Hair Loss Assessment & Treatment Online

Types and causes of hair loss

Hair loss is extremely common. Pattern hair loss (androgenetic alopecia) affects approximately half of men by age 50 and a substantial proportion of women, particularly after menopause. Alopecia areata has a lifetime prevalence of around 2% in the general population. Telogen effluvium (diffuse shedding) is common after pregnancy, illness, or significant stress and usually resolves over months.

Hair loss can have many causes. The most common is androgenetic alopecia (male and female pattern hair loss). Other forms include telogen effluvium (temporary, often triggered by stress, illness, or pregnancy), alopecia areata (patchy loss, autoimmune), and scarring alopecias. Medical conditions such as iron deficiency and thyroid disorders may also contribute.

Identifying the pattern and likely cause is the first step. This usually involves a careful history and some basic blood tests. In some cases, specialist assessment by a dermatologist is needed.

How a telehealth GP can help

A NewDoc GP can take a thorough history, discuss the pattern of hair loss, review medications that can contribute, order relevant blood tests, and discuss treatment options that may be appropriate in your case. If specialist assessment is needed, your GP can issue a dermatologist referral.

Because hair loss often needs visual assessment of the scalp, an in-person review may be recommended in some situations. Your GP will let you know.

Risk factors for hair loss

Family history is one of the strongest risk factors for pattern hair loss. Hormonal changes, such as those occurring around pregnancy, postpartum, menopause, or with polycystic ovary syndrome, may also contribute. Thyroid disorders, iron deficiency, and vitamin D or B12 deficiency are common medical contributors that can often be addressed.

Temporary diffuse shedding (telogen effluvium) can follow major physical stressors such as surgery, childbirth, significant weight loss, severe illness (including COVID-19), or psychological stress, often two to three months after the trigger. Certain medications, such as some antihypertensives, antidepressants, or chemotherapy agents, can also contribute and are worth reviewing with your GP.

Hair loss medications: topical, oral, and specialist

Treatment depends on the cause. Where a reversible medical contributor is identified (iron deficiency, thyroid dysfunction, vitamin D deficiency), treating the underlying condition often partly reverses the shedding. Your GP can arrange blood tests and review the results with you.

Topical minoxidil — first-line for pattern hair loss

• Topical minoxidil 5% solution or foam (Rogaine and generics) — applied to the scalp twice daily; available OTC; works for both male and female pattern hair loss; expect a temporary increase in shedding for 2–8 weeks before regrowth

Minoxidil works for most patterns of pattern hair loss and is the only widely available treatment with strong evidence in both sexes. Effect plateaus around 12 months; stopping reverses the gains over 3–6 months.

Oral options — individualised, prescription-only

• Finasteride 1 mg daily (Propecia, Finasta) — 5-alpha-reductase inhibitor for male pattern hair loss; contraindicated in pregnancy (do not handle if you may become pregnant); side-effect counselling required
• Dutasteride 0.5 mg daily (Avodart) — alternative 5-alpha-reductase inhibitor; off-label for pattern hair loss but more potent than finasteride; same pregnancy precautions
• Spironolactone 50–200 mg daily (Aldactone) — anti-androgen for female pattern hair loss in women, often started after menopause or in PCOS; requires monitoring of blood pressure and electrolytes
• Cyproterone acetate — alternative anti-androgen in selected women
• Low-dose oral minoxidil (off-label) — increasingly used for selected patients where topical fails; your GP can prescribe with appropriate counselling on cardiovascular monitoring and off-label use

Oral therapies are individualised, considering medical history, sex, pregnancy potential, cardiovascular status, and concurrent medications. Counselling on sexual side effects (finasteride, dutasteride) and electrolyte risks (spironolactone) is part of starting these.

Alopecia areata and specialist options

For alopecia areata, scarring alopecia, or rapidly progressive hair loss, a dermatologist referral is usually appropriate. Dermatologists can perform scalp dermoscopy and biopsy, and may offer intralesional triamcinolone injections, topical corticosteroids, JAK inhibitors (baricitinib, ritlecitinib — PBS-restricted), or platelet-rich plasma (PRP) therapy.

Hair transplant (FUE, FUT) is an option for stable pattern hair loss after at least 12 months of medical therapy. Your GP can refer to a hair-transplant clinic.

Tips for supporting scalp and hair health

A balanced diet that includes iron, protein, zinc, and B vitamins supports healthy hair growth. If you follow a restricted diet or have been unwell, your GP can arrange blood tests to check key levels.

Gentle hair care may help reduce breakage, though it will not reverse genetic hair loss. Try to avoid tight hairstyles that pull on the scalp, heavy heat styling, and harsh chemical treatments. Protect your scalp from sun exposure with a hat or sunscreen on exposed areas.

Hair loss can have a significant effect on wellbeing and self-esteem. If it is impacting your mental health, your GP can discuss a Mental Health Treatment Plan to support access to psychology sessions alongside physical care.