Pattern hair loss: the usual answer
Everyone loses hair all the time. Between 50 and 100 hairs a day is normal, and most of it goes unnoticed. What most people mean when they ask this question is pattern hair loss, and the clue is in the family: it's hereditary, it comes on gradually over years, and it follows a recognisable shape.
In men it starts with a receding hairline or a thinning crown, usually from the twenties or thirties onwards. In women it tends to show as a widening parting and less overall volume rather than a bald patch, and it becomes more common after the menopause. Around half of men have noticeable pattern loss by 50.
The NHS treats it as a normal part of ageing rather than an illness. Hair lost this way doesn't come back on its own, but it poses no risk to your health, and whether to do anything about it is entirely your call.
Temporary shedding after illness, stress or childbirth
Hair grows in a cycle: a long growing phase, a short resting phase, then the hair falls and the follicle starts again. A shock to the body can push far more follicles than usual into the resting phase at once. Because that phase lasts a couple of months, the shedding turns up around two to three months after whatever caused it — which is why it so often seems to come from nowhere. Doctors call this telogen effluvium.
Common triggers include:
- A significant illness, a high fever or an operation.
- Childbirth. Post-partum shedding is common and settles on its own.
- Rapid weight loss or a very restrictive diet.
- A sustained period of intense stress.
- Starting or stopping some medicines. Your pharmacist can tell you whether anything you take lists hair loss as a side effect.
This kind of loss is diffuse — thinner all over rather than in patches — and it usually reverses. Once the trigger has passed, hair generally regrows over the following months without any treatment at all.
Patchy loss and other medical causes
A smaller group of causes look different from both of the above, and these are the ones worth a proper diagnosis.
- Alopecia areata. The immune system attacks the hair follicles, producing round, coin-sized bald patches, sometimes in the beard or eyebrows too. Hair often regrows within a year, and the condition is unpredictable either way. A GP can confirm it and talk through what's available, including support if it's hitting you hard.
- Traction alopecia. Years of tight ponytails, braids, buns or extensions can damage follicles along the hairline. Caught early it recovers when the tension stops; kept up for long enough, it becomes permanent.
- Scalp conditions. Fungal infection of the scalp (ringworm) causes scaly, itchy patches of loss and is most common in children. It needs treating, so see a GP or pharmacist rather than waiting it out.
- General health. An underactive thyroid and low iron levels can both thin hair gradually. Both show up on a blood test, which is one good reason to involve your GP before paying anyone for treatment.
- Medicines. Some prescription medicines list hair loss as a side effect, and some cancer treatments cause it directly. Don't stop anything you've been prescribed — raise it with the prescriber instead.
When to see a GP
Most hair loss needs no medical attention. Book an appointment if any of these apply:
- Hair is coming out suddenly or in clumps.
- You have bald patches, or loss in a pattern that doesn't run in your family.
- Your scalp is itchy, sore, scaly or scarred where the hair has gone.
- You feel unwell alongside the hair loss, or you've noticed other changes such as tiredness or weight change.
- The hair loss is affecting how you feel about yourself. Distress is a legitimate reason to see a GP in its own right, and support exists.
A GP can rule out the medical causes above, arrange blood tests where they're useful, and refer you to a dermatologist if the diagnosis isn't clear.
If you decide to do something about it
For pattern hair loss, treating it is optional and doing nothing is a perfectly good choice. If it bothers you enough to act, the routes run from a conversation with a pharmacist to a regulated online clinic that assesses you before anything is prescribed — and the service behind the treatment deserves as much scrutiny as the treatment itself.
Our hair-loss guide sets out the options and the five checks worth running before you pay anyone, starting with verifying the pharmacy is GPhC-registered. The comparison then shows what each regulated provider's service includes and charges.