Hair Loss

Overview

Hair loss is shedding, thinning, or balding that is more than usual. Some hair loss every day is normal, but noticeable thinning, patchy loss, or increased shedding often prompts concern. Hair loss has many causes, and because the hair cycle is sensitive to internal changes, it is frequently a clue to an underlying medical condition or nutritional deficiency rather than a primary skin problem.

Common causes

• Iron deficiency and anaemia — a very common, treatable cause (see Anaemia & Blood Problems).
• Thyroid disorders — both underactive and overactive thyroid (see Thyroid Disorders).
• Telogen effluvium — increased shedding 2–3 months after a major illness, surgery, fever, significant weight loss, or stress.
• Diabetes and metabolic factors (see Diabetes & Metabolic Health).
• Androgenetic (pattern) hair loss — common, inherited, gradual.
• Alopecia areata — patchy hair loss from an immune process.
• Skin conditions of the scalp — fungal infection, seborrhoeic dermatitis (see Fungal Skin Infection, Eczema / Dermatitis).
• Certain medicines, nutritional deficiencies (B12, folate, zinc), and severe dieting.

Evaluation and investigations

Evaluation considers the pattern (diffuse thinning, patchy loss, receding hairline), onset, recent illness or stress, medicines, menstrual history, and any skin signs. Blood tests commonly include complete blood count, iron studies and ferritin, thyroid function, B12 and folate, blood sugar, and, when relevant, hormonal tests. See Anaemia & Blood Problems, Thyroid Disorders, and Abnormal Test Results.

Management overview

Management treats the underlying cause — correcting iron deficiency, treating thyroid disease, improving diabetes control, addressing scalp conditions, and reviewing medicines. Hair lost from a reversible cause usually regrows over months. Pattern hair loss and alopecia areata are best managed with a dermatologist; Dr. Nayak identifies the cause, begins treatable factors, and refers when needed.

Warning signs — seek prompt care

• Sudden, rapid, or patchy hair loss — needs evaluation.
• Hair loss with scalp redness, scaling, scarring or pus — needs assessment.
• Hair loss with tiredness, weight change, irregular periods or heavy periods — check for anaemia, thyroid, or hormonal causes.

How we help

Dr. Nayak identifies the cause of hair loss through history, examination and blood tests, treats reversible causes such as iron deficiency and thyroid disease, and refers to a dermatologist for pattern hair loss or alopecia areata. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Anaemia & Blood Problems
• Thyroid Disorders
• Diabetes & Metabolic Health
• Fungal Skin Infection
• Eczema / Dermatitis
• Fatigue, Weakness & General Symptoms
• Abnormal Test Results