Hair loss can develop gradually or more suddenly. Men commonly notice a receding hairline or thinning on the crown. Women more often see a widening part or reduced fullness over the top of the scalp, with more visible scalp despite an apparently stable frontal hairline.

Some individuals are most aware of increased shedding in the brush, on the pillow, or in the shower. Others observe smooth, round bald patches or areas of short, broken hairs where chronic tension or pulling has affected the follicles. The scalp itself may feel normal or may be itchy, sore, or flaky, depending on the cause. Any persistent change in hair density, pattern, or shedding that causes concern is a good reason to seek evaluation by a board-certified dermatologist.

The most common cause of hair loss in both men and women is androgenetic alopecia, also known as male or female pattern hair loss. In this condition, inherited sensitivity to hormones leads follicles in specific scalp regions to gradually shrink. Over time, these follicles produce finer, shorter hairs until the area appears thin. In men, this typically involves the temples and crown. In women, it usually causes diffuse thinning over the central scalp, while the frontal hairline often remains relatively preserved.

Other causes are also frequent. Telogen effluvium is a shedding state that can follow illness, surgery, childbirth, major weight change, medication changes, or significant emotional stress. Alopecia areata is an autoimmune condition that targets hair follicles and creates sharply defined bald patches or more extensive loss. Tight hairstyles and chronic traction can result in traction alopecia. Various inflammatory scalp disorders can lead to scarring alopecia, in which follicles are permanently destroyed. Thyroid disease, iron deficiency, nutritional problems, and certain medications may also contribute. More than one factor can be present at the same time, making careful evaluation especially important.

At Peak Skin Center, a hair loss visit begins with a detailed medical history and scalp examination. Board-certified dermatologist Dr. Thomas Knackstedt and his team reviews when the problem started, how it has changed, any family history of hair loss, and relevant medical conditions, medications, hormonal changes, hair care practices, diet, and stressors.

During the physical examination, the pattern of thinning, scalp health, and hair shaft characteristics are assessed. In many cases, dermoscopy using a magnified, lighted examination tool is used to inspect follicles and hair caliber in greater detail. Blood tests may be ordered to identify contributing issues such as thyroid abnormalities, iron deficiency, or vitamin deficiencies. If scarring alopecia is suspected or the diagnosis remains unclear, a small scalp biopsy may be recommended to obtain microscopic information. After the type or types of hair loss are identified, the dermatologist discusses prognosis and outlines which treatments are most likely to help.

Treatment is customized based on the diagnosis, the stage of hair loss, the individual’s overall health, and cosmetic goals.

For male and female pattern hair loss, management commonly includes topical and sometimes oral therapies aimed at slowing follicle miniaturization and supporting thicker regrowth. Topical minoxidil is frequently used to prolong the growth phase of the hair cycle and increase hair density. In selected cases, oral medications or hormone-modulating treatments may be appropriate, and options such as low-level light therapy or referral for hair transplantation may be discussed when indicated.

For inflammatory or autoimmune forms of hair loss, such as alopecia areata or certain scarring alopecias, treatment may involve topical or injected corticosteroids and other anti-inflammatory or immune-modulating medications to control the process and preserve remaining follicles. Telogen effluvium often improves once the underlying trigger is identified and addressed, but supportive counseling and monitoring are important while the hair cycle recovers.

Nutritional support can also play a role in a comprehensive plan. Biotin supplementation is often discussed as one component of hair health. Biotin may support hair and nail strength, particularly in individuals with low levels or increased needs, but it is not a stand-alone cure for pattern hair loss. The best results occur when biotin is combined with other evidence-based therapies and a balanced diet. Appropriate dosing and the need to pause biotin before certain laboratory tests are reviewed to ensure safe, targeted use.

Across all forms of hair loss, realistic expectations are emphasized. Most therapies aim to slow or stabilize hair loss, improve thickness, and enhance hair quality rather than completely restore a youthful hairline. Because hair growth is inherently slow, visible improvement usually takes several months, and consistent adherence to the treatment plan is essential.