Hair loss (alopecia) treatment

Alopecia is the medical term for hair loss. Hair loss is common, affecting more than 50 million men and 30 million women in the United States alone. In the UK, around 6.5 million men and 8 million women are currently affected by hair loss. Hair loss isn't usually a sign of anything serious, though losing your hair can be distressing.

Alopecia can have several causes including genetics, stress, auto-immune disease and a side effect of some medications. It can be temporary or permanent and may affect only your scalp, or your entire body.

Call or book online today to arrange a consultation to discuss private alopecia treatment with a consultant of your choice at Circle Health Group.

This page explains what alopecia is, what causes alopecia and what treatments are available.

The cost of alopecia treatment depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

A normal hair growth cycle consists of four parts:

• Anagen (growth phase) - this is the longest phase and lasts on average three to five years. During this phase, cells in your hair follicles divide rapidly, creating new hairs which are then pushed out of the follicle. At any given time, around 80% to 90% of your hair follicles are in the anagen phase.
• Catagen (transition phase) - during this phase, the lower part of your hair follicle regresses and your hair stops growing. Around 5% of your hairs are in the catagen stage at any given time.
• Telogen (resting phase) - hair follicles in this phase of the hair growth cycle are inactive and new hairs are not growing. A bulb of keratin holds your hair in the follicle until it enters the shedding phase, and the cycle starts again. Around 5% of your hair is in the telogen stage at any time.
• Exogen (shedding phase) - this phase is an extension of the telogen stage in which hairs are shed from your scalp. Around 50 to 100 hairs per day are normally shed during this phase which typically lasts around two to five months.

Signs of alopecia vary between men, women and children and depend on the type and severity of alopecia you have.

Signs of alopecia may include:

• A receding hairline
• Gradual thinning of hair on your scalp
• A widening parting
• A horseshoe-shaped pattern of hair loss on your crown
• Patchy or circular bald spots on your scalp, eyebrows or beard
• Complete hair loss all over the body
• Losing large amounts of hair (particularly when combing or washing your hair)
• Changes to your nails - this can be a sign of alopecia areata and may include:
  
  • Pinpoint dents in your nails
  • White spots and lines on your nails
  • Your nails may become brittle or thin and split
  • Your nails may become rough and lose their shine

Alopecia has many possible causes including:

• Age
• Genetic factors/ family history
• Stress such as illness, surgery, injury or childbirth
• Medications like chemotherapy, blood thinners, some blood pressure medications, and birth control pills
• Weight loss
• Low-calorie intake
• Deficiency in some nutrients such as protein, iron, biotin or zinc
• Autoimmune disease
• Hair treatments such as perming, relaxing or colouring
• Hormonal imbalances
• Scalp infection
• Scalp psoriasis
• Ringworm
• Medical conditions like thyroid disorders, lupus, diabetes and anaemia

There are several types of alopecia including:

Involutional alopecia

This is a natural occurrence where your hair gradually thins as you age. It occurs when the growth cycle of your hair becomes shorter meaning more of your hair follicles are in the resting phase.

Hairs also become shorter and fall out faster than usual, leading to thinning hair.

Androgenic alopecia

This is a genetic condition that affects both men and women. In men, the condition is known as male pattern baldness, and in women, female pattern baldness or female pattern hair loss.

Male pattern baldness begins as a gradual receding hairline (creating a "U" or "M" shape) and a bald spot on the top of your head. It progresses over many years until the receding hairline and bald spot join up resulting in no hair on the top of your head and a thin band of hair around the side of your head. Male pattern baldness usually begins in your 30s but can start as early as your teens or early 20s.

Female pattern baldness normally involves a general thinning of your hair over your entire scalp without a receding hairline. Women don't usually experience signs of female pattern hair loss until their 40s or later.

Alopecia areata

Alopecia areata is an autoimmune disorder that occurs when the body's immune system mistakenly attacks its own cells - in this case, the hair follicles. It can affect anyone but is most common in children and young adults. The condition usually starts suddenly and causes patchy hair loss normally on the head and face. You may experience itching or burning around the area before your hair starts to fall out. Alopecia areata can occur as a single episode or may reoccur throughout your life. Most cases of alopecia areata resolve without treatment.

There are several types of alopecia areata depending on the severity of your hair loss and where on your body the hair loss occurred.

• Alopecia areata totalis - total loss of hair on your scalp
• Alopecia areata universalis - total loss of hair on your scalp and body
• Diffuse alopecia areata - Your hair thins rather than falls out
• Ophiasis alopecia areata - hair loss occurs in a band at the sides and back of your head

Telogen effluvium

This is a type of temporary hair loss that occurs in response to stress or a major change to your body and may be triggered by certain medical conditions, illness, surgery, vitamin or mineral deficiency, and some medications. Telogen effluvium results in changes to your hair growth cycle and occurs when a large number of hairs enter the resting phase of the cycle, and the next growth phase doesn't begin. It normally begins around three months after the triggering event. If the cause is resolved, hair normally grows back without treatment after around six months.

Scarring (cicatricial) alopecia

This is a type of permanent hair loss that occurs when the hair follicle is destroyed. It can be caused by an autoimmune disorder, infection, burns, chemicals or some skin conditions that cause scarring such as acne, cellulitis, folliculitis, some types of lupus and lichen planus.

Traction alopecia

This type of alopecia may occur when your hair is pulled too tightly from your scalp for extended periods, such as too tight ponytails, braids, dreadlocks, or from wearing tight headwear. It is caused by damage to your hair follicles. If your traction alopecia is identified early, and the cause removed, your hair can grow back, but in severe cases, hair loss may be permanent.

Trichotillomania (hair pulling disorder)

This is a psychological disorder where a person feels compelled to pull out their own hair. It is most commonly seen in children and normally starts between 10 and 13 years of age. People with trichotillomania may pull out the hair on their head, or other parts of their body such as their eyebrows or eyelashes.

At your first consultation, you will be seen by a consultant dermatologist,  a doctor specialising in diseases affecting the skin.

To determine the cause of your hair loss, your consultant will start by asking you some questions. They may ask you about:

• Your symptoms, such as what they are and when they started
• Your general health
• Your medical and family history
• Your lifestyle, including your diet, any styling techniques or hair treatments you use regularly, and whether you smoke
• Any medications or supplements you take
• Your mental health including any recent stress, or history of anxiety or depression
• What effect your hair loss is having on your emotional well-being and self-esteem
• Whether you have tried any other treatments previously, and what effect, if any, they had

Your consultant will examine your hair and scalp as well as any other areas of your body where you have noticed hair loss and your nails.

How is a diagnosis made?

Alopecia can normally be diagnosed using a combination of your symptoms, medical and family history and a physical examination.

In some cases, your consultant may order tests such as:

• Scalp biopsy - a small sample of skin and hair follicles is taken from your scalp and sent to the laboratory to be examined for possible causes of your hair loss
• Blood tests - to check for any nutritional deficiencies or underlying medical conditions that could be causing your hair loss

Why is this first consultation so important?

At Circle Health Group, your first appointment is very important as it's where your consultant will ask you about your symptoms, perform a physical examination, provide a diagnosis, and discuss possible treatment options.

Your first consultation is also where you meet your consultant, the doctor responsible for your care. Your consultant will spend time getting to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible during your hair loss treatment, so please discuss any questions or concerns with your consultant during your appointment.

At the end of your appointment, your consultant will discuss possible treatment options and decide on the best treatment or combination of treatments depending on your symptoms and diagnosis.

In many cases hair loss is temporary, and your hair will grow back once the underlying cause is resolved. For other types of hair loss, your consultant may recommend a treatment or combination of treatments. The best treatment for you depends on the type of alopecia you have.

Some treatments for alopecia include:

Finasteride

Finasteride is a prescription-only medication that can help with male pattern baldness. It is normally taken as a tablet once a day. Finasteride works by blocking the active male hormone that causes hair loss and may help prevent further hair loss and encourage hair regrowth. It only works for as long as you are taking it. As it is a hormonal treatment, women and people under the age of 18 should not take finasteride.

Side effects of finasteride may include:

• Skin rash
• Nipple swelling and tenderness
• Reduced libido (sex drive)
• Depression
• Erectile problems

Minoxidil

Minoxidil is a topical treatment that can be used for hereditary (male and female pattern) baldness. It is applied as a solution or foam directly to your scalp where hair loss has occurred and may help prevent further hair loss and encourage regrowth. It typically takes around 12 weeks of treatment with minoxidil before you see results, and it only works for as long as you are using it. Minoxidil can be bought over the counter without a prescription.

Side effects of minoxidil may include:

• Scalp irritation
• Headaches
• Unusual hair growth

Corticosteroids

Corticosteroids work by suppressing your immune system and reducing inflammation. They may be used to treat alopecia areata. Corticosteroids can be taken orally, injected into your scalp (or other affected parts of your body) or applied to your skin as an ointment, cream or foam.

Side effects of corticosteroids may include:

• Increased appetite
• Weight gain
• Thinning of your skin
• Acne
• Blurred vision
• Mood changes

Platelet-rich plasma

Platelet-rich plasma injections involve taking a small sample of your blood, processing it and injecting it back into your scalp to stimulate hair growth. It may be used to treat male pattern baldness and to encourage hair growth after a hair transplant.

Side effects of platelet-rich plasma may include:

• Scalp pain and irritation
• Itching
• Swelling
• Headache

Topical immunotherapy

This treatment aims to stop your immune system from attacking your hair follicles by rubbing a chemical into your skin to trigger an allergic reaction (contact dermatitis). It may be used to treat alopecia areata.

Side effects of topical immunotherapy may include:

• Scalp irritation
• Skin discoloration
• Lymphadenopathy (swollen lymph nodes)
• Eczema

Phototherapy treatment

Phototherapy uses ultraviolet (UV) light from special lamps to reduce inflammation in certain skin conditions. In some cases, you may be given a drug called psoralen to increase your skin's sensitivity to light before having phototherapy. Phototherapy may be used to treat alopecia areata.

Side effects of phototherapy may include:

• Skin redness and irritation (like sunburn)
• Skin dryness
• Itching

Hair transplant surgery

Hair transplantation is a procedure where plugs of skin that contain active hair follicles are moved from parts of your scalp or body with hair to bald or thinning areas. It can be used to treat hereditary (male or female pattern baldness). A hair transplant is performed as a day case under local anaesthetic.

Side effects of hair transplant surgery may include:

• Scalp tightness, pain and swelling (this resolves after a few days)
• A temporary scab
• Scarring

Possible complications of hair transplant surgery may include:

• Bleeding
• Infection
• Adverse reaction to the anaesthetic

Possible side effects or complications of alopecia treatment depend on the type of treatment used and are explained in more detail above.

Before your alopecia treatment, your consultant will explain any possible side effects and complications of your treatment and answer any questions you may have.

It is important that you are as well-informed as possible about any potential risks and complications as this will allow you to make an informed decision before your alopecia treatment.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about alopecia treatment, book your appointment online today or call a member of our team directly on 0808 189 5499.

Content reviewed by Circle in-house team in November 2024. Next review due November 2027.

Alopecia areata National Institute of Arthritis and Musculoskeletal and Skin Diseases

Hair loss NHS

Hair Loss Types: Alopecia Areata overview American Academy of Dermatology Association

Hair Loss: Who Gets And Causes  American Academy of Dermatology Association