Hair Frequently Asked Questions

The most frequent causes I see in clinic are female pattern hair loss, male pattern hair loss and telogen effluvium, a temporary increase in shedding following illness, stress or hormonal change. More rarely, inflammatory or scarring scalp conditions may be responsible. Careful assessment is important, as treatment depends entirely on establishing the correct diagnosis.

No. Telogen effluvium is usually self-limiting and improves over time. Pattern hair loss tends to be gradual and progressive, but may be stabilised with appropriate treatment. Scarring alopecia can lead to permanent loss if not identified early, which is why persistent symptoms warrant specialist review.

Yes. Significant physiological or psychological stress can precipitate telogen effluvium. Shedding typically becomes noticeable two to three months after the triggering event. In most cases, this settles gradually once the underlying cause has resolved.

Not routinely. Many hair loss conditions are diagnosed clinically through history and scalp examination, often supported by dermoscopy. Blood tests are arranged selectively if there are features suggesting an underlying deficiency or systemic condition. Extensive routine testing is not required in most patients.

Iron deficiency can contribute to hair shedding in some individuals. However, mildly reduced ferritin levels do not necessarily explain thinning, and results need to be interpreted in clinical context. Supplementation is recommended only where appropriate.

Most commercially available supplements are not supported by strong clinical evidence unless a true deficiency is present. Management should be guided by diagnosis rather than by general supplementation. Clear explanation and realistic expectations are important in this area, where misinformation is common.

You may wish to seek advice if:

• Shedding persists beyond several months

• There is progressive thinning or widening of the parting

• Hair loss is patchy

• The scalp is symptomatic (itching, burning or discomfort)

• There is concern about possible scarring alopecia

Early evaluation is particularly important where inflammation is suspected.

The consultation includes a detailed medical history, scalp examination and dermoscopy where appropriate. A working diagnosis is discussed, along with evidence-based management options and realistic expectations. Further investigations are arranged only if clinically indicated.

Yes. Inflammatory conditions such as psoriasis, seborrhoeic dermatitis and certain autoimmune disorders can contribute to shedding and, in some cases, permanent follicular damage. Treatment focuses on controlling inflammation and protecting remaining follicles.

Hair disorders remain an active area of clinical research and evolving therapeutic options. I have previously written on developments in medical hair loss management in What’s New in Hair Loss (Dermatology in Practice, 2020), and my clinical approach reflects current evidence and established dermatology guidance.

Due to the added and additional time required to adequately examine and then plan management for hair loss, longer appointments are necessitated. Standard hair loss new patients get 45 minutes with Dr. Karanovic.

This is then compounded by the fact that the majority of insurance companies do not cover hair loss consultations & do not recognise the need for longer appointment times. Therefore all alopecia/hair loss consultations will be conducted on a self-funded basis. If you feel that your insurer will contribute, then you can personally reclaim back any allowances directly from your insurance company after the appointment.