Start with your concern

Hair thinning

Reviewed by Dr Ong Jin Khang

Hair thinning is a symptom, not a diagnosis. Pattern hair loss, a shedding phase after illness or stress, iron or thyroid deficiency, traction from years of tight styling, and scalp disease all end the same way in the mirror, and they are treated entirely differently. Starting treatment before knowing which one is at work wastes the one thing hair loss does not give back: time.

Thinning is a symptom. The cause is the diagnosis.

What is actually going on

Pattern hair loss, in both men and women, is a gradual miniaturisation of follicles driven by genetics and hormones; in men it often announces itself as a receding hairline. Telogen effluvium, the sudden heavy hair fall that alarms people most, is different: a synchronised shedding two to three months after a trigger, illness, postpartum hormonal shifts, crash dieting, severe stress, and it usually recovers on its own. Deficiencies of iron, vitamin D or thyroid hormone thin hair diffusely and reverse when corrected. Traction and scarring conditions damage follicles mechanically or inflame them outright.

Each of these has a different tempo and a different prognosis, and two often overlap. The history and examination, sometimes with blood work, separate them.

The honest map

For pattern loss and treatable thinning, the clinic's hair loss treatment pathway starts with identifying the cause, then matches it: prescription medication where the indication supports it, scalp treatments that support the follicle, and correction of whatever the blood work finds. The earlier miniaturisation is caught, the more there is to protect.

Shedding phases mostly need reassurance, time and the trigger addressed, and being told that honestly is worth more than a package of sessions sold against a problem that was already resolving.

What we protect above all is time. Follicles that have miniaturised away do not return, so the plan is built around keeping what is active, not chasing what is gone.

When we would say no

Sudden patchy loss, scarring, redness, scale or pain is not aesthetic territory. Those patterns point to conditions that need a dermatologist, and the referral goes out before any treatment is discussed here.

We also do not sell hair treatments against a deficiency that a supplement and a corrected diet will fix, and we do not promise regrowth where follicles are gone. Where the honest ceiling is 'keep what you have', we say that sentence out loud.

How the cause gets found

The assessment is built to find the cause before any treatment, because the causes look identical in the mirror and behave nothing alike. The history matters most: when the thinning started, whether it was sudden or gradual, what happened two to three months before a heavy shed, and whether there is a family pattern. The scalp is examined for the miniaturised hairs of pattern loss and for scarring, redness or scale, and blood work is added where deficiency or thyroid is plausible. What looks like one problem usually resolves into a specific one under that lens.

Tempo and prognosis fall out of the cause. A synchronised shed after illness or childbirth is usually recovering already and needs time, not a package. Deficiency reverses when corrected. Pattern loss is slowed and partly held while follicles are active. Scarring conditions are urgent and belong with a dermatologist. Naming which one is at work decides both the treatment and how fast it has to start.

Our view

Hair loss is sold with urgency and hope, and both are easy to exploit, because people are frightened and will pay to do something now. Our view is that the honest first move is usually to slow down and diagnose rather than to start a treatment against an unnamed problem.

The one thing this concern does not return is time. Follicles that have fully miniaturised do not come back, so the value is in catching treatable loss early, and in refusing to sell regrowth where the honest ceiling is keeping what you have.

Common questions

Why is my hair suddenly shedding so much?

Sudden diffuse shedding is most often telogen effluvium, a synchronised shed that follows illness, childbirth, crash dieting or severe stress by two to three months. It usually recovers once the trigger has passed. The assessment confirms the pattern and checks nothing else is hiding under it.

Is hair thinning reversible?

It depends on the cause and the stage. Deficiency-driven thinning reverses when corrected. Shedding phases recover. Pattern loss can be slowed and partly regained while follicles are still active, but follicles that have fully miniaturised do not come back, which is why early assessment matters more here than in almost any aesthetic concern.

Do I need a hair transplant?

Not as a first question. A transplant relocates hair; it does not stop the loss that created the problem, and untreated pattern loss keeps moving behind it. Stabilise first, then judge what, if anything, needs rebuilding. If surgery is genuinely the right step, we say so and refer.

Does thinning in women mean something is wrong?

Sometimes. Female pattern loss is common and gradual, but new or rapid thinning in women justifies checking iron, thyroid and hormonal status before anything is treated cosmetically. That is a blood test, not a package.

Do supplements work?

Only against a deficiency. If your iron or vitamin D is low, correcting it helps and the improvement is real. If nothing is deficient, supplements mostly produce expensive urine, and the honest money goes to treating the actual cause.

How much does hair loss treatment cost?

It depends entirely on the cause, which is why the assessment comes first. A corrected deficiency can be inexpensive; pattern loss is an ongoing plan; a shedding phase may need nothing but time and reassurance. We would rather diagnose than sell a standard package against a problem that has not been named, because the wrong treatment here also costs you time you cannot recover.

Does PRP or do hair supplements actually regrow hair?

Only against the right cause. Supplements help when a genuine deficiency is present and mostly waste money when nothing is deficient. Adjunctive treatments have a place inside a plan built on a diagnosis, and no place as a substitute for one. What regrows hair is treating the actual cause early, not a single product applied hopefully.

Is it normal to lose hair every day?

Yes. Shedding around a hundred hairs a day is normal turnover, and a heavier but even shed for a few months after a clear trigger is usually a recovering telogen effluvium. What justifies assessment is thinning that is progressive, patchy, or paired with scalp symptoms, because those point to causes that reward being caught early.

From the journal

Losing hair? The cause decides everything.

In person, with Dr Ong. History, scalp examination and blood work where needed, then a plan matched to the cause, and a straight answer about what can and cannot be regained.

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