Hair Loss: Causes, Types,
& Treatment Options

Losing hair is far more common than most people realize. Across Canada, an estimated 40% of women experience noticeable hair thinning by age 50, while roughly half of all men show signs of significant hair loss by their mid-thirties.¹ Yet despite how widespread it is, hair loss remains one of the most misunderstood, and underdiagnosed, conditions people quietly deal with alone.

The reasons hair falls out are surprisingly varied. Genetics, hormonal shifts, nutritional deficiencies, chronic stress, and autoimmune triggers can all play a role. Understanding which factor is driving your hair loss is the crucial first step, because the wrong treatment won't just fail to help, it can waste months of your hair regrowth window.

This guide covers everything you need to know: the different types of hair loss, their causes, how they're properly diagnosed, and the full range of treatment options now available.

Hair loss, medically known as alopecia, refers to the partial or complete absence of hair from areas of the scalp or body where it would normally grow. It's important to distinguish everyday shedding from true hair loss: it's entirely normal to shed between 50 and 100 hairs per day as part of the natural hair growth cycle.

The hair growth cycle has three phases. During the anagen phase (active growth), hairs grow for two to seven years. The catagen phase is a short transition period. Finally, the telogen phase is the resting stage, after which the hair is shed and a new cycle begins. Hair loss becomes a clinical concern when this cycle is disrupted, causing excessive shedding, follicular miniaturization, or follicle dormancy.

Not all hair loss is the same. Identifying the correct type is essential, treatments that work for one form may be completely ineffective, or even counterproductive, for another.

The most prevalent type by far, androgenetic alopecia affects both men and women. In men, it typically presents as a receding hairline or thinning crown. In women, it more commonly manifests as a widening part and diffuse thinning across the top of the scalp.

The underlying driver is a sensitivity of hair follicles to dihydrotestosterone (DHT), a byproduct of testosterone. Over time, DHT causes genetically susceptible follicles to miniaturize: the hair they produce becomes finer and shorter until the follicle eventually stops producing hair altogether.

Source: American Journal of Clinical Dermatology, 2019

Alopecia areata is an autoimmune condition in which the immune system mistakenly attacks healthy hair follicles. It typically presents as sudden, coin-sized circular patches of hair loss on the scalp, though it can affect eyebrows, beard, or body hair. In more severe cases it can progress to alopecia totalis or alopecia universalis.

Alopecia areata affects approximately 2% of the population at some point in their lifetime and does not discriminate by age or sex.²

Telogen effluvium is a temporary, diffuse form of hair loss triggered when a significant stressor causes a large number of follicles to enter the resting phase simultaneously. The result is heavy shedding, typically occurring two to four months after the triggering event.

Common triggers include major surgery, rapid weight loss, childbirth, severe illness, extreme psychological stress, and nutritional deficiencies. Telogen effluvium is largely reversible once the underlying cause is addressed.

• Traction alopecia caused by chronic tension from tight hairstyles; can become permanent if not addressed
• Scarring alopecia (cicatricial alopecia) inflammation destroys follicles and replaces them with scar tissue, resulting in permanent loss
• Tinea capitis a fungal infection causing patchy hair loss, predominantly in children
• Trichotillomania a psychological condition involving repetitive hair pulling

Hair loss is rarely caused by a single factor. In many cases, multiple contributors, genetic predisposition, hormonal fluctuations, and lifestyle habits, act together to accelerate the process.

Hereditary hair loss is the dominant cause globally. Hormonal changes amplify the effect: puberty, pregnancy, postpartum recovery, perimenopause, and polycystic ovary syndrome (PCOS) all create environments that can accelerate genetically programmed hair loss.

Hair follicles depend on a steady supply of micronutrients. Deficiencies in the following are well-established contributors to hair loss:

• Iron and ferritin particularly common in premenopausal women; even low-normal ferritin levels can impair hair growth
• Vitamin D receptors are found in hair follicle cells; deficiency disrupts the growth cycle
• Zinc essential for follicle repair and immune function; deficiency leads to diffuse thinning
• Biotin (Vitamin B7) true deficiency causes diffuse hair loss and brittle nails
• Protein insufficient intake triggers telogen effluvium as the body prioritizes essential functions

Source: Dermatology Practical & Conceptual, 2017

Chronic psychological stress elevates cortisol levels, pushing follicles into the telogen phase prematurely. Over-processed hair, through excessive heat styling, chemical treatments, and tight hairstyles, causes mechanical damage and, over time, traction alopecia. Poor sleep quality and crash dieting further compound the effect.

• Thyroid disorders both hypo- and hyperthyroidism; among the most commonly overlooked causes
• Autoimmune diseases lupus, psoriasis, and alopecia areata itself
• Scalp conditions seborrheic dermatitis and folliculitis create inflammatory environments hostile to hair growth
• Medications chemotherapy agents, blood thinners, antidepressants, retinoids, beta-blockers, and certain contraceptives

While the underlying biology shares common ground, hair loss often presents differently, and carries different emotional weight, depending on sex.

Women with hair loss face a statistically higher likelihood of an identifiable, treatable underlying cause, which is why a full bloodwork panel is particularly important before initiating any treatment plan.

Accurate diagnosis is the cornerstone of effective treatment. Many people try over-the-counter remedies for months without identifying the actual cause. A proper clinical assessment eliminates that guesswork.

Trichoscopy is a non-invasive technique using a high-powered dermatoscope, or, in advanced setups, a live HD video trichoscope, to examine hair follicles and the scalp at up to 70× magnification. It allows a physician to assess:

• Follicular density and diameter variation (a hallmark of androgenetic alopecia)
• Signs of inflammation or scarring around the follicle opening
• Broken hairs, yellow dots, and exclamation-mark hairs (indicators of alopecia areata)
• Scalp condition including sebum, scaling, and vascular patterns

At Monarch MD, live HD trichoscopy allows patients to see their own scalp magnified on screen in real time, providing immediate, objective evidence of what's happening beneath the surface.

A targeted blood panel identifies systemic contributors that trichoscopy alone cannot detect. A comprehensive panel typically includes:

• Full thyroid panel TSH, T3, T4
• Iron studies serum iron, ferritin, and transferrin saturation
• Hormonal markers testosterone (total and free), DHEA-S, prolactin, LH, FSH
• Micronutrients Vitamin D, Vitamin B12, zinc
• CBC complete blood count to rule out anaemia

At Monarch MD, blood requisitions are provided at no charge through Life Labs, so nothing is missed before a treatment plan is developed.

In some cases, a physician may also perform a pull test to gauge active shedding, or request a scalp biopsy when scarring alopecia or other rare inflammatory conditions are suspected.

The landscape of hair loss treatment has advanced significantly. The most effective approaches combine multiple modalities, addressing the root cause while simultaneously stimulating follicular activity and slowing progressive loss.

Genetic hair loss cannot be fully prevented, but its onset and progression can often be significantly delayed with early intervention and the right lifestyle foundations. For non-genetic hair loss, prevention is often highly achievable once the trigger is identified.

Practical Prevention Strategies

1. Maintain a balanced diet rich in protein, iron, Vitamin D, and zinc; supplement based on confirmed deficiencies, not assumption
2. Address thyroid dysfunction and hormonal imbalances early; get annual blood work if you have a family history of hair loss
3. Avoid hairstyles that create sustained tension on the hairline over years
4. Minimize heat styling and harsh chemical treatments; use sulfate-free, scalp-nourishing products
5. Manage chronic stress through evidence-based approaches: regular exercise, quality sleep, and mindfulness
6. If you notice early signs of thinning, seek a physician's assessment immediately; the earlier treatment begins, the more follicles can be preserved

There's a persistent tendency to delay seeking help for hair loss, either because it's normalized, or because over-the-counter options create a false sense that a doctor's visit is unnecessary. Acting quickly matters: many follicles that appear dormant are still capable of producing hair if treated within a window, and that window closes progressively as miniaturization becomes permanent.

You should consult a physician promptly if you notice:

• Sudden or patchy hair loss rather than gradual thinning
• Noticeable hair loss accompanied by scalp itching, pain, or redness
• Hair loss occurring alongside fatigue, weight changes, or other systemic symptoms
• Rapid overall thinning occurring within weeks to months
• A family history of early-onset hair loss, prompting proactive assessment
• Any hair loss that doesn't respond to six months of appropriate treatment

At Monarch MD, every assessment begins with a comprehensive physician consultation, not a sales conversation. Dr. Akbari personally reviews your history, conducts live trichoscopy, and develops a treatment plan calibrated to your specific pattern, underlying causes, and goals.

Hair loss is not inevitable, and it's rarely untreatable. What separates patients who regain density from those who don't is almost always the same thing: early, accurate diagnosis followed by a treatment protocol tailored to the actual cause, not a generic off-the-shelf approach.

Whether you're noticing the first signs of a widening part, a receding hairline, or sudden diffuse shedding, now is the right time to get clarity. A proper assessment takes 15 to 30 minutes and gives you a complete picture of what's happening and what can be done about it.