Hair loss – causes, diagnosis, effective treatments

Hair loss is an issue that affects men and women of all ages. Losing several dozen hairs a day is a physiological process, but when you notice that significantly more are left on your brush, pillow, or in the shower drain, it’s time to take action. The diagnosis and treatment of alopecia are our areas of expertise at our clinic, and we take a customized approach to each patient.

How to recognize if your hair loss is excessive?

Identifying excessive hair loss is not always easy, as every person loses between 50 and 100 hairs a day, which is a natural part of the hair life cycle. The problem arises when this process accelerates – the hair becomes thinner, sparser, and its presence becomes noticeable not only during brushing but also on pillows, clothes, or in the shower drain.

When you notice that more hair falls out while washing than before, this is one of the first warning signs. It might feel as though the water is literally washing your hair away, leaving you with handfuls in your hands. Similar symptoms may occur while brushing – if your hairbrush is covered with hair after each use and needs to be cleaned more frequently than usual, it’s worth investigating further.

Another sign may be visible thinning of the hairstyle. Hair may lose its volume and become less dense – affecting the hairline, temples, and crown. In women, thinning often involves the widening of the parting line, while in men, a receding hairline and balding crown are typical.

Why does hair fall out? The most common causes

One of the most common causes of hair loss are hormonal factors, especially androgenetic alopecia. In men, this appears as a receding hairline and thinning crown, while in women it often presents as diffuse thinning across the scalp, particularly along the parting. The main culprit is a derivative of testosterone – DHT (dihydrotestosterone), which weakens hair follicles and causes gradual miniaturization.

Another important factor is stress and psychological strain. Chronic stress disrupts hormonal balance, constricts blood vessels, and can lead to telogen effluvium, where a large number of hairs simultaneously enter the resting phase and fall out in a short period. This is a typical reaction after emotional shock, hospitalization, childbirth, or surgery.

Nutritional deficiencies are also a major cause – especially iron, zinc, biotin, vitamin D, and B vitamins. Since hair is not considered a vital structure, it is one of the first to suffer in cases of malnutrition or an imbalanced diet. This leads to weakened hair roots and slowed growth.
Autoimmune diseases – such as lupus or alopecia areata – can also lead to hair loss. In such cases, the immune system mistakenly attacks the hair follicles, causing sudden bald patches that are often unpredictable and recurrent. Untreated alopecia areata may even lead to total hair loss.
Hormonal imbalances caused by menstruation, pregnancy, menopause, and postpartum periods are significant for women. Fluctuations in estrogen and progesterone directly affect hair condition. Postpartum hair loss affects many women and usually goes away on its own, but it can be very upsetting. We should not forget about external factors – such as aggressive hair treatments, frequent coloring, straightening, heat styling, as well as tight hairstyles or synthetic wigs. Regular damage to hair structure and chemical exposure can permanently weaken follicles and cause micro-injuries.

How many hairs fall out daily and how does the hair growth cycle work?

Every human being goes through a daily physiological process called hair shedding. On average, we lose 50–100 hairs per day. This number is within the normal range and results from the natural hair growth cycle, which includes three phases: growth, transition, and rest. Each hair functions independently, ensuring that under normal conditions, the hairstyle does not thin abruptly – some hairs grow, some shed, and new ones replace them.

The growth phase, called anagen, is the most active stage and can last 2–6 years. During this time, the follicle works intensively – cells multiply, the hair grows, and the bulb remains well-nourished. Up to 90% of our hair is in this phase, which is why the length and density of hair largely depend on the duration of anagen.

The catagen phase is a short, 2–3 week transitional stage during which the follicle shrinks, nourishment ceases, and growth stops. Only 1–2% of hairs are in this phase at the same time.

The telogen phase lasts around 2–3 months. Hair does not grow, remains inactive, and gradually moves to the skin’s surface before shedding. Normally, 10–15% of hairs are in this phase. After shedding, the cycle begins again with new hair growth from the same follicle.
Any disruption of these stages – shortening anagen, prolonging telogen, or stalling in catagen – can cause visible thinning and excessive shedding. This is why it’s crucial to consult a specialist if you experience concerning hair loss. Accurate diagnosis helps identify which phase is disrupted and tailor the right therapy to restore balance.

When does hair loss require a specialist consultation?

You should seek medical help if hair loss is sudden and intense – handfuls fall out during washing, brushing, or even gentle touch. Chronic, persistent shedding leading to thinning should also raise concern. Receding hairlines, bald patches, or widening partings can indicate serious conditions like androgenetic alopecia or alopecia areata.

Other worrying symptoms include itching, burning, excessive oiliness, or flaking of the scalp. These may signal scalp conditions such as seborrheic dermatitis, psoriasis, or fungal infections. Hair loss following infection, antibiotics, severe stress, or hormonal changes (e.g., after pregnancy, menopause, or thyroid disorders) should also be investigated.

A specialist – trichologist, dermatologist, or aesthetic medicine doctor – can determine whether hair loss is temporary and reversible, or the beginning of a more serious condition. Using diagnostic tools such as trichoscopy, microscopic hair analysis, or lab tests, they can recommend targeted therapy tailored to the root cause.

Seeking professional help not only increases treatment success but also prevents mistakes in self-care and unnecessary product experimentation. With hair, time is crucial – the earlier proper measures are taken, the better the chances of recovery.

Hair loss diagnostics – how to identify the cause?

The first step is always a detailed medical history. The doctor or trichologist asks about the duration and intensity of hair loss, lifestyle, stress, diet, illnesses, medications, cosmetic treatments, and family history. This often reveals potential risk factors such as hormonal imbalances, vitamin deficiencies, autoimmune diseases, or chronic stress.

Following that, trichoscopy, a cutting-edge imaging technique that magnifies the scalp, is frequently used for a scalp and hair examination. Trichoscopy assesses hair density, follicle condition, miniaturization, signs of inflammation, or flaking. It is invaluable in differentiating types of alopecia such as androgenetic, alopecia areata, or telogen effluvium.

If systemic conditions are suspected, laboratory tests are ordered, including iron and ferritin levels, vitamin D3, zinc, thyroid hormones (TSH, FT3, FT4), androgens (testosterone, DHT), complete blood count, and autoimmune markers. These tests help identify conditions such as anemia, hypothyroidism, PCOS, or other endocrine disorders.