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Understanding hair loss
Understanding and treating hair loss
Causes, diagnosis, established treatment pathways and a balanced assessment of PRP in androgenetic alopecia.
Hair loss is a symptomDiagnosis before treatmentPRP is not a universal treatment
01
Hair loss is not one single condition
Hair loss may develop gradually, begin suddenly or affect only selected areas of the scalp. The key question is not simply how many hairs are shed, but why the hair cycle has changed and whether the follicles are still intact.
Visible hair loss may be associated with genetic predisposition, temporary physical stress, autoimmune disease, inflammation, infection, medication or repeated traction. Treatment therefore has to follow the diagnosis rather than a one-size-fits-all formula.
Four common patterns — four different clinical questions
Androgenetic alopecia
Gradually progressive thinning. In men it commonly affects the hairline and crown; in women the central part and upper scalp. Follicles miniaturise but are initially still present.
Genetics · androgen sensitivityTelogen effluvium
Diffuse shedding, often several weeks or months after illness, surgery, childbirth, major weight change, stress, medication changes or a deficiency.
Identify trigger · observe courseAlopecia areata
Usually round or oval patches. It is an autoimmune condition, and the course and regrowth are difficult to predict.
Dermatology assessmentInflammatory or scarring loss
Redness, pain, burning, pustules, marked scaling or smooth areas with few visible follicular openings may indicate inflammatory or scarring alopecia.
Prompt diagnostic work-upThe hair cycle explains why results take time
Each follicle repeatedly passes through growth, transition and resting phases. Treatment cannot alter this process overnight.
1
Anagen · Growth phase
The hair shaft is actively produced. On the scalp, this phase usually lasts several years.
2
Catagen · Transition phase
Cell division slows and the follicle prepares for the resting phase.
3
Telogen · Resting and shedding phase
The old hair is released and a new cycle may then begin.
02
Diagnosis: identify the cause before choosing treatment
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Assessment includes medical history, family history and examination of the pattern of loss and the scalp.
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Trichoscopy can reveal miniaturisation, inflammatory signs and characteristic patterns.
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Laboratory tests are useful when the history or examination suggests, for example, iron deficiency, thyroid disease or a hormonal abnormality.
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A biopsy may be required when the diagnosis is unclear or scarring alopecia is suspected.
03
Treatment pathways depend on the diagnosis
Androgenetic alopecia
Topical minoxidil is an established option. Prescription finasteride may be considered for selected men. Benefits, contraindications and possible adverse effects require individual medical discussion.
Telogen effluvium
The priority is to identify and address the trigger. Once corrected, the hair cycle often recovers. Supplements are appropriate only when a deficiency or clear medical indication is present.
Alopecia areata
Depending on severity, local or systemic immunomodulating treatments may be used. JAK inhibitors are authorised in the EU for certain severe cases; selection and monitoring require specialist care.
Scarring or infectious forms
Inflammation needs early control and infections need targeted treatment. Cosmetic procedures do not replace treatment of the underlying disease.
Hair transplantation
In suitable candidates, existing follicles can be redistributed from a donor area. The procedure does not create new follicles.
A balanced view of PRP
What role can platelet-rich plasma play?
PRP is prepared from the patient’s own blood. After centrifugation, a plasma fraction with a system-dependent increase in platelet concentration is obtained. Platelets can release signalling molecules that influence cell communication and tissue processes.
Most clinical studies concern androgenetic alopecia. Systematic reviews report possible improvements in hair density. However, studies vary considerably in preparation method, concentration, white-cell content, activation, injection schedule and outcome measurement.
PRP is therefore best described as a possible adjunctive medical option for selected people with androgenetic alopecia. There is no guaranteed response and no universally accepted standard protocol.
04
Limits and risks
PRP cannot restore follicles that have been destroyed or fully scarred.
Not everyone responds; outcome depends partly on diagnosis, stage and preparation method.
Possible adverse effects include pain, tenderness, bleeding, bruising, redness, swelling and infection.
Anticoagulants, local anaesthetics and other materials used in the procedure also need to be considered in the risk assessment.
When should hair loss be assessed promptly by a dermatologist?
Sudden or very rapid hair loss
Round patches or loss of eyebrows and eyelashes
Pain, burning, pustules, oozing or marked inflammation
Smooth, shiny areas with few visible follicular openings
Associated symptoms such as weight change, severe fatigue or menstrual disturbance
05
Reasonable supportive steps
Avoid chronically tight hairstyles and repeated traction.
Eat a balanced diet; do not take high-dose hair supplements without a reason.
Document progress with similar lighting, distance and styling.
Stress management may help, but it does not replace diagnosis.
FAQ
Frequently asked questions
Is daily shedding normal?
Yes. Hairs are in different cycle phases and some are shed every day. Visible thinning, a changing pattern or unusually heavy and persistent shedding is more relevant.
Can one blood test identify every cause?
No. Laboratory testing is selected according to the history and examination. Many forms are diagnosed mainly by clinical assessment and trichoscopy.
Is PRP better than minoxidil?
Direct comparisons have not shown a clear general advantage for key outcomes. The appropriate option depends on diagnosis, tolerability and treatment goals.
How quickly can results be seen?
Hair growth is slow. Changes are generally assessed over several months, not a few days or weeks.
Can PRP regrow hair on fully scarred bald areas?
No. Once follicles are permanently destroyed, PRP cannot create new ones.