Hair loss: causes, overview and treatments

Hair loss or alopecia represents temporary or permanent hair loss which can be caused by genetics, illness, stress or other factors. It represents a major aesthetic problem, both for women and for men. However, the good news is that modern treatments, such as PRP or mesotherapy, I can help restore it and stimulate its regrowth.

It is natural to lose a certain amount of hair every day as part of its normal natural regeneration cycle. It is considered normal to lose between 50 and 100 hairs a day. This is particularly noticeable after washing, when hair is heavy and wet, making it easier for hairs that are already ready to fall out to do so. This can sometimes even frighten us and create the impression of a greater loss. However, let us consider that on average we have about 100,000 hairs on our head and therefore the loss of 50 to 100 hairs during the day is not alarming.

Yet, when is it time to ask ourselves whether our hair is falling out excessively and if something is wrong?

In most people, lost hair grows back, so it remains thick and healthy. However, illnesses, hormonal changes, stress, ageing and hereditary factors can disrupt its growth cycle. More hairs then fall out, and new ones do not always grow back or they grow much slower. Therefore, any hair loss greater than what is considered normal is called alopecia.

To clarify. As it grows, hair goes through certain phases. The anagen phase is the active growth phase, the catagen phase is the transitional phase, while the telogen phase is the resting phase when the hair follicles “rest”. After the resting phase ends, the hair falls out, and a new one grows in the follicle. However, due to various factors, the natural cycle of hair growth and renewal can be disrupted – at that point, it sheds rapidly, thins out, and baldness or bald patches often appear on certain parts of the head.

Hair loss – causes

Hair loss represents a major aesthetic problem, but it also significantly impacts an individual's psychological state, leading to a lack of self-confidence and even depression in some patients. Let us also mention that there is a hair-pulling disorder, the so-called trichotillomania – the urge to pull out or break one's own hair, which most commonly occurs in early childhood up to adolescence.

The most common causes of alopecia are:

Genetics and family history of baldness

Professionally, this is referred to as androgenetic alopecia and represents the most common form of hair loss, genetically conditioned and hormonally mediated. In men, it occurs as a receding hairline and baldness at the crown, and in women as diffuse hair thinning at the top of the head. It is caused by the hypersensitivity of hair follicles to dihydrotestosterone (DHT), which shortens the hair growth phase and leads to the weakening of the follicles.

Hormonal imbalance

Most commonly in women, hormonal changes during pregnancy, after childbirth or during the menopause can cause sudden hair loss and thinning.

Stress and emotional or physical shock

Stress directly affects the immune system and can lead to sudden and progressive hair loss.

Medical conditions

Certain conditions such as diabetes, lupus, polycystic ovary syndrome or thyroid problems can cause hormonal changes and consequently hair loss.

Scalp infections

Fungal and other scalp infections can disrupt normal hair growth and lead to localised hair loss.

Use of medications, supplements and oncological therapies

Certain medications, supplements, chemotherapy and radiotherapy often cause temporary or permanent hair loss.

Poor diet and dehydration

A lack of essential nutrients, proteins, vitamins and minerals, as well as insufficient hydration of the body, negatively affect the hair follicle and can accelerate hair loss.

What are the clear signs of accelerated hair loss?

Gradual thinning at the crown of the head

This is the most common form of hair loss and occurs with ageing. In men, the hair often begins to recede along the hairline, whilst in women, a widening of the parting is usually observed. An increasingly common pattern in older women is frontal fibrosing alopecia, which can also lead to eyebrow loss.

Circular or partial bald patches

When hair falls out in circular or uneven patches on the scalp, beard, or eyebrows, itching or pain often occurs just before the hair loss itself. This is characteristic of alopecia areata.

Sudden hair loss

It can arise as a result of severe stress, physical or emotional shock. Locks of hair can fall out in large amounts when combing, washing or even with a gentle pull. Most commonly, it leads to diffuse thinning and is usually of a temporary nature.

Hair loss over the whole body

It occurs in certain medical conditions or after medical treatments, especially chemotherapy. Once the therapy is finished, the hair usually regenerates.

Patches with flaking on the scalp

Such changes are a typical sign of a fungal infection known as ringworm (tinea capitis). The infection attacks the hair follicles and the scalp, and it may be accompanied by hair breakage, redness, swelling, and sometimes fluid discharge.

Hair loss – how to get a diagnosis?

Timely detection of the first signs of sudden and excessive hair loss is extremely important. In the case of partial loss known as alopecia areata, hair loss occurs suddenly and usually begins with one or more circular bald patches that may overlap. Early signs may also include a feeling of discomfort, itching or a tingling sensation on the scalp.

The basis for an effective treatment is certainly finding the cause and establishing an adequate diagnosis. It is important to disclose to the doctor all factors that could be the cause, ranging from genetics and potential stress to taking certain medications. Diagnosis can be established by examining the scalp, as well as by analysing the hair strands under a microscope. According to the doctor's assessment, blood tests or a hormone status check can be done, and in certain cases also vertex biopsy. In assessing the causes, the dermatologist may also use trichoscopic examination of the hair and scalp, and further tests are determined according to the findings.

All of this is important in order to create an appropriate treatment protocol and determine the treatments that are suitable for each individual patient.

Hair loss treatments

Depending on the cause of sudden hair loss, various treatment methods and therapies can be applied. The use of certain medications, corticosteroid ointments or sprays that stimulate hair growth and prevent its further loss is often required. Alongside the therapy prescribed by a doctor, medical treatments for hair loss—such as PRP and mesotherapy—are often combined.

We perform both treatments in Imedic, and the plan is made after the scalp examination.

PRP treatment for hair loss

During the PRP treatment, platelet-rich plasma is separated from your blood and injected into the scalp using fine needles. Growth factors from the platelets strengthen weakened hair follicles and prolong the hair growth phase. The most data exists for hereditary, androgenetic hair loss, and the effect is better when started early. To find out what the treatment looks like, how many treatments are needed and when results are visible, read the page PRP hair treatment.

Mesotherapy for hair loss

During mesotherapy, a cocktail of vitamins, amino acids, minerals and other active ingredients that support follicle nourishment is introduced into the scalp. It is performed in a series of treatments, either independently or alongside PRP, according to the doctor's assessment. Read more about the protocol and results on the page hair mesotherapy.

PRP or hair mesotherapy – which to choose?

PRP and hair mesotherapy work in different ways, so the choice depends on the cause of hair loss and the condition of the scalp, and sometimes they are combined. A detailed comparison, with a table, can be found in the section PRP or hair mesotherapy on the PRP hair treatment page.

Scalp examinations and trichoscopy at Imedic are performed by dermatologists Dr Marina Ćirović and Dr Sanja Kekić, while hair PRP and mesotherapy are carried out by the polyclinic's doctors according to a plan made after the examination.