Hair Loss: Symptoms, Causes & Which Doctor to See

What causes hair loss?

Losing around 50 to 100 hairs a day is normal, because hair grows in cycles and old hairs fall to make way for new ones. Problems arise when more hairs enter the shedding phase at once, when follicles gradually shrink, or when the immune system or inflammation damages them.

Pattern hair loss (androgenetic alopecia) is the most common cause in both men and women and runs in families. Telogen effluvium is heavy shedding that starts two to three months after a trigger such as high fever (including dengue or typhoid), surgery, childbirth, crash dieting or severe stress. Alopecia areata causes smooth round patches. Fungal infection of the scalp is common in children.

• Pattern hair loss (genetic and hormonal)
• Shedding after illness, fever, childbirth or stress
• Iron deficiency and low protein intake
• Thyroid disorders and PCOS
• Alopecia areata (an autoimmune condition)
• Fungal scalp infection (tinea capitis)
• Tight hairstyles, harsh chemical treatments and heat styling
• Some medicines and cancer treatment

What are the symptoms and patterns of hair loss?

The pattern gives important clues. Men with pattern loss typically notice a receding hairline and thinning at the crown. Women more often notice a widening centre parting with the front hairline preserved. Telogen effluvium causes diffuse shedding, with handfuls of hair in the shower or on the pillow, but rarely complete baldness.

Alopecia areata causes sudden, smooth, coin-shaped patches, sometimes with nail pitting. Scaly, itchy patches with broken hairs, particularly in children, suggest fungal infection. Redness, pain, pus or shiny scarred skin where hair has been lost suggests scarring alopecia, which needs prompt treatment to prevent permanent loss.

• Receding hairline or crown thinning
• Widening parting
• Increased shedding all over
• Round smooth bald patches
• Scaly, itchy patches with broken hairs
• Redness, pain or scarring on the scalp
• Eyebrow, eyelash or body hair loss

When is hair loss urgent?

Hair loss itself is rarely an emergency, but a severe allergic reaction to hair dye is. Dyes containing para-phenylenediamine (PPD), including some black henna products, can cause dangerous swelling. If you have facial, lip or tongue swelling, difficulty breathing or swallowing after using dye, go to the nearest emergency department or call 112 or 108.

Some patterns need a dermatology appointment within days rather than months, because early treatment can protect follicles.

• Face, lip or tongue swelling or breathing difficulty after hair dye (emergency)
• Painful, red, pus-filled or rapidly scarring scalp
• Sudden widespread hair loss with fever, rash, mouth ulcers or joint pain
• Scaly patches with swollen glands in a child
• Rapidly enlarging bald patches
• Hair loss with unexplained weight loss, extreme fatigue or irregular periods

Which doctor should I see for hair loss?

A dermatologist is the qualified medical specialist for hair and scalp disorders. At Lotus, the dermatology team assesses hair loss, examines the scalp, orders targeted tests and plans treatment. Seeing a dermatologist before spending on commercial hair clinic packages helps ensure the right diagnosis and avoids unnecessary procedures.

Book an appointment if shedding has continued for more than three months, if you notice thinning patches or a widening parting, if you have bald patches, scaling or scalp pain, or if hair loss is affecting your confidence. If the cause seems linked to thyroid disease or PCOS, the dermatologist may coordinate with a physician or gynaecologist.

• Shedding lasting more than three months
• Visible thinning or widening parting
• Bald patches of any size
• Scalp itching, scaling or pain
• Hair loss in a child
• Distress about appearance

What happens at a dermatology consultation for hair loss?

The dermatologist asks when the hair loss started, any illness, fever, surgery, pregnancy or weight change in the previous six months, diet, periods, medicines, supplements, hair care habits and family history. Wash your hair normally before the visit and avoid applying oil, gel or dye for a day or two so the scalp can be seen clearly.

They examine the pattern, perform a gentle pull test, and often use trichoscopy, a magnified view of the scalp and hair shafts, which helps distinguish pattern loss, alopecia areata, fungal infection and scarring conditions. Nails and skin are also checked.

Hair loss can affect confidence, relationships and work. If it is causing distress, say so; the dermatologist can discuss camouflage options such as hair fibres, wigs or styling, and support for anxiety or low mood alongside medical treatment.

• Note when shedding started and any illness before it
• Bring recent blood reports
• List all supplements, including biotin
• Describe styling, dyes and chemical treatments
• Bring photos showing how your hair looked before

Which tests are done for hair loss?

Tests are chosen based on your history and examination rather than a large routine panel. Common blood tests include a blood count, ferritin (iron stores) and thyroid function. Vegetarians may be checked for vitamin B12. Women with irregular periods, acne or excess hair may have hormone tests for PCOS.

Biotin supplements can interfere with some laboratory tests, including thyroid tests, so tell your doctor and follow advice on stopping them before blood is taken. Scalp scrapings check for fungus, and a small scalp biopsy may be needed when scarring alopecia is suspected.

• Complete blood count and ferritin
• Thyroid function
• Vitamin B12 in selected people
• Hormone tests when PCOS is suspected
• Fungal scraping or culture
• Scalp biopsy for scarring or unclear cases
• Vitamin D is often tested but has a limited role in most hair loss

How is hair loss treated?

Treatment targets the cause. Telogen effluvium usually settles over several months once the trigger has passed, and correcting iron deficiency or thyroid problems supports regrowth. Pattern hair loss is commonly treated with minoxidil, and men may be offered finasteride after discussing benefits and possible side effects; women may be offered other prescribed medicines. Results take three to six months to show and continue only while treatment is used.

Alopecia areata may be treated with steroid injections or creams, and newer oral medicines are considered for extensive disease. Fungal scalp infection needs oral antifungal medicine, not just shampoo. Platelet-rich plasma, microneedling and low-level light therapy have variable evidence. Hair transplant can help selected people with stable pattern loss.

• Topical minoxidil
• Oral medicines such as finasteride, after discussion
• Iron, vitamin or thyroid treatment when deficient
• Steroid injections or creams for alopecia areata
• Oral antifungals for tinea capitis
• Procedures such as PRP in selected cases
• Hair transplant for stable pattern hair loss

How can I look after my hair and scalp?

Eat enough protein from dal, pulses, paneer, curd, eggs, fish or meat, along with iron-rich foods such as greens and millets. Avoid crash diets, which commonly trigger shedding a few months later. Supplements, including biotin, do not help unless you are deficient.

Gentle care matters. Avoid tight buns, braids and ponytails that pull at the hairline, limit hot straighteners and chemical smoothing treatments, and do a patch test before any hair dye. During the humid monsoon, dry the scalp properly and do not share combs, towels or helmets, which can spread fungal infection. Helmets do not cause baldness; wear a clean cotton cloth or liner and wash it often. Oil massage (champi) is relaxing but does not prevent pattern hair loss.

• Eat enough protein and iron
• Avoid crash diets
• Avoid tight hairstyles and harsh chemicals
• Patch-test hair dyes every time
• Keep helmets and combs clean and personal
• Manage stress and sleep well

When should I follow up for hair loss?

Hair grows slowly, so most treatments are reviewed after three to six months, often with standardised photographs to compare. Some temporary extra shedding in the first weeks of minoxidil is common and usually settles.

Return sooner if bald patches spread, the scalp becomes painful or inflamed, or side effects occur. Long-term treatment plans for pattern hair loss are reviewed periodically.

• Review at three to six months with photos
• Report side effects promptly
• Earlier review for spreading patches or scalp pain
• Long-term maintenance for pattern hair loss