Hair Loss: Causes, Diagnosis and Treatment Options

What causes hair loss?

Hair loss can have several possible causes, and often more than one factor is at play. To choose the right treatment, the cause needs to be identified first. The most common causes include:

• Androgenetic hair loss – hereditary thinning driven by hormones (DHT). This is the most frequent cause of permanent hair loss in both men and women.
• Hormonal changes – for example the postpartum period, menopause or thyroid dysfunction can affect hair growth temporarily or longer term.
• Stress and acute physical strain – severe stress, fever, surgery or rapid weight loss can trigger telogen effluvium, a widespread temporary shedding.
• Nutritional deficiency – low iron, vitamin D or protein, for instance, can weaken the hair.
• Inflammatory and other scalp-related conditions – in some cases the issue requires a separate medical assessment.
• Mechanical strain – tight hairstyles or friction can damage hair follicles over time.

Because there are so many possible causes, a reliable diagnosis cannot be made from a photo alone. Accuracy comes from a trichological assessment.

Male and female patterns (Norwood and Ludwig)

Androgenetic hair loss typically presents differently in men and women, and is described using internationally recognised scales.

• Men (Norwood scale) – loss often begins at the temples and a receding hairline, and may progress to thinning at the crown. Norwood stages NW2–NW5 help describe the extent and plan possible treatment.
• Women (Ludwig scale) – loss is usually more diffuse, concentrated on the crown and part, while the frontal hairline generally stays intact. The Ludwig scale describes the degree of thinning.

Identifying the pattern is only one part of the assessment – the treatment choice is decided by the doctor together with you, once the causes have been clarified.

Diagnosis – identifying the causes of hair loss

Before starting any treatment, it is important to understand why the hair is falling out. Diagnosis, or a trichological assessment, focuses on examining the condition of the hair and scalp hair growth and on identifying the causes of hair loss. The assessment may include a history (medical background, family tendency, medications), examination of the scalp and hair, and referral for further tests where needed.

The aim of diagnosis is to distinguish temporary shedding from permanent loss and to choose the most suitable approach. Some causes are reversible and resolve once the trigger is addressed; others require longer-term monitoring or treatment.

Treatment options

Treatment always depends on the cause, the extent of the loss and your expectations. Broadly, the options are:

• Addressing the cause – if a nutritional deficiency, hormonal imbalance or stress is behind the loss, treating the underlying factor may improve the situation.
• Medication (general overview) – for androgenetic hair loss, certain medications are used to slow shedding or support density. The suitability, benefits and possible side effects of any medication are always decided by a doctor – this page must not be treated as a treatment instruction.
• PRP therapy (supportive) – PRP therapy is a supportive procedure based on plasma from your own blood, intended to support hair density. It is an adjunctive therapy with developing evidence, and is therefore not regarded as a standalone solution.
• Hair transplant – for permanently thinned or lost areas, a hair transplant (manual FUE or DHI) may be suitable when the loss has stabilised and the donor area is sufficient.

Approaches are often combined – for example treating the cause, supportive therapy and, where appropriate, a transplant. A suitable plan can only be drawn up after an individual assessment.

When should you consider a hair transplant?

A hair transplant is not suitable for everyone, nor at every stage of hair loss. As a rule, a transplant is worth discussing when:

• the cause of the loss has been identified and the condition is relatively stable;
• the lost or clearly thinned area is permanent rather than temporary;
• the donor area (usually the back and sides of the scalp) has sufficient density;
• your expectations are realistic – a transplant restores hair within the limits of the available donor supply, without guaranteeing a specific outcome.

The final decision on whether a transplant is suitable, and on the method and extent, is made by the doctor together with you after an assessment. If you are unsure which step is right for you, start with a free consultation for personalised guidance. Feel free to reach us via our contact page.