What should you know about chronic hair loss?

Hair may come out during washing, partings may look wider, or patches may become visible. The pattern matters: gradual thinning at the front or crown can occur with male or female pattern hair loss, while smooth patches can occur with alopecia areata. Hair loss after physical or emotional strain may reflect telogen effluvium. Tight styles can contribute to traction alopecia, and scaling or broken hairs can point toward scalp ringworm. These conditions need different approaches, so the appearance and timing should be recorded rather than guessed from shedding alone.

Arrange a dermatology assessment if loss continues, spreads, or changes your scalp appearance. Note when it began, whether it is diffuse or patchy, recent illness or major stress, new medicines, diet changes, family pattern, and styling or chemical practices. Use gentle handling, avoid tight hairstyles and repeated traction, and do not scratch a scaly scalp. Do not start finasteride treatment without discussing suitability, pregnancy-related precautions, and monitoring with a clinician.

Seek prompt medical care for rapidly enlarging bald patches, painful or tender scalp, pus, marked redness, thick scale, broken hairs, fever, or loss of eyebrows or eyelashes. A clinician should also examine hair loss accompanied by fatigue, weight change, or other new symptoms. Sudden extensive loss is a reason to arrange an assessment soon, even when the scalp feels normal.

Ask what pattern the examination shows, whether the scalp needs testing, which reversible triggers should be checked, how long regrowth might take, and how progress will be monitored. Ask whether a treatment is intended to reduce shedding, support regrowth, or both, and what happens if it is stopped.