What causes hair thinning and bald spots on the head?

Question

Hello doctor,

I am 25 years old. My hair is thinning at a fast rate and I am getting bald spots at the top of my head. And I am not taking any medication for that. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I went through your photo (attachment removed to protect patient identity). Yes, you have lost a lot of hair. Now in women, most common causes of hair loss are female pattern hair loss and telogen effluvium. Some women can develop telogen effluvium over female pattern hair loss. First, I need to find out if any underlying cause is there in your case that is causing hair loss and then make a diagnosis. Do you get your periods regularly? Duration of hair loss? Did you fall sick in the last six months? Any medical or surgical illness? Do you have thyroid disease or anyone in family has it? Do you have thinning of hair? How severe is your hair fall? Approximately how much hair are you losing daily? Please revert with answers to each questions so I can provide you definitive diagnosis and suggest you treatment accordingly. My approach would be to control hair fall first then add some more medications to promote hair growth.

Answer 2

Hello,

Welcome back to icliniq.com.

From all the history and photos (attachment removed to protect patient identity), you have female pattern hair loss with telogen effluvium. Now female pattern hair loss occurs due to genetic and hormonal components. It is a chronic progressive condition so treatment for this will go for long time. But acute telogen effluvium is a condition in which severe hair fall occurs due to any stress or illness or thyroid disease. It will get controlled easily. You have many underlying factors for hair fall like hormonal imbalance, anemia, etc. You need to get your hormonal profile done. We need to rule out polycystic ovarian disease also. Investigations required are thyroid profile, antimullerian hormone, serum fasting insulin, Hb (hemoglobin), USG (ultrasound) abdomen and pelvis to rule out PCOD. Treatment: Tablet Hair fact as per instruction on the box of Hair fact kit. Apply Halobetasol lotion daily at night on small quantity like only 8 to 10 drops on the scalp for seven days. Then alternate days for the next two weeks. I need to start you on Minoxidil and hormonal imbalance treatment also, but first you get your investigations done and get back to me so I can suggest you further management.