Hair Loss / Hair Fall

Overview#

Hair fall (also called hair loss or alopecia) is one of the most common dermatological complaints in India, affecting both men and women across all age groups. Normally, losing 50–100 hairs per day is considered physiological. Hair fall becomes a concern when shedding exceeds this amount, hair becomes visibly thinner, or bald patches appear.

In India, nutritional deficiencies (iron, vitamin D, B12), thyroid disorders, and hormonal conditions like PCOS are leading reversible causes. Androgenetic alopecia (male/female pattern hair loss) is the most common cause of progressive, permanent hair thinning.

Common Causes#

1. Nutritional deficiencies — iron, ferritin, vitamin D, vitamin B12, biotin, and zinc deficiency are extremely common in Indian patients with hair fall.
2. Thyroid disorders — both hypothyroidism and hyperthyroidism cause diffuse hair thinning.
3. Androgenetic alopecia — genetically determined pattern hair loss; receding hairline in men, central thinning in women.
4. Telogen effluvium — excessive shedding 2–3 months after a trigger such as fever (dengue, COVID-19, typhoid), surgery, childbirth, or severe stress.
5. PCOS — hormonal imbalance causes hair thinning on the scalp and excess hair on the face and body.
6. Scalp conditions — dandruff (seborrhoeic dermatitis) and fungal infections weaken hair roots.
7. Alopecia areata — autoimmune condition causing coin-shaped bald patches on the scalp.

Associated Symptoms#

Hair fall may be accompanied by scalp itching or flaking, visible thinning of ponytail thickness, widening part line, bald patches, brittle nails, fatigue, or irregular periods (if hormonal).

Home Remedies & Self-Care#

• Eat a protein-rich diet — eggs, paneer, dal, sprouts, nuts, and seeds support hair growth.
• Include iron-rich foods: spinach, beetroot, jaggery, ragi, and poha.
• Oil your scalp 1–2 times per week with coconut or castor oil; gently massage for 5–10 minutes.
• Use a mild, pH-balanced shampoo; avoid washing with very hot water.
• Minimise heat styling, tight hairstyles (ponytails, braids), and chemical treatments.
• Manage stress — it is a significant trigger for telogen effluvium.

When It's Serious#

Consult a dermatologist promptly if:

• You notice sudden, large clumps of hair falling out.
• Coin-shaped bald patches appear on the scalp (possible alopecia areata).
• Hair fall is accompanied by significant fatigue, weight changes, or menstrual irregularities.
• Scalp shows redness, scarring, or pus-filled bumps (possible scarring alopecia — irreversible if untreated).
• Eyebrows or eyelashes are also thinning.

Diagnosis & Tests#

Your doctor may recommend:

• Complete Blood Count (CBC) — to check for anaemia.
• Iron studies (serum ferritin) — ferritin below 40 ng/mL is associated with hair fall, even without frank anaemia.
• Thyroid Profile (TSH, T3, T4) — to rule out thyroid disease.
• Vitamin D (25-OH) — deficiency is very common in Indian patients with hair fall.
• Vitamin B12 — especially in vegetarians.
• Hormonal panel (testosterone, DHEAS, LH, FSH) — if PCOS or androgenetic alopecia is suspected.
• Trichoscopy — a non-invasive dermatoscopic examination of hair and scalp.

When to See a Doctor#

See a dermatologist if hair fall has been persistent for more than 3 months, is worsening, or is accompanied by other symptoms. Nutritional and hormonal causes of hair fall are highly treatable, and early intervention gives the best results.