Hair loss: causes and treatment options
Hair loss is common and can affect both self-confidence and quality of life. Whether the hair loss is temporary or long-term, professional help is available.
At Akacia Medical, we perform a thorough assessment and recommend an individual plan with the right treatment at the right time. Read more about our treatments or explore common conditions that cause hair loss.
DHT and hair loss: the hormone behind androgenetic alopecia
DHT (dihydrotestosterone) is a hormone that in genetically sensitive people can affect follicles so hair gradually becomes thinner. Understanding the mechanism helps explain why early treatment is often important.
What is DHT?
DHT is formed when testosterone is converted via the enzyme 5-alpha-reductase. It is a normal part of hormonal balance, but in the scalp it can trigger hair loss in people with genetic sensitivity.
Miniaturisation: when the follicle shrinks
When DHT binds to receptors in genetically sensitive follicles, each growth cycle can become shorter and the hair strand progressively thinner. Over time, the follicle can become so small that it stops producing visible hair.
That is a key reason why early action can matter, for example PRP treatmentwhich can support follicles that are still active.
Want to learn more about the condition? See androgenetic alopecia.
Can you influence DHT and slow hair loss?
Yes, there are medical treatments that can affect conversion to DHT or reduce its impact on the follicle. The right approach depends on your situation, risk profile and goals, and should be medically assessed.
Hair structure and growth cycle
To understand hair loss and how treatments such as hair transplantation work biologically, it helps to know how a hair strand is built and how the follicle’s growth cycle works.
From medulla to cuticle
A hair strand consists mainly of the protein keratin. In cross-section it is often described as three layers:
- Medulla: the innermost layer, often thin or absent in fine hair.
- Cortex: the main part of the strand – pigment is found here and most of the hair’s strength.
- Cuticle: the outermost scale layer that protects the strand and affects shine and friction.
The follicle drives growth
Hair grows from the follicle in the scalp. Blood supply and nutrients to the follicle affect how strong and thick the strand becomes – which is why a healthy scalp matters for both medical treatment and transplantation.
Three phases: anagen, catagen and telogen
Each follicle follows a cycle. Different strands are in different phases at the same time – which is why most people shed a certain number of hairs every day without it being disease.
Anagen (growth)
The hair grows actively. This phase often lasts several years and most follicles are in anagen.
Catagen (transition)
A short transition phase where growth stops and the follicle prepares for the resting phase.
Telogen (rest and shedding)
The hair remains but does not grow. After a while the strand sheds and a new anagen phase can begin.
On average, scalp hair grows about 1 cm per month, but speed varies with genetics, age and general health.
Shedding around 50–100 hairs per day can be normal and reflects the cycle. Clearly increased daily shedding should be investigated.
Telogen, “shock loss” and hair transplantation
After a hair transplant it is common for transplanted hairs to shed within a few weeks – so-called shock loss or a shedding phase. This is an expected reaction linked to the growth cycle: the follicle may enter telogen before new hair starts to grow. The follicle remains in the skin, and new growth usually appears after a few months.
Read more about timeline and aftercare for hair transplantationTo see what regrowth often looks like in practice, see interviews and month-by-month follow-ups among our patient stories and more on our YouTube channel.
Seasonal hair shedding – often more shedding in autumn
Many people notice more hair in the brush in September–October. That can be a normal consequence of the hair growth cycle rather than a new medical condition.
During summer a larger proportion of hairs may be in the growth phase (anagen). When more hairs then enter the resting phase (telogen) at the same time, shedding can increase for a while – often called seasonal or “autumn” shedding. It is usually temporary and evens out.
If shedding is heavy, sudden or comes with clearly thinner areas you should still get a medical assessment – other causes than seasonal shifts may exist.
Summer effects on hair growth and practical tips are on the page All about hair.
Natural stimulation and home care
Some habits can create better conditions for the hair and scalp. They do not replace medical treatment for hereditary hair loss, for example, but can be a useful complement, especially early in the process.
Scalp massage - what does research say?
Studies suggest that regular scalp massage may increase blood flow to hair follicles, reduce tension and influence the follicle environment over time. The effect depends on consistency rather than force.
- 4-5 minutes daily may have positive effects over time
- Massage with your fingertips, not your nails, using gentle circular movements
- See it as a complement, not a replacement, for progressive or hereditary hair loss
If you want to take the next step, you can read about PRP treatment and which treatments may be relevant depending on cause and goal.
Can hair grow back?
The short answer is: sometimes. If the hair follicles are still active, there is often a chance to improve growth. If the follicles have been inactive for a long time, regrowth can be harder without surgical treatment.
What determines whether hair can come back?
It mainly depends on:
- the cause of the hair loss
- how long the hair loss has been present
- how much activity remains in the follicles
- whether you receive the right treatment at the right time
On the page about symptoms we describe common scenarios: temporary hair loss, hereditary hair loss and long-term thinning.
Medications and temporary hair loss
Antibiotics rarely cause hair loss on their own, but the infection being treated, your body’s stress response, or side effects that affect gut flora and nutrient uptake can push more hairs into the resting phase at the same time, leading to temporary, diffuse shedding.
Strong antibiotic treatment can temporarily shift gut flora and reduce uptake of B vitamins and biotin. The illness itself or fever can also stress the body and disrupt the hair growth cycle. That is why increased shedding after antibiotics often reflects several factors, not just the tablet.
What is telogen effluvium?
Telogen effluvium means an unusually large number of follicles enter the telogen (resting) phase at the same time and shed a few months later. It is common after infection, fever, medication or other physical stress and often feels like overall thinning, unlike patterned hereditary hair loss, which needs a different assessment.
Once the trigger has passed and the body recovers, follicles can return to a normal growth phase, but it may take several months before density feels like before.
Recovery and next steps
If shedding persists or is severe, it is important to get a medical evaluation of the cause. Depending on your situation, scalp support with PRP may be relevant together with nutrition advice and follow-up.
Myths and lifestyle factors
Many people wonder how everyday products and habits affect the scalp. Here we summarise facts on a common topic: dry shampoo and how product residue can affect the hair follicles if it is not rinsed away properly.
Dry shampoo absorbs oil and gives a quick dry feel, but it does not replace a normal hair wash. If product is left on the scalp or used often without thorough cleansing, residue can build up around the follicles, which may irritate the scalp and eventually affect how comfortably hair grows.
It is rarely about a single product in small amounts, but rather repeated use without restoring the scalp’s balance. If you have irritation, itching or increased hair shedding, it is wise to get a medical assessment of the cause.
On the page about symptoms we describe common signs of hair loss. Worried about your scalp? You are welcome to book a consultation and we will review your situation.
Practical tips for scalp health
- Use dry shampoo sparingly and treat it as a temporary solution, not a replacement for shampoo.
- Wash your hair thoroughly between uses so product residue is removed.
- Avoid using dry shampoo several days in a row if the scalp feels irritated or clogged.
- If symptoms persist, seek care to rule out other causes of hair loss.
Common causes of hair loss
- Androgen Alopecia (hereditary hair loss)
- Hereditary hair loss
- Thyroid problems and hormonal imbalance
- Illness, malnutrition, trauma and long-term stress
Clear signs that you are losing hair
Temporarily increased amounts of hair in the shower, on the pillow or in the brush.
A visibly receding hairline, wider parting or thinner hair on the crown.
If you lose more than about 150 hairs per day for a longer period, the cause should be medically assessed.
Male hair loss
Male hair loss is often hereditary and driven by DHT. Usually the hairline and crown are affected first, while the donor area at the back of the head is often preserved.
In cases of pronounced thinning, a hair transplant may be an effective option after professional evaluation.
Female hair loss
Female hair loss can be caused by hormonal imbalance, thyroid problems, nutrient deficiency, stress and autoimmune conditions such as alopecia areata.
Diagnosing hair loss
To find the underlying cause, we carry out a structured assessment with medical history, clinical evaluation, microscopic analysis of hair follicles and, when needed, blood tests and hormonal evaluation.
The goal is to establish the right diagnosis early so you receive treatment that is medically justified and realistic for your situation.
Treatment for hair loss
In the early stages, medical treatment and PRP can stimulate hair growth and slow further hair loss.
In larger bald areas, hair transplantation is the method that provides the most lasting results.
We often combine several treatment methods for better long-term outcomes.
Sudden hair loss after physical or psychological stress
Telogen effluvium means that an abnormally large number of hair follicles enter the resting phase at the same time. Hair shedding is often noticed a few months after a stressful period.
Common triggers include infection, high fever, rapid weight loss, childbirth, nutritional deficiency, medication or hormonal changes.
If the hair loss continues for a long time or is severe, you should seek care to rule out underlying disease and get the right treatment. Read more about hair loss caused by stress.
Medication for hair loss
When indicated, medicines such as minoxidil and finasteride can be used to slow hair loss.
At our clinic, medical treatment is often combined with PRP to create better conditions for hair growth.
The most suitable treatment is decided after medical evaluation and a personal treatment plan.
DHT and hair loss: the hormone behind androgenetic alopecia
Long-term exposure to DHT can cause hair follicles to gradually produce thinner, shorter and weaker hairs. At a later stage, some follicles may stop producing hair completely.
This is a common mechanism behind Androgen Alopecia in both men and women and must be assessed in relation to your clinical picture.
Shedding hair - what is normal?
It is common for hair to become thinner with age. But if you notice clear changes in the hairline, density or increased daily hair shedding, it is wise to investigate the cause early.
Early action often gives better treatment outcomes. We help both men and women of different ages with individually tailored treatment plans.
Scales used to assess hair loss
We use established scales to assess the extent of hair loss and plan suitable treatment, for example the Ludwig scale for women and Hamilton-Norwood for men.
The assessment helps us create a realistic and structured plan, including whether medical treatment is sufficient or whether transplantation should be considered.
- Scale 1: No hair transplant is needed.
- Scale 2: Usually no transplant, but in asymmetry 800-1,000 follicles may be considered.
- Scale 3: Often about 1,800-2,000 follicles for frontal coverage.
- Scale 5: For example 2,000 follicles in the front + 1,500 in the crown, about 3,500 in total.
- Scale 6-7: Often a two-step plan with initial front work and later crown treatment depending on donor status.
The Ludwig scale for female hair loss
The Ludwig scale is used to describe the degree of diffuse thinning in women and is an important tool when planning treatment.
The scale helps us assess whether the focus should be medical treatment, PRP or whether hair transplantation may be suitable in selected areas.
- Grade I: Mild thinning, usually with the frontal hairline preserved.
- Grade II: More pronounced thinning over the top of the head and a wider parting.
- Grade III: Pronounced thinning over larger parts of the scalp.
Article in Aftonbladet Woman
The first time Sofie Jansson, 45, noticed that she was losing hair was in her early thirties. Over ten years, her hair gradually became thinner.
In the article, she describes her journey and how the right treatment can help restore both hair and confidence.
Read the article in AftonbladetNext step
If you notice that your hair is changing, it is important to act early. We help you understand the cause and choose the right treatment with a clear, safe plan.
References
- [1]Sinclair R. Male pattern androgenetic alopecia. BMJ. 1998.
- [2]Pratt CH, et al. Alopecia areata. Nat Rev Dis Primers. 2017.
- [3]Rebora A. Telogen effluvium: a comprehensive review. Clin Cosmet Investig Dermatol. 2019.
- [4]Kaliyadan F, Nambiar A. Androgenetic alopecia: an update. Indian J Dermatol Venereol Leprol. 2013.
- [5]Herskovitz I, Tosti A. Female pattern hair loss. Int J Endocrinol Metab. 2013.
- [6]Phillips TG, et al. Hair loss: common causes and treatment. Am Fam Physician. 2017.
- [7]Hetz SP, et al. Patient satisfaction and clinical effects of platelet-rich plasma on pattern hair loss in male and female patients. Cureus. 2022.
