia areata), and scarring types.
Why diagnosis matters: The right treatment depends entirely on the cause — and some scarring types can cause permanent loss if missed.
Treatment: Well-established medical treatments, matched to the diagnosis; earlier is better for progressive types.

Understanding the condition

Why hair is lost

Each hair follicle cycles through phases of growth, rest and shedding. At any time most follicles are growing and only a small proportion are shedding, so hair density stays roughly constant. Hair loss becomes noticeable when this balance is disturbed — either because follicles are miniaturising (shrinking and producing finer, shorter hairs, as in pattern hair loss) or because too many are shedding at once (as after a stressful event).

Because different processes underlie different types of hair loss, the treatments differ too. This is why an accurate diagnosis — rather than a generic "hair growth" product — is the starting point.

Earlier is better For progressive types such as pattern hair loss, hair that has been lost for a long time is harder to recover than hair that is thinning now. Starting treatment earlier generally preserves more.

Identifying the cause

The main types of hair loss

Knowing which type you have shapes the whole approach. More than one can occur together.

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Pattern hair loss

Androgenetic alopecia — the most common type.

Genetic and hormone-driven, and progressive
Receding hairline or thinning crown in men
Diffuse thinning over the top in women
Responds best to early, sustained treatment

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Telogen effluvium

Temporary shedding after a trigger.

More even, diffuse hair fall
Follows illness, surgery, childbirth, stress or crash dieting
Usually appears a couple of months after the trigger
Typically recovers once the cause resolves

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Alopecia areata

Patchy loss with an autoimmune basis.

Well-defined round bald patches
Can affect the scalp, beard or elsewhere
May regrow spontaneously, or need treatment
Sometimes linked to other autoimmune conditions

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Scarring alopecia

Less common, but important not to miss.

Redness, scaling or scarring of the scalp
Can cause permanent loss if untreated
Needs prompt assessment

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Nutritional & medical

Hair loss reflecting something else.

Iron deficiency
Thyroid disease
Certain medications
Identified and corrected where present

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Traction & styling

From repeated pulling or tension.

Tight hairstyles, braids or extensions
Loss at the hairline and temples
Reversible early, permanent if prolonged

Getting to the cause

How hair loss is assessed

A useful assessment starts with the history — how quickly the loss came on, whether it is patchy or diffuse, any recent illness, childbirth, weight change or stress, medications, and family history.

The scalp and hair are then examined, often with a dermatoscope, which magnifies the scalp and helps distinguish the pattern of loss and whether the scalp is scarred. This is what separates pattern hair loss from shedding, alopecia areata or a scarring condition.

Where appropriate, blood tests check for treatable contributors such as iron deficiency or thyroid disease. Occasionally a small scalp biopsy is helpful when the diagnosis is unclear or a scarring condition is suspected.

Treatment

How hair loss is treated

Treatment is directed at the diagnosis. Consistency matters more than any single measure — results build over months, not weeks.

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For pattern hair loss

The most established treatments, used to slow loss and support regrowth.

Topical minoxidil
Oral medication in suitable patients
Long-term, consistent use for lasting benefit

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For specific causes

Treating what underlies the loss.

Correcting iron deficiency or thyroid disease
Reviewing contributing medications
Treatment for alopecia areata where needed
Prompt treatment of scarring conditions

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Adjunctive options

Used alongside medical treatment in selected cases.

Platelet-rich plasma
Advice on gentle hair care and styling
A realistic plan and expectations

Patience and consistency Hair grows slowly, so meaningful change takes months to become visible, and treatment for pattern hair loss usually needs to continue to maintain the benefit. A realistic timeframe set at the outset makes it much easier to stay the course.

Seeking help

When to see a dermatologist

Consider a specialist assessment if:

Hair loss is sudden, patchy or rapidly progressing
The scalp is red, scaly, itchy or looks scarred
Hair loss follows a clear trigger and is not recovering
It is affecting your confidence or wellbeing
You would like an accurate diagnosis before starting any treatment
Over-the-counter products have not helped

Because several types of hair loss are progressive, an earlier assessment generally allows more hair to be preserved — and rules out the less common but important scarring conditions.

Dr Chen Qiping

Consultant Dermatologist · MBBS, MRCP (UK), M.Sc, FAMS (Dermatology)

Dr Chen practises general adult and paediatric dermatology, including hair and scalp disorders, alongside surgical, laser and cosmetic dermatology. Consultations are available in English and Mandarin.

Full profile →

Common questions

Hair loss — frequently asked questions

Is hair loss treatable, or do I just have to accept it?

Most hair loss is treatable, and the single most useful thing to know is that acting early gives far better results than waiting. The most common type — pattern hair loss — is progressive, so treatment works best when started before a lot of hair is lost. Other causes, such as shedding after illness or stress, often recover on their own once the trigger passes. Getting an accurate diagnosis first is what shapes the right approach.

What is the difference between pattern hair loss and general shedding?

Pattern hair loss (androgenetic alopecia) is gradual, genetic and hormone-related — a receding hairline or thinning crown in men, and diffuse thinning over the top of the scalp in women. Telogen effluvium is a temporary, more even shedding triggered by an event such as childbirth, illness, surgery, crash dieting or significant stress, and it usually recovers within months once the trigger resolves. They are treated quite differently, which is why the distinction matters.

Can stress cause hair loss?

Yes. Significant physical or emotional stress — a serious illness, an operation, childbirth, or a major life event — can push a larger-than-usual proportion of hair follicles into the shedding phase, producing noticeable hair fall a couple of months later. This is called telogen effluvium. It is usually temporary and recovers once the underlying stress has passed, though it can be alarming while it lasts.

Are the vitamins and shampoos advertised for hair loss worth trying?

The treatments with the strongest evidence for hair loss are medical and well established. Shampoos and supplements are heavily marketed but rarely address the underlying cause, and time spent on them can delay effective treatment for a progressive condition. If a specific deficiency such as low iron is found on testing, correcting it helps — but taking supplements without a deficiency generally does not. A proper diagnosis avoids wasted money and lost time.

Could my hair loss be a sign of something else?

Sometimes. Hair loss can reflect an underlying issue such as thyroid disease, iron deficiency, or, less commonly, an autoimmune or scarring scalp condition. Patchy, well-defined bald areas may indicate alopecia areata; redness, scaling or scarring of the scalp needs particular attention, as some scarring conditions can cause permanent loss if not treated. This is why assessment, and sometimes blood tests or a scalp examination, is worthwhile.

When should I see a dermatologist about hair loss?

Consider assessment if hair loss is sudden, patchy, or rapidly progressing; if the scalp is red, scaly, itchy or scarred; if hair loss is affecting your confidence; if it follows a clear trigger and is not recovering; or simply if you want an accurate diagnosis before starting treatment. Because pattern hair loss is progressive, earlier assessment generally allows better preservation of hair.

References

DermNet. Hair loss (alopecia), Androgenetic alopecia and Telogen effluvium. dermnetnz.org
American Academy of Dermatology. Hair loss: Diagnosis and treatment. aad.org
British Association of Dermatologists. Patient information leaflets: Alopecia. bad.org.uk

Page last reviewed: 28 July 2026.

Important — This page is general information about a skin condition and is not medical advice. It cannot take the place of an individual consultation, examination and diagnosis. Treatment options, their suitability and their possible side effects should be discussed with a qualified doctor who has assessed your skin. Individual results vary. If you have concerns about your skin, please arrange a consultation.

Concerned about hair loss or thinning?

Arrange a consultation with Dr Chen Qiping at our Collyer Quay clinic — two minutes' walk from Raffles Place MRT. Consultations available in English and Mandarin.

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