Hair loss

Hair loss Dermatologist in London

Hair loss is a distressing condition that affects both men and women at various stages of life. A consultation with a Dermatologist can help you understand the cause of hair loss and work out ways in which to minimise hair loss. Dr Rajpar has a specialist interest in hair loss.

What causes hair loss?

Hair follicles are a complex structure – we have over 100,000 on our scalp alone. There are many disorders which can lead to hair loss.  A diagnosis can only be made after a detailed assessment by a Dermatologist. Sometimes further investigations such as blood tests and a biopsy from the scalp are required. Sometimes there are multiple causes to hair loss in one person. Common causes of hair loss include:

  • Female pattern hair loss
  • Hair loss during the menopause and perimenopause
  • Hair loss from Testosterone in HRT or in other forms of Testosterone treatment
  • Male pattern hair loss
  • Alopecia areata
  • Hair loss from Iron Deficiency
  • Telogen effluvium
  • Hair loss because of a dermatological condition such as dermatitis
  • A scarring condition such as lichen plano pilaris

Female pattern hair loss

Hereditary hair loss in women is much more common than most people would think. It is estimated that up to 40% of women will be affected by female pattern hair loss at some point in their lives. The term androgenetic alopecia, which is widely used for male pattern hair loss, should be avoided in women as the disorder is not always clearly driven by androgens. The features are similar to male pattern hair loss, in that the hairs become miniaturised.

Hair loss and the menopause and perimenopause

40% of ladies may experience hair loss around the time of the menopause. This can be very stressful. Hair loss may be all over the scalp or limited to the frontal areas. Sometimes hair loss on the scalp is combined with too much hair growing on the face. To some extent, hair loss with the menopause may be because the lack of oestrogens means that androgens can go about causing thinning. This is not the only cause though and combination cause are frequent. Sometimes hair loss starts after Testosterone supplements are started and using specific androgen blockers either as a tablet or as a lotion can be useful.

A podcast featuring Dr Rajpar from Belgravia Dermatology and Dr Louise Newson from Newson Health where the two specialists discuss hair loss during the menopause can be found here. A fact sheet on hair loss and the menopause written by Dr Rajpar can be found here.

Male pattern hair loss

This is the most common cause of hair loss in men, and affects 50% of men by the age of 50. Hairs become progressively narrower with subsequent hair cycles. This is known as miniaturisation. Treatment may including topical therapy, anti-hormonal pills and hair transplant.

Alopecia areata

Alopecia areata is a form of hair loss that affects up to 1.7% of people at some point in their lives. It occurs as a result of the immune system ‘fighting’ hair follicles, and preventing them from producing hair. The hair loss can be quite sudden and abrupt, leaving patches void of hair. Treatment may include creams or injections.

Hair loss from low levels of iron or other dietary issues

What we eat can affect our hair. Low levels of iron are very common especially in Vegans and Vegetarians. Low iron levels can cause hairs to become finer and brittle. Rapid weight loss and yo-yo dieting can also cause hair loss.

Telogen effluvium

This is a disorder of the hair cycle. Normally only 10-15% of hairs should be in the resting phase. In this condition, either spontaneously or because of severe physical or psychological, a larger proportion of hairs enter the resting and shedding phases.

Hair loss with an itchy or scaly scalp

Sometimes hair loss accompanies itching and scaling on the scalp. This can be caused by eczema, dermatitis, psoriasis and a variety of other dermatological disorders. Assessment with a Dermatologist can help pin point the exact cause.

Scarring alopecia

In this condition, there is inflammation of the hair follicle which leads to the formation of a scar, and possibly permanent hair loss. There are many causes of scarring alopecia including lichen plano-pilaris, frontal fibrosing alopecia and lupus.

What happens during a hair loss consultation?

The doctor will take a history to understand how your hair loss has developed. Information about your diet, weight and any medications you have been taking will be reviewed as these can be linked to hair loss. How the hair is in other members of your family can be helpful in understanding your hair loss. Previous hair styling methods, including braiding, will be enquired about. A close look at your scalp will be taken. The doctor may use a dermatoscope as well which gives a magnified view of the hairs and the skin.

Can hair loss be cured?

Certain forms of hair loss can be reversed. Many other forms of hair loss can be slowed down in their path with medical treatments. Some forms of hair loss continue despite medication.

Personalised medications

We work very closely with a compounding pharmacist to bring individually prepared treatments containing active pharmacological ingredients. This helps us go beyond the very few ‘licensed’ medications that are available for hair loss and to personalise treatment the needs of individual patients.

Medications used for treating hair loss

We have considerable experience in using the following therapies for hair loss

  • Minoxidil hair tonics – minoxidil increases blood flow to the hair follicle, and lengthens the growth (anagen) phase. Minoxidil can be made in stronger concentrations to aid effectiveness. Finasteride and other ingredients can be added to hair tonics to make a single preparation.
  • Minoxidil tablets – minoxidil is available in a tablet form for those who find it difficult to use the hair tonic.
  • Finasteride hair tonics – Finasteride inhibits 5 alpha reductase in the hair follicle, and stops Dihydrotestosterone from damaging hair follicles. Finasteride can be compounded into a tonic for those who do not wish to take the medication by mouth. Finasteride tonics are also useful in those who might be suffering from side effects from finasteride tablets such as reduced libido, erectile dysfunction and gynaecomastia.
  • Finasteride tablets 
  • Latanoprost – this is a prostaglandin and stimulates hair growth. This can be added to hair tonics for the scalp and used on the eyebrows and eyelashes to strengthen growth.
  • Oestradiol and Progesterone  – increases the ratio of oestrogens to testosterone, and reduces the effect of DHT
  • Cyproterone – interferes with the binding of DHT to the receptors
  • Caffeine – increases blood flow and has a mild effect of inhibiting 5 alpha reductase.
  • Spironolactone – blocks the actions of androgens and stops DHT from binding the receptor.
  • Tretinoin and Salicylic acid are sometimes added to tonics to improve the absorption of medications into the hair follicle

Other treatments that are also used to help with hair loss include

  • Steroids – steroids reduce inflammation and can be given as a cream, hair tonic, by microdroplet injection into the scalp and by tablet
  • Hydroxychloroquine – this medication is used for controlling certain forms of scarring alopecia
  • Immunosuppressants such as Mycophenolate and Ciclosporin – these medications are used to control certain forms of scarring alopecia

Treatments for hair loss at Belgravia Dermatology

  • About – Hair loss can be a difficult condition to come to terms with. The first step in the journey is to meet with an understanding professional who can help you by making a diagnosis and suggesting ways in which you may be able able to improve your hair
  • Treatments – Treatments for hair loss may include creams, lotions, injections and tablets.
  • Bespoke prescription – We work closely with a compounding pharmacist to generate prescriptions of medications which are formulated especially for an individual
  • Next step – If you are experiencing hair loss and would like to discuss this with a Dermatologist then please contact us to make an appointment

How is hair loss treated?

Following a detailed consultation, our Dermatologists will be able to offer you treatments which are tailored to the type of hair loss which you have you have.

Hair loss service at Belgravia Dermatology

  • Detailed discussion of the hair loss problem followed by examination and trichoscopy
  • Option to have a skin biopsy and blood tests if recommended
  • Treatment to address the relevant diagnosis
  • A realistic discussion on the outlook for the type of hair loss which you have

How effective are hair loss treatments?

The response of hair loss to treatments is incredibly variable. Some individuals respond well where as others may have a slower response.

What should I do next?

If you suffer from hair loss then please arrange to see one of our Dermatologists who will be happy to help.

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      +44 (0) 207 112 8622

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