Hair Loss Causes โ Why It Happens and What Actually Helps (2026)
- Androgenetic alopecia (male/female pattern) accounts for 90% of hair loss in adults
- Telogen effluvium โ shedding after stress, illness, or childbirth โ typically reverses within 6 months
- Iron deficiency and vitamin D deficiency are the most common nutritional causes โ both treatable
- Minoxidil (Regaine) is the most evidence-backed over-the-counter treatment
- Finasteride (prescription for men) is the most effective pharmacological treatment for pattern hair loss
Types of Hair Loss
Hair loss (alopecia) has many causes, and identifying the correct type is essential before choosing treatment. The most important differentiation is whether the loss is from the follicle itself being destroyed (scarring/cicatricial โ permanent) or the follicle being suppressed (non-scarring โ potentially reversible).
The Most Common Causes
1. Androgenetic Alopecia (Pattern Hair Loss) โ 90% of Cases
Caused by sensitivity of hair follicles to DHT (dihydrotestosterone). In men: receding temples and vertex thinning (Hamilton-Norwood scale). In women: diffuse thinning at the crown with preserved frontal hairline (Ludwig scale). Genetic, progressive, but manageable.
2. Telogen Effluvium โ Stress Shedding
After any significant physiological stress (childbirth, surgery, illness, severe psychological stress, extreme calorie restriction), hair follicles prematurely enter the shedding phase. Shedding begins 2โ3 months later and can be dramatic. Typically self-limiting โ resolves in 6โ9 months once the trigger is removed.
3. Alopecia Areata
Autoimmune condition causing patchy, circular hair loss. Can progress to total scalp loss (alopecia totalis) or total body hair loss (alopecia universalis). Treatment options include topical/injectable corticosteroids and the newer JAK inhibitors (baricitinib, ritlecitinib โ highly effective, now NICE-approved in UK).
Evidence-Based Treatments
| Treatment | Type | Effectiveness | Availability |
|---|---|---|---|
| Minoxidil (2% / 5%) | Pattern hair loss | Stops progression in 90%; regrowth in 40โ60% | OTC (Regaine) |
| Finasteride 1mg | Male pattern only | Stops progression in 83%; regrowth in 66% | Prescription |
| Oral minoxidil (low dose) | All types | Emerging evidence โ effective and well-tolerated | Prescription |
| Platelet-rich plasma | Pattern + areata | Moderate evidence | Private clinic |
| Correct nutritional deficiencies | Nutritional causes | Highly effective if deficiency is the cause | Via GP blood tests |