My hair is falling out: understanding the cause before treating
Video in Spanish · subtitles available
If your hair is falling out, before reaching for shampoos, vitamins, or treatments there is a more important question: why? I explain, in a video, how I reason through hair loss in the clinic — especially in women — because hair loss is a symptom, not a diagnosis.
Hair loss describes a symptom, but it does not establish a diagnosis. The first step is to distinguish between excessive, temporary shedding — such as telogen effluvium, which typically follows a trigger two or three months earlier (infection, surgery, stress, rapid weight loss, pregnancy, or the postpartum period) — and a progressive loss of density due to follicle miniaturization, as in female androgenetic alopecia, where the part line widens.
In women, I also assess the hormonal and metabolic context — iron deficiency, thyroid function, menopause, signs of hyperandrogenism, or PCOS — without ordering tests indiscriminately: the history and physical examination indicate which investigations are warranted. Trichoscopy is helpful, but a camera cannot diagnose on its own, and supplements (biotin, iron, zinc) only make sense when a deficiency has been demonstrated.
The correct order in trichology is always clinical history, scalp examination, trichoscopy, tests when indicated, and only then treatment. Because hair loss is not a diagnosis: it is a signal that must first be understood.
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Doctor Florian A. Vallecillo Cabrera
The doctor on video
Informational content by Doctor Florian A. Vallecillo Cabrera. It does not replace an in-person consultation or an individual diagnosis.
