Quick Answer
Hair loss isn't one condition. Pattern hair loss, telogen effluvium, alopecia areata, traction alopecia and scarring alopecias all look different, have different causes, and need completely different treatment, so correct diagnosis matters more here than almost any other skin concern. Topical minoxidil has the strongest evidence base of any treatment; several popular add-on options have real but much more limited evidence behind them.
What's actually happening
Five main patterns account for most hair loss: androgenetic (pattern) hair loss is hereditary and DHT-driven, causing gradual, predictable thinning; telogen effluvium is diffuse shedding that starts 2 to 4 months after a stressor like illness, childbirth or major stress, and is usually self-limited; alopecia areata is an autoimmune condition causing well-defined round patches; traction alopecia comes from sustained hairstyle tension and can become permanent if untreated; and scarring alopecias are a group of inflammatory conditions that permanently destroy hair follicles.
Because these need entirely different treatments, diagnosis comes before anything else. Dermatologists typically use a gentle pull test and magnified scalp examination (trichoscopy) to look for specific signs, and reserve a scalp biopsy for suspected scarring alopecia or an unclear diagnosis. Bloodwork, checking thyroid function and iron levels, is common for diffuse, unexplained shedding, since correcting an underlying deficiency is sometimes the actual treatment needed.
Explore the different types
Tap a type to see how it presents and what it actually needs.
Hereditary, gradual, most common
DHT-driven, progressive thinning following a predictable pattern, a receding hairline and vertex thinning in men, a widened central part in women. Manageable long-term with consistent treatment, though it requires ongoing use to maintain results.
What we know, and what's still debated
Different causes need different treatments entirely, which is why getting the diagnosis right matters most here.
Genetics
The strongest factor in pattern hair loss, and a contributor to alopecia areata risk, with over 16 identified genetic risk loci.
Hormonal changes
Pregnancy, childbirth, menopause, stopping hormonal contraceptives and thyroid disease are all recognised telogen effluvium triggers.
Physical or psychological stress
A classic telogen effluvium trigger, and self-reported as an aggravating factor in alopecia areata too.
Nutritional deficiency
Iron deficiency and general nutritional deficiency are named triggers for diffuse shedding by multiple health authorities.
Mechanical tension
Tight hairstyles, buns, cornrows, tight ponytails, or repeated hairpiece attachment at the same spot, the direct cause of traction alopecia.
Who's commonly affected
Most common
cause of hair loss overall
androgenetic (pattern) hair loss, in both men and women
2–4 months
typical delay
between a stressor and visible telogen effluvium shedding
16+
genetic risk loci identified
for alopecia areata, an autoimmune condition
Irreversible
if scarring alopecia progresses
early treatment aims to preserve remaining hair, not regrow lost follicles
Correctly identifying which type you have changes everything about treatment, which is why a proper diagnosis, not a stronger version of whatever product you already tried, is the right starting point.
What to expect at your consultation
Pattern & history review
Diffuse vs. patchy vs. marginal hair loss, onset speed, and associated symptoms (itch, pain, scaling) are reviewed first.
Pull test & trichoscopy
A gentle hair-pull test and magnified scalp examination look for specific signs tied to each condition.
Bloodwork where indicated
Thyroid function, iron and ferritin levels are checked for diffuse, unexplained shedding.
Scalp biopsy when needed
Reserved for suspected scarring alopecia or an uncertain diagnosis, since catching this early matters most for preserving hair.
Condition-specific plan
Treatment is built around your actual diagnosis, not a generic hair-thinning product stack.
Important Cautions
- • Not all hair loss responds to the same treatments; minoxidil, finasteride, PRP and microneedling are studied for pattern hair loss specifically, not alopecia areata, traction or scarring alopecias, which need different approaches entirely.
- • Finasteride is not recommended for women; evidence in women specifically found it no better than placebo in a Cochrane-based synopsis.
- • Benefits from minoxidil and finasteride are not permanent; regrowth is typically lost within months of stopping treatment.
- • Loss of visible follicular openings (smooth, shiny patches) signals scarring alopecia, which is irreversible once established, so this needs prompt dermatologist referral, not a cosmetic routine.
- • Sudden, patchy hair loss, or hair loss with scalp pain, burning, redness or scaling, needs prompt medical assessment rather than self-treatment, since these can indicate autoimmune or scarring conditions.
Treatment categories, by evidence strength
Evidence strength varies a lot between options, here's what's actually established versus still emerging.
Strongest evidence
Topical minoxidil
The longest-standing, most evidence-backed option for pattern hair loss in both men and women, available without prescription.
Oral finasteride
Well-established for men specifically; evidence in women has not shown it to outperform placebo, and it isn't recommended for them.
Addressing the underlying trigger
For telogen effluvium specifically, correcting a thyroid, iron or nutritional deficiency is often the actual treatment, not a cosmetic product.
A tailored plan, not a product stack
Hair and scalp concerns are assessed individually with your doctor before any treatment plan is proposed, since the right next step depends entirely on which type of hair loss you have.
Your questions, answered
References
- [1] American Academy of Dermatology — Types of Hair Loss
- [2] American Academy of Dermatology — Causes of Hair Loss
- [3] DermNet NZ — Telogen Effluvium
- [4] DermNet NZ — Alopecia Areata
- [5] NHS — Hair Loss
- [6] American Academy of Family Physicians — Platelet-Rich Plasma for Androgenic Alopecia
This page changes as evidence evolves. It is for general education, not personalised medical advice — a consultation with your doctor confirms suitability, risks and options for you specifically.
Reviewed by Dr. Dinesh Kanasen (MMC 43953) · Last updated 16 October 2026
Not sure what type of hair loss you're experiencing?
A doctor-led assessment identifies the actual cause, since the right treatment depends entirely on getting that diagnosis right.