Hair loss: causes and medical treatments

Hair loss almost always has an identifiable cause and, in most cases, a scientifically supported treatment. Before trying remedies on your own, the useful thing is to understand what is behind that loss, because what works and what does not depends on that diagnosis. In this guide we review the main causes in men and women, how to tell normal hair loss from one that warrants a consultation, what tests doctors use, and which hair treatments have real evidence.

Hair follows a natural cycle of growth, rest and shedding. That is why losing some hair every day is to be expected. The problem arises when that balance breaks down and density begins to decrease visibly.

Main causes of hair loss in men and women

Not all types of hair loss are the same. Identifying the pattern is the first step towards guiding treatment.

Androgenetic alopecia

It is the most common cause in both men and women. It has a genetic and hormonal component, and according to the clinical reference StatPearls it can affect up to 50 per cent of men and women over the course of their lifetime. In Caucasian men, approximately 50 per cent are affected by the age of 50 and nearly 80 per cent by the age of 70.

In men it usually begins at the temples and crown. In women, the pattern is different: the central parting widens and the hair loses thickness in a diffuse manner, without clearly defined bald patches appearing.

Telogen effluvium

It is a diffuse and temporary form of hair loss in which many follicles enter the resting phase at the same time. It is often triggered by childbirth, a febrile illness, surgery, a very restrictive diet or a period of intense stress. Its hallmark is that it appears a few weeks or months after the triggering event and tends to resolve once that trigger is addressed.

Nutritional deficiencies and medical conditions

The condition of the hair reflects the general state of the body. Among the factors that may contribute are:

• Iron deficiency or low ferritin, common in women.
• Thyroid disorders, whether overactive or underactive.
• Vitamin D deficiency, which can influence the follicle cycle.
• Hormonal changes, especially during the menopause.

Alopecia areata and inflammatory causes

Alopecia areata causes rounded hairless patches through an autoimmune mechanism. Other types of alopecia are associated with inflammation or scarring of the scalp and require specialist assessment, because the approach is very different from that for common hair loss.

When Hair Loss Is Normal and When to See a Doctor

Losing between 50 and 100 hairs a day is within the normal range. This renewal is part of the cycle and does not reduce overall density.

It is advisable to seek medical advice when any of the following signs appear:

• Hair loss increases clearly and persistently over several weeks.
• You notice areas with less density, a receding hairline, or a wider parting.
• Round bald patches appear suddenly.
• It is accompanied by itching, redness, flaking, or scalp pain.
• The hair loss does not recover after several months.

Seeking an early consultation has a concrete advantage: the sooner androgenetic hair loss is treated, the better the follicle retains its ability to respond. Waiting until the area is very sparse reduces the options.

Medical Diagnosis to Identify the Cause

The right treatment starts with the right diagnosis. Two people with the same complaint may have completely different causes, and applying the same product to both rarely works.

During a consultation, the process typically includes:

• Medical history and examination. Dr. Florian A. Vallecillo Cabrera assesses the pattern of hair loss, the duration of the condition, family history, and possible triggers.
• Scalp dermoscopy. This allows observation of the follicle, shaft thickness, and signs of miniaturisation that the naked eye cannot detect.
• Blood test. To rule out iron deficiency, thyroid disorders, vitamin D deficiency, or other medical causes.

This evidence-based medicine approach is what we apply at Clínica Valorian: first understand the cause, then choose the treatment. If you are unsure who to turn to, our guide on when to see a dermatologist in Marbella will help you understand what to expect from your first visit.

Available Treatments and Their Scientific Support

This is where it matters most to separate what has evidence behind it from what is sold as a miracle solution. A good hair treatment starts with a diagnosis and is tailored to each individual.

Minoxidil

It is one of the reference treatments. It works by prolonging the follicle's growth phase and is used in a topical formulation and, in clinical settings, also orally at low doses in selected cases. It requires consistency, as results are seen after several months and are maintained for as long as it is used.

Finasteride

Indicated primarily in men with androgenetic alopecia, it reduces the action of the hormone responsible for follicle miniaturisation. It is a prescription medication that must be assessed on an individual basis, taking into account both benefits and possible side effects.

Other options for women

In women with androgenetic pattern, specific approaches are used. The American Academy of Dermatology notes that spironolactone is effective in around 40 percent of women with female-pattern hair loss, always under medical supervision.

Platelet-rich plasma (PRP)

PRP involves applying a concentrate of the patient's own platelets to the scalp to stimulate the follicle. There are studies supporting its usefulness as a complement in certain cases, although it does not replace first-line treatments.

The key point: no single treatment works for every type of hair loss. The right combination and consistency, guided by a proper diagnosis, make all the difference.

Habits and care that promote healthy hair

Good hair care habits cannot reverse genetic hair loss, but they do create the conditions for the follicle to function better and help prevent additional damage.

• Watch your diet. An adequate intake of proteins, iron and vitamins supports hair growth.
• Manage stress and get enough rest. Telogen effluvium is frequently associated with periods of stress or lack of sleep.
• Treat your scalp gently. Avoid excessive heat, very tight hairstyles and harsh washing.
• Do not self-medicate. Supplements taken without a proven deficiency rarely provide any benefit and may delay an accurate diagnosis.
• Review your general health. Hair loss is sometimes the first sign of an underlying problem, so a preventive medical check-up can be very useful.

Take the first step with a diagnosis

If you notice your hair losing density, seek a medical assessment before spending money on products without knowing what is happening. Book a consultation so that Dr. Florian A. Vallecillo Cabrera can examine your scalp with dermoscopy and, if appropriate, request blood tests. With a clear diagnosis you will know exactly which hair treatment makes sense for your case and avoid wasting time on solutions that are not going to work.