Why Your Hair Is Falling Out — And Why You Can Fix It
We’ll explain common causes, stress, hormones, nutrition, genetics, and simple, evidence-based steps to stop shedding and regrow hair. You may lose 50–100 hairs daily; with the right plan, you can often quickly slow, stop, and reverse hair loss for good.
Hair Loss: Dermatologist on Causes and Top Treatments (Minoxidil and More)
Step 1 — Diagnose the Type and Cause of Hair Loss
Is it stress, genes, or something hiding in plain sight? Learn how to tell.Start by identifying the pattern and timeline of hair loss: diffuse shedding, patchy loss, or a receding hairline. Note when it began and any triggering events (illness, childbirth, new medication, major stress, diet change).
Gather a quick history: ask about family hair loss, recent fevers or infections, new prescriptions, dieting or vegan/low-protein changes, hormonal events (pregnancy, stopping birth control), and hairstyles that pull the hair.
Perform simple at-home checks:
Watch for red flags that need urgent medical attention:
This step focuses on narrowing causes into categories—genetic (androgenetic alopecia), telogen effluvium, alopecia areata, traction/scarring alopecia, and medical/nutritional causes—so next steps are targeted.
Step 2 — Fix the Basics: Nutrition, Sleep, and Stress
Want thicker hair without a pill? Start with the three underrated pillars most people ignore.Address modifiable lifestyle contributors.
Optimize protein. Aim for 20–30 g protein per meal (eggs, Greek yogurt, beans, chicken, tofu). Increase calories slightly if you’ve recently dieted.
Check and correct key micronutrients. Order targeted tests if you suspect deficiency: ferritin, 25‑OH vitamin D, B12, CBC, and zinc. Consider iron (ferritin <50 ng/mL may matter for hair), vitamin D, B12 for vegans, and zinc; use biotin only if a deficiency or after clinician advice.
Improve sleep hygiene. Keep a fixed sleep schedule, get 7–9 hours, stop screens 30–60 minutes before bed, dim lights, and use a cool, quiet room.
Manage chronic stress. Practice short, practical techniques: 10 minutes daily mindfulness, progressive muscle relaxation, brisk 30‑minute walks 3–5×/week, and simple CBT moves—write worries down, challenge catastrophic thoughts, schedule a 15‑minute “worry time.”
Review restrictive diets. Replace missing nutrients with food first; supplement strategically when needed.
Small, consistent changes here can drastically reduce shedding within weeks to months for non-scarring causes.
Step 3 — Gentle Hair Care and Scalp Health
Your shampoo might be the problem — or the solution. Simple swaps that save strands.Adopt a scalp- and strand-friendly routine. Avoid traction from tight ponytails, braids, and buns — try loose styles or hair clips instead. Cut back on heat: use the lowest effective temperature, apply a heat protectant, and limit blow‑drying and straightening to special occasions.
Wash smartly: adjust frequency by hair type — oily/scalp-prone: daily or every other day; normal: 2–3×/week; dry/curly: 1–2×/week. Detangle wet hair with a wide-tooth comb, working from ends up to the roots to prevent breakage. Sleep on a silk or satin pillowcase or wear a silk bonnet to reduce friction and split ends.
Use gentle products. If your scalp itches or flakes, switch to mild, sulfate-free cleansers and avoid heavy chemical treatments (frequent bleaching, perming). Treat inflammatory scalp conditions with targeted topical care — medicated shampoos, ketoconazole, or prescribed topical steroids under a clinician’s guidance.
Adopt a scalp- and strand-friendly routine: avoid tight styles and heat damage, switch to mild, sulfate-free cleansers if scalp irritation exists, and reduce chemical treatments. Learn proper washing frequency for your hair type, use wide-tooth combs for wet hair, and protect hair during sleep with silk or satin. For inflammatory scalp conditions (seborrheic dermatitis, psoriasis), follow specific topical regimens (medicated shampoos, ketoconazole, topical steroids as prescribed). This step reduces mechanical and inflammatory causes of hair loss and supports regrowth.
Step 4 — Medical Treatments: Which Ones Work and When
From over-the-counter heroes to prescription powerhouses — what to try (and when to call a pro).Review evidence-based medical options and match each to the diagnosis.
Use topical minoxidil for androgenetic and some other thinning: apply consistently; expect visible improvement in 3–6 months and continued use to maintain gains.
Prescribe oral finasteride for men (and consider for selected postmenopausal women only under specialist care): monitor for sexual side effects and discuss fertility/teratogenic risks.
Inject intralesional corticosteroids for patchy alopecia areata (e.g., triamcinolone every 4–6 weeks) to prompt regrowth.
Treat infected or scaly scalp conditions with topical/oral antifungals or antibiotics (for tinea capitis, use oral terbinafine; for bacterial infections, use targeted antibiotics).
Consider adjuncts with modest evidence: PRP (platelet‑rich plasma) and low‑level laser therapy (LLLT) — discuss realistic, often modest, benefits and costs.
Evaluate hair transplant candidacy only after stabilization of hair loss, sufficient donor hair, and realistic expectations.
Expect side effects, set timelines, and obtain baseline labs (thyroid, ferritin, CBC, pregnancy test where relevant).
Discuss options and monitor results with a dermatologist for a tailored plan.
Step 5 — Build a Long-Term Prevention and Maintenance Plan
Stop blaming your shampoo forever: simple habits that keep hair healthy for years.Create a personalized maintenance plan that combines effective treatments, regular monitoring, and daily habits. Set measurable goals and timelines.
Set measurable checkpoints:
• Take standardized photos every 3 months.
• Keep a shedding log or weekly comb test (count hairs).
• Record products, meds, and symptoms.
Schedule and act:
• Book follow-ups every 3–6 months with your dermatologist or trichologist.
• Escalate care if shedding increases for 2–3 consecutive months or if no regrowth after expected timelines (e.g., 6 months on minoxidil).
• Taper therapies only with clinician guidance to avoid relapse.
Maintain prevention habits:
• Use protective styling (loose braids, low-tension ponytails) and limit heat/chemical damage.
• Check nutrients regularly (ferritin, vitamin D, TSH) every 6–12 months.
• Manage stress with sleep, exercise, and brief daily relaxation.
Improve appearance now:
• Use concealers (fibers, powders), smarter cuts (layers), or wigs/toppers to boost confidence while treatments work.
Be patient — hair regrowth is slow, but consistent maintenance prevents relapse.
Start Small, Act Smart, and Be Patient
Identify the cause, fix basics, apply targeted treatments, and commit to a simple maintenance plan—progress often takes months; consistent, patient steps yield durable results and better scalp health. Ready to keep going starting today and see what small changes achieve?
Really appreciated the clear steps — especially the part about diagnosing the type of hair loss first. I wish my dermatologist had explained it this simply.
Quick question: how long should I try the basic fixes (nutrition, sleep) before expecting visible improvement? Anyone seen results in under 3 months?