Hair

Overview

Hair is a normal part of the body, made mostly of a strong protein called keratin. Each strand grows from a tiny pouch in the skin called a follicle. Hair grows in cycles: a long growing phase, a short resting phase, and then it falls out so a new strand can take its place. Because of this cycle, some shedding every day is normal. 'Hair problems' is a broad term that covers many different things — hair that is shedding more than usual, thinning or balding, bald patches, dry or brittle hair, an itchy or flaky scalp, or extra hair growing where you don't want it. Most hair concerns are not a sign of serious illness, but they can be upsetting and are worth talking about with a doctor or pharmacist.

Yes. Hair concerns are very common. Hair thinning is so common that most men develop some degree of it as they get older, and many women notice thinning too, especially around the time of the menopause. Scalp flaking and dandruff are also extremely common and easily treated.

Anyone can be affected, at any age. Inherited hair thinning is more common in men and usually starts in the twenties or thirties. In women, thinning often becomes noticeable in the forties, fifties and sixties. Children can get scalp infections and patchy hair loss. Sudden heavy shedding can happen to anyone after illness, stress, childbirth or a big change in diet.

Symptoms

Common symptoms

• More hair than usual on your pillow, in the shower or on your brush
• Gradual thinning at the front, sides or top of the head, or a widening parting
• Bald patches that appear suddenly, often round or coin-shaped
• Hair that looks thinner all over and feels less full in a ponytail
• Dry, brittle hair that breaks easily or splits at the ends
• An itchy, flaky or greasy scalp (dandruff)
• Scalp redness, soreness or small bumps
• Unwanted hair growth on the face, chest or stomach, sometimes with irregular periods in women
• Changes in hair texture — for example, hair becoming coarser or finer

Symptoms in children

• Patches of scaling or broken hairs on the scalp, which can be a fungal scalp infection
• Sudden bald patches, sometimes after an illness
• Hair pulling or twirling habits that leave thin or bald areas
• Cradle cap in babies — yellow, crusty patches on the scalp that are harmless
• Thinning linked to a limited diet or a long illness

Symptoms in older adults

• Slow, steady thinning over many years, usually following a family pattern
• Hair becoming drier, finer and more brittle with age
• Greying, which is normal and caused by pigment cells slowing down
• Thinning in women around and after the menopause
• Scalp becoming more visible, which can feel uncomfortable in the sun

Causes

Main causes

• Inherited pattern hair loss — a family tendency that makes hair follicles shrink over time
• Temporary heavy shedding after illness, high fever, surgery, childbirth, crash dieting or a period of intense stress
• Low iron stores, an underactive or overactive thyroid, or other hormone changes
• Hormonal conditions such as polycystic ovary syndrome (PCOS), which can cause thinning on the scalp and extra hair on the face and body
• Some prescription medicines, including certain treatments for blood pressure, arthritis, depression and cancer
• Harsh styling — very tight braids, ponytails, weaves or extensions that pull on the roots, and frequent strong chemical treatments or heat
• Scalp infections, such as fungal infection, and scalp skin conditions like psoriasis or eczema
• An autoimmune condition called alopecia areata, where the body's immune system mistakenly attacks hair follicles and causes round bald patches
• Poor nutrition — not enough protein, iron, zinc or certain vitamins over a long period

Risk factors

• A family history of hair thinning or baldness
• Getting older
• Recent pregnancy, childbirth or menopause
• Long-term stress or a recent major life event
• Crash diets, eating disorders or a very restricted diet
• Medical conditions such as thyroid disease, diabetes, lupus or PCOS
• Taking certain medicines long term
• Frequent tight hairstyles, chemical relaxers, bleaching or hot styling tools
• Smoking, which may reduce blood flow to the scalp

When to see a doctor

See a doctor urgently if:

• You notice bald patches or heavy shedding that started suddenly
• Your scalp is painful, sore, red, crusted, oozing or bleeding
• You feel generally unwell, are losing weight without trying, or feel very tired alongside hair loss
• Your child has a scaly patch of hair loss that seems to be spreading
• You have a severe reaction to a hair product — swelling, blistering or trouble breathing — call your local emergency number straight away

Book a routine appointment if:

• Your hair is thinning and you want to know why, or what can be done
• Shedding has gone on for more than a few weeks
• Flaking, itching or dandruff does not improve with a gentle anti-dandruff shampoo from the pharmacy
• You have unwanted hair growth along with irregular periods or other symptoms
• Hair loss is affecting your confidence or mood

Diagnosis

A doctor will usually start by asking about your hair and health history — when the change started, whether it was sudden or gradual, what hairstyles and treatments you use, your diet, stress levels, medicines and family history. They will look closely at your scalp and hair, often checking several areas of the head. This simple assessment is enough to identify many common causes. If the cause is not clear, or if they suspect an underlying condition, they may arrange blood tests or refer you to a specialist skin doctor (dermatologist).

Tests that may be done

• A gentle pull test, where the doctor holds a small strand of hair to see how easily it comes away
• Blood tests to check iron levels, thyroid function, vitamin levels and sometimes hormone levels
• A closer look at the scalp and hair using a magnifying instrument
• A small sample of scalp skin (biopsy) in unusual or unclear cases
• A scalp swab or scraping if an infection is suspected

What to expect at your appointment

Most appointments are quick and painless. Bring a list of your medicines and any hair products or treatments you use, and think about when you first noticed the change — this helps a lot. Results from blood tests usually take a few days. Your doctor should be able to explain what is likely going on and what happens next, and it is always fine to ask questions or to ask for a second opinion.

Treatment

Treatment depends entirely on the cause. If a temporary trigger such as illness, stress, low iron or a new medicine is found, hair often regrows on its own once that is addressed. For inherited pattern hair loss, treatments work best when started early and need to be used long term. For scalp infections and skin conditions, targeted treatment usually clears things up. For hair loss caused by harsh styling, giving the hair a rest is often the most important step. Your doctor or pharmacist can talk you through the options that fit your situation.

Self-care at home

• Be gentle — wash with a mild shampoo, pat dry, and avoid brushing wet hair roughly
• Loosen tight braids, ponytails, buns and extensions, and give the hairline a rest
• Limit chemical relaxers, bleaching, perming and very high heat
• Use a wide-toothed comb and a soft brush
• Eat a balanced diet with enough protein, iron-rich foods, fruit and vegetables
• Try to manage stress — sleep, movement, time outdoors and talking to someone all help
• Protect your scalp from sunburn with a hat or scarf, especially where hair is thin
• Ask your pharmacist before starting any supplement, so you don't take more than you need

Medical treatments

Doctors treat hair problems by targeting the cause. That might mean correcting low iron or a thyroid problem, reviewing a medicine that could be contributing, or treating a scalp infection or skin condition with prescription creams, lotions or tablets. For inherited thinning, there are prescription treatments that can slow hair loss and sometimes help regrowth — these only work while you keep using them, and they are not right for everyone. For patchy hair loss caused by the immune system, doctors sometimes use treatments applied to the skin or small injections into the scalp. Some people are referred for light therapy or specialist support. Your doctor will explain the benefits, the time it takes to see a difference, and any side effects, so you can decide together.

When is surgery considered?

Surgery is only considered in a small number of cases. Hair transplant surgery — where small pieces of scalp with healthy hair are moved to thinning areas — is an option for some people with stable inherited hair loss, and it works best alongside other treatment. Surgery is not helpful for active, spreading or unexplained hair loss, so a proper assessment comes first. If you are thinking about a transplant, talk to your doctor before paying for any private procedure, and check that the clinic is properly qualified and regulated.

Living with this condition

Living with hair changes can be practical and emotional at the same time. On a practical level, small adjustments help: a gentle routine, looser styles, a scalp-friendly shampoo, and a hat for sun protection. On an emotional level, it can help to talk about how you feel rather than brushing it aside. Many people find that learning about the cause makes it feel less frightening, and that having a plan — even a simple one — restores a sense of control.

Lifestyle tips

• Keep hairstyles loose and change them often so no one area is pulled constantly
• Avoid sharing combs, brushes, hats or pillows if you have a scalp infection
• Wash your hair as often as you need to — there is no rule that frequent washing causes hair loss
• Be patient: hair grows slowly, about 1 cm a month, so changes take months to show
• Take photos in similar lighting every few months so you can see real progress
• Limit smoking and keep alcohol within recommended levels
• Get enough sleep and build small stress-relief habits into your week

Diet and exercise

There is no single food that grows hair, but a varied, balanced diet gives your body what it needs. Include protein at most meals — beans, lentils, eggs, fish, chicken, dairy or tofu — plus iron-rich foods such as leafy greens, and fruit and vegetables for vitamins. If you follow a vegan or very restricted diet, ask your doctor or pharmacist whether you need any checks. Regular movement helps with stress, sleep and circulation, and supports your overall health. Avoid crash diets, which are a common and reversible trigger for heavy shedding.

Mental health and emotional wellbeing

Hair is closely tied to identity and confidence, so changes can genuinely affect mood. It is common to feel self-conscious, anxious or low about it, and those feelings are valid. If hair loss is affecting your sleep, work, relationships or sense of self, please tell your doctor — support is available and you do not have to cope alone. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis helpline in your country straight away, or reach out to someone you trust and ask them to stay with you.

Prevention

Not all hair loss can be prevented — inherited thinning and ageing are not something you can control, and it is not your fault. But some causes are avoidable or manageable. Being gentle with styling, avoiding crash diets, keeping iron and thyroid problems treated, and looking after your general health all help protect your hair. If you notice a change early, getting advice sooner often gives you more options.

Screening programmes

There is no routine screening programme for hair problems. The best approach is simply to check in with yourself — notice unusual shedding, patches or scalp changes — and see your doctor if something changes or worries you. If you have a condition that can affect hair, such as thyroid disease, PCOS or low iron, keeping up with your regular reviews helps catch problems early.

Complications

If left untreated

• Some types of hair loss, especially those caused by scarring scalp conditions, can become permanent if not treated
• Scalp infections can spread and, rarely, cause more serious illness
• An underlying condition such as low iron or thyroid disease may go unnoticed
• Ongoing hair loss can affect confidence, mood, sleep and social life
• Constant tight styling can lead to permanent thinning at the hairline

Long-term outlook

The outlook is good for most people. Many types of hair loss are temporary and improve once the trigger is addressed, and there are effective treatments for inherited thinning and scalp conditions. Hair grows slowly, so patience matters — but with the right advice, most people find their situation is manageable, and there is real reason to feel hopeful.

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