What does increasing testosterone actually do to your hair and skin?

Both are highly responsive to androgens. The skin, sebaceous glands and hair follicles contain androgen receptors and can also metabolise testosterone locally.

For some men, the changes are barely noticeable. For others, increased oiliness, acne or accelerated hair thinning can become significant concerns.

The effects are not the same for everyone. Genetics, androgen sensitivity, age, baseline hormone levels, dose and the type of testosterone treatment all play a part.

So, what does the evidence actually show?

Does TRT cause hair loss?

Not necessarily – but it may accelerate male-pattern hair loss in men who are genetically susceptible.

Testosterone acts directly through the androgen receptor, but it can also be converted by the enzyme 5-alpha-reductase into dihydrotestosterone (DHT), a more potent androgen.

In susceptible scalp follicles, particularly around the temples, frontal hairline and crown.

DHT contributes to a process called follicular miniaturisation.

Over successive hair cycles, affected follicles become smaller and produce progressively shorter and finer hairs. Eventually, some may stop producing visible hair altogether.

This is androgenetic alopecia, commonly known as male-pattern hair loss.

TRT therefore doesn’t simply “cause baldness”. A more accurate way of looking at it is that increasing androgen exposure may accelerate androgenetic alopecia in someone whose follicles are already genetically susceptible.

Indeed, major testosterone-treatment guidelines describe familial male-pattern balding as a possible adverse effect of testosterone therapy, although the evidence directly linking therapeutic TRT to balding remains relatively weak.

A strong family history of early male-pattern hair loss is therefore worth considering before starting treatment.

Why can testosterone increase body hair but reduce scalp hair?

This is one of the interesting paradoxes of testosterone.

Higher androgen activity can encourage thicker beard and body hair while having exactly the opposite effect on susceptible scalp follicles.

The reason is that hair follicles in different parts of the body respond differently to androgens.

Androgens stimulate many facial and body hair follicles. In genetically susceptible scalp follicles, however, DHT promotes progressive miniaturisation.

So the same hormonal pathway can effectively encourage one follicle to grow while causing another to shrink.

Does TRT cause acne?

This is where the evidence is considerably stronger.

Acne and increased skin oiliness are recognised adverse effects of testosterone replacement therapy.

Sebaceous glands produce sebum, the lipid-rich substance responsible for the skin’s natural oiliness. Androgens stimulate sebaceous gland activity, which is one reason acne commonly appears during puberty as androgen activity increases.

TRT can produce a similar effect.

A 2026 scoping review specifically examining the dermatological effects of TRT found acne to be the most frequently reported skin complication, affecting approximately 0.6–9.1% of men across the studies included.

Other reported effects included itching, rashes and changes in hair growth.

Importantly, these figures are considerably lower than some of the acne rates quoted online, which may be derived from different populations receiving testosterone rather than men receiving physiological testosterone replacement for hypogonadism.

Acne may affect the:

• Face
• Chest
• Shoulders
• Upper back

For most men it is relatively mild, although inflammatory and occasionally nodulocystic acne can occur.

And developing acne does not automatically mean that TRT needs to be stopped.

Conventional acne treatments — including topical retinoids and, where appropriate, oral treatments — can usually be used while testosterone therapy continues.

Does the type of TRT matter?

Possibly.

Different testosterone preparations produce different patterns of testosterone exposure.

Some injectable preparations can produce greater peaks and troughs in circulating testosterone concentrations, whereas transdermal preparations tend to provide more continuous exposure.

Interestingly, the recent dermatology review found that injectable testosterone preparations generally had higher rates of acne than topical or oral preparations, while oral formulations had the lowest reported rates.

However, the studies were heterogeneous and dermatological side effects were not always systematically assessed. We therefore cannot say that simply changing formulation will prevent acne or hair loss in an individual patient.

The aim of genuine testosterone replacement therapy is generally to restore testosterone to an appropriate physiological range rather than produce supraphysiological concentrations.

If significant skin or hair problems develop, it is reasonable to review the dose, blood levels and formulation with the prescribing clinician rather than treating the skin or hair completely in isolation.

Does testosterone make your skin thicker?

The relationship between testosterone and skin is more complicated than simply causing acne.

Androgen signalling influences several components of skin biology, including sebaceous glands, fibroblasts and the extracellular matrix within the dermis.

Sex hormones also contribute to some of the structural differences between male and female skin, with male skin generally being thicker.

This has led to interest in whether correcting testosterone deficiency might influence dermal structure.

However, this area needs some perspective.

Although there are biological reasons why testosterone could influence dermal thickness and collagen, TRT should not be regarded as a skin rejuvenation or anti-ageing treatment. Evidence that testosterone replacement meaningfully improves wrinkles, elasticity or the cosmetic appearance of ageing skin remains limited.

The much better-established dermatological effects are increased sebaceous activity and the potential for acne.

Can you protect your hair while taking TRT?

Potentially.

If progressive androgenetic alopecia develops while taking testosterone, there are established treatments.

1. Minoxidil

Topical minoxidil can help prolong the hair growth phase and maintain or improve hair density.

Low-dose oral minoxidil is also increasingly used in appropriately selected patients, although its use for hair loss is off-label and requires appropriate medical assessment.

2. Finasteride

Finasteride inhibits 5-alpha-reductase and therefore reduces the conversion of testosterone into DHT.

It is one of the best-established treatments for male-pattern hair loss and can significantly slow progression in many men.

3. Dutasteride

Dutasteride inhibits both type I and type II 5-alpha-reductase and suppresses DHT more strongly than finasteride.

Its regulatory status for androgenetic alopecia differs between countries, and its use needs to be considered individually.

For someone receiving TRT, the decision to use a 5-alpha-reductase inhibitor should ideally be discussed with the clinicians managing both their testosterone treatment and their hair loss.

Should you think about your hair before starting TRT?

If preserving your hair is important to you, it makes sense to establish a baseline before starting treatment.

Look at:

• Your frontal hairline
• Your temples
• Crown density
• Evidence of existing miniaturisation
• Your family history of male-pattern hair loss

Baseline photographs taken under consistent lighting can be surprisingly useful for identifying gradual changes. Dermoscopic or trichoscopic images are a more objective measure of hair follicle appearance and can be undertaken in a specialist clinic.

The same principle applies to the skin. Someone who already has oily or acne-prone skin may notice increased sebaceous activity after starting testosterone.

Early intervention is generally preferable to waiting until significant acne scarring or advanced hair miniaturisation has occurred.

So, does TRT mean sacrificing your hair and skin?

No.

But it does mean understanding how testosterone affects them.

TRT can increase skin oiliness and trigger acne. It can increase facial and body hair while potentially accelerating male-pattern scalp hair loss in genetically susceptible men.

Individual susceptibility matters enormously.

Some men will experience very little change. Others may notice acne or progressive hair thinning relatively quickly.

The important point is that many of these effects are predictable, monitorable and treatable.

If you already have acne or a strong family history of male-pattern hair loss, it is worth thinking about these issues before starting TRT rather than after the changes have become established.

And if skin or hair problems do develop, they can usually be treated without automatically having to abandon medically indicated testosterone replacement therapy.

References

1. Abou Chawareb E, Campos L, Savio L, et al. Dermatological adverse effects of testosterone replacement therapy: a scoping review of the literature. Sexual Medicine Reviews. 2026;14(1).
2. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism. 2018;103(5):1715–1744.
3. Lai JJ, Chang P, Lai KP, Chen L, Chang C. The role of androgen and androgen receptor in skin-related disorders. Archives of Dermatological Research. 2012;304:499–510.
4. Zouboulis CC. Acne and sebaceous gland function. Clinics in Dermatology. 2004;22(5):360–366.
5. Zouboulis CC, Degitz K. Androgen action on human skin — from basic research to clinical significance. Experimental Dermatology. 2004;13(Suppl 4):5–10.
6. Kanti V, Messenger A, Dobos G, et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men. Journal of the European Academy of Dermatology and Venereology. 2018;32(1):11–22.
7. Kaiser M, Abdin R, Gaumond SI, Issa NT, Jimenez JJ. Treatment of androgenetic alopecia: current guidance and unmet needs. Clinical, Cosmetic and Investigational Dermatology. 2023;16:1387–1406.
8. Piraccini BM, Blume-Peytavi U, Scarci F, et al. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III randomised controlled clinical trial. Journal of the European Academy of Dermatology and Venereology. 2022;36(2):286–294.

This article is intended for general education and does not replace individual medical advice. Testosterone replacement therapy should be prescribed and monitored by an appropriately qualified clinician.

Dr Iaisha Ali Consultant Dermatologist

Dr Iaisha Ali, MB ChB MRCP MSc(Oxon)

A London-based dermatologist, specialises in acne, hair loss, hormonal skin disorders, and skin cancer treatment.

Dr Ali has been practising dermatology since 2002, with over 25 years of medical experience delivering consultant-led dermatological care. She previously served as Consultant Dermatologist and Clinical Head of Dermatology at Imperial College Healthcare NHS Trust, where she led complex dermatology services and specialist referral clinics.

iadermatology.com/

As a consultant dermatologist specialising in hair treatments, I’ve spent a significant part of my career trying to understand exactly why this happens. During my research at Oxford University, our team investigated hair changes in postmenopausal women across a large population — one of the first studies of its kind — and the findings, later published in the British Journal of Dermatology, helped reframe how we think about this problem.

What they confirmed is something I see in clinic every week: menopausal hair change is extremely common, frequently distressing, and almost always more complex than simply “getting older.”

The Hormone–Hair Connection: Why Does Menopause Cause Hair Loss?

Hair follicles are remarkably hormone-sensitive structures. During menopause, levels of oestrogen and progesterone decline — and both hormones normally play a role in supporting the hair growth cycle, helping to keep follicles in the active growing phase for longer. As those levels fall, hair may spend less time growing and more time resting or shedding. Over time, this leads to reduced density and finer hair overall.

At the same time, the relative influence of androgens — hormones present in all women — can become more noticeable in those who are genetically susceptible. This can drive follicular miniaturisation, a gradual process in which individual hairs become progressively finer, shorter and sparser often diagnosed as female patterned hair loss.

What Our Oxford Research Showed About Menopause Balding

In our Oxford study of 758 postmenopausal women, over 40% reported some degree of hair loss after menopause. The most common pattern — described by around a quarter of participants — was diffuse, all-over thinning. A smaller group developed more noticeable thinning at the front or crown.

Perhaps the most clinically useful finding was that not all menopausal hair change looks the same, or comes from the same cause. We identified two distinct patterns.

The first was a more generalised thinning, associated with increasing age and a reduction in both scalp and body hair. This likely reflects broader, age-related changes in follicular activity rather than hormonal change alone.

The second pattern was rather different: frontal thinning combined with increased facial hair growth. This tended to occur in relatively younger postmenopausal women and is more suggestive of androgen sensitivity playing a prominent role.

This distinction matters enormously in practice, because the two patterns don’t necessarily respond to the same treatments.

Does Your Hair Change During Menopause or Is It Simply Ageing?

This is one of the questions I’m asked most often, and the honest answer is: usually both.

Research by Professor Andrew Messenger and colleagues has shown that female hair thinning increases with age even in women without elevated androgens — which tells us that hormones are not the whole story. The hair growth cycle gradually shortens over time. Follicular activity declines. Hair fibre diameter reduces. Years of environmental exposure take their toll. Genetics plays a background role throughout.

Our Oxford data supported this view: some women appeared to develop thinning driven primarily by these age-related changes, while others showed patterns more clearly linked to hormonal or androgen-related mechanisms. In reality, for most women, all of these factors are operating at once.

Hair Texture Changes During Menopause

Menopause doesn’t only affect scalp hair. In our study, nearly half of women reported increased facial hair — particularly around the chin — while simultaneously noticing less hair on their legs and underarms. This apparent paradox, more hair in some places and less in others, reflects the way different follicles respond differently to the same hormonal shifts.

Many women also notice changes in texture that have nothing to do with density. Hair may become drier, more brittle, less shiny and harder to style. These changes reflect a combination of reduced scalp oil production, alterations in the hair fibre itself, and the cumulative effects of follicular ageing.

When Hair Loss Isn’t Just Menopause

Something I always stress with patients: menopause may be contributing to hair change, but it doesn’t mean it’s the only thing going on. Iron deficiency, thyroid disorders, vitamin D deficiency, chronic stress, inflammatory scalp conditions, autoimmune hair disease and certain medications can all cause or worsen hair thinning — and these are entirely treatable if identified.

This is why a proper assessment matters rather than assuming everything is hormonal. In clinic, that usually means a detailed history, scalp examination, trichoscopy and targeted blood tests where appropriate. Getting the diagnosis right is the foundation for getting the treatment right.

Can Menopause Hair Loss Be Treated?

In many cases, yes — and that’s often reassuring for women who assumed nothing could be done.

Treatment depends entirely on what’s driving the change. Topical minoxidil has a solid evidence base for female hair loss.

Nutritional deficiencies, when identified, are corrected. Scalp inflammation is treated. Some women are good candidates for oral therapies. Procedural options like low-level laser therapy or platelet-rich plasma exist, though the evidence varies and these work best as part of a broader plan rather than standalone solutions.

Hormone replacement therapy isn’t prescribed specifically as a hair treatment, but for some women, stabilising hormonal symptoms more broadly may have a positive indirect effect on hair.

The Emotional Weight

Hair is deeply tied to how women feel about themselves — their confidence, their identity, their sense of being well. When hair changes are dismissed as trivial or inevitable, it can feel isolating.

Our research was motivated partly by the sense that this was an area that deserved to be taken seriously. The changes are common, they’re real, and — with the right approach — many of them can be meaningfully improved.

The first step is understanding what’s actually happening. From there, a targeted, evidence-based plan can make a real difference, not just to the hair itself, but to how a woman feels in her own skin.

Dr Iaisha Ali Consultant Dermatologist

Dr Iaisha Ali, MB ChB MRCP MSc(Oxon)

A London-based dermatologist, specialises in acne, hair loss, hormonal skin disorders, and skin cancer treatment.

Dr Ali has been practising dermatology since 2002, with over 25 years of medical experience delivering consultant-led dermatological care. She previously served as Consultant Dermatologist and Clinical Head of Dermatology at Imperial College Healthcare NHS Trust, where she led complex dermatology services and specialist referral clinics.

iadermatology.com/

Introduction

Hair loss is one of the most distressing and frequently overlooked manifestations of thyroid dysfunction. While fatigue, weight gain, and cold intolerance are the most commonly recognised symptoms of an underactive thyroid (hypothyroidism), a significant number of patients present first — and sometimes exclusively — with diffuse thinning of the scalp. Understanding the bidirectional relationship between thyroid hormones and the hair follicle cycle is essential for clinicians and patients alike, particularly given the rising burden of hypothyroidism in the United Kingdom.

Epidemiology: The UK Burden of Hypothyroidism

Hypothyroidism is among the most common endocrine disorders in the United Kingdom and its prevalence is rising. Data examining NHS and Office of National Statistics records across all 237 health areas found that the prevalence of treated hypothyroidism increased from 2.3% (approximately 1.4 million people) in 2005 to 3.5% (2.2 million) by 2014, with projections estimating a further rise to 4.2% (2.9 million) by 2025 (Leese et al., Thyroid, 2019). This represents one of the steepest increases of any chronic endocrine condition in the UK over the last two decades.

The condition is strongly sex-linked: hypothyroidism is seen ten times more often in women than in men, with a UK female-to-male ratio of approximately 6:1. The incidence of clinical (overt) hypothyroidism has been estimated at 40 per 10,000 women per year compared with just 6 per 10,000 men per year (AAFP, 2015). The overall prevalence of clinically overt hypothyroidism sits at approximately 1–2% of the general UK population, though subclinical hypothyroidism — where TSH is elevated but free T4 remains within range — is found in 8–10% of the population, increasing substantially with age (Thyroid UK).

A UK survey found that approximately 7.5% of women and 2.8% of men have elevated serum TSH levels when screened, suggesting that a large proportion of cases remain undiagnosed or untreated (Hussein et al., PMC, 2019). There is significant geographical variation within the UK: London reports the lowest prevalence of treated hypothyroidism (1.4%), while the Western Isles of Scotland records the highest (6.3%), a pattern partially explained by iodine availability, ethnicity, and environmental factors.

Of particular clinical relevance is the relationship between hypothyroidism and the menopausal transition. The incidence of thyroid disease — including hypothyroidism — is highest in postmenopausal women, and symptoms frequently overlap, leading to diagnostic delays. Hypothyroidism is most commonly diagnosed in women aged 40–50 years, often coinciding with perimenopause. Many women find it difficult to distinguish between hair change during menopause and a pathological thyroid condition.

The Thyroid Gland and the Hair Follicle: Biological Mechanisms

The thyroid gland produces two principal hormones: thyroxine (T4, the prohormone) and triiodothyronine (T3, the biologically active form). These regulate metabolism, cell growth, differentiation, and thermogenesis throughout the body. The hair follicle is a highly metabolically active structure and one of the most sensitive target organs for thyroid hormones.

Thyroid hormone receptors are expressed directly within the hair follicle, particularly in the dermal papilla — the mesenchymal core of the follicle that governs hair cycling. T3 and T4 play a direct role in regulating follicular activity at the root. When hormone levels become insufficient, hair follicles may enter the telogen (resting) phase prematurely, remain there longer than normal, and fail to transition back into the anagen (growth) phase.

The Hair Growth Cycle: Disrupted by Hypothyroidism

Normal hair cycling consists of four phases:

• Anagen – active growth (lasting 2–7 years on the scalp)
• Catagen – regression (2–3 weeks)
• Telogen – resting (approximately 3 months)
• Exogen – shedding

In states of adequate thyroid function, the vast majority of scalp hairs (~85–90%) are in the anagen phase at any given time. In hypothyroidism, this balance is disrupted. Hypothyroidism inhibits cell division in the epidermis and skin appendages, resulting in an increased proportion of hairs in the telogen (resting) phase. The prolonged telogen phase eventually results in excessive shedding — the hallmark of hair shedding or hair loss (telogen effluvium). (Hussein et al., Cureus, 2023).

A retrospective study of 500 female patients with telogen effluvium, examining thyroid function over a decade (2012–2022), found that the hypothyroid group had a significantly higher mean severity of alopecia (SALT) score than both euthyroid and hyperthyroid groups, with a higher proportion of patients experiencing severe hair loss. These findings support the hypothesis that hypothyroidism is a common and frequently underestimated cause of telogen effluvium (published in Medicine, 2024).

Importantly, hypothyroid hair loss typically presents as diffuse thinning across the scalp rather than a localised patch. A classic additional clinical sign is thinning or loss of the outer third of the eyebrows — known as the Sign of Hertoghe — which, while not pathognomonic, is a useful clinical pointer. Hair quality also deteriorates: thyroid hormones regulate sebum production and the structural integrity of the hair cuticle. Without adequate hormonal support, hair becomes dry, brittle, and coarse before visible shedding begins.

It is also important to note that hair loss due to thyroid disease typically becomes apparent several months after the onset of thyroid dysfunction, given the length of the hair growth cycle. This lag frequently confuses both patients and clinicians.

The Menopausal Overlap: A Compounding Factor

The convergence of hypothyroidism with menopause represents a particularly significant clinical challenge. In the first comprehensive population-based study of its kind, the author of this article — Ali and Wojnarowska (2011) — examined subjective hair changes across the scalp, face, and body in postmenopausal women of northern European origin aged 45 years or over, published in the British Journal of Dermatology (164(3):508–513). Crucially, women with a history of thyroid disease were excluded from the study, allowing the authors to characterise hair changes attributable specifically to the menopausal transition rather than thyroid dysfunction.

Their findings revealed two distinct patterns: diffuse generalised scalp hair loss, reported by 26% of women, which was significantly correlated with body hair loss and increasing age; and frontal hair loss, reported by 9% of women, which was associated with higher facial hair scores and relatively younger age. Facial hair gain — particularly at the chin — was reported by 39% of participants. These two patterns likely reflect different underlying pathophysiological mechanisms, with diffuse hair loss representing progressive androgen-related follicular change with ageing, and frontal loss reflecting an earlier androgenic hormonal shift. The study underscores the importance of distinguishing physiological postmenopausal hair change from pathological causes — including hypothyroidism — and provides a critical reference framework for clinicians assessing hair loss in this age group.

The broader hormonal milieu of the menopausal transition — characterised by declining oestrogen and progesterone and a relative increase in androgens — directly impacts the hair follicle, which is an oestrogen-sensitive tissue. These hormonal fluctuations lead to decreased hair density, reduced hair calibre, and changes in hair texture.

The broader literature strongly supports this intersection. A 2025 review in Maturitas (Gupta et al.) notes that female-pattern hair loss, telogen effluvium, and frontal fibrosing alopecia all occur with higher frequency in postmenopausal women. Oestrogen acts as a “hair-friendly hormone,” prolonging the anagen phase and protecting follicles against androgen-mediated miniaturisation. When oestrogen declines, these protective effects are lost — and if hypothyroidism co-exists (as it commonly does in this demographic), the impact on hair is compounded by two independent but synergistic hormonal mechanisms.

A 2023 paper in Biomedicines (Rinaldi et al.) further explored the concept of the hair follicle itself “going through menopause” — proposing that hormonal fluctuations and reduced metabolic efficiency during the menopausal transition directly alter follicular energy metabolism and reduce blood flow to the follicular unit, impairing nutrient delivery. This has important implications for nutritional management (see below).

Given the significant symptomatic overlap between hypothyroidism and menopause — including fatigue, mood changes, weight gain, dry skin, and hair loss — clinicians must maintain a low threshold for thyroid function testing in perimenopausal and postmenopausal women presenting with hair concerns.

Diagnosis: Laboratory Testing for Hypothyroidism

If you suspect a thyroid disease hair issue, comprehensive testing is required:

TSH (Thyroid-stimulating hormone) is the primary and most sensitive first-line test for diagnosing hypothyroidism. Produced by the anterior pituitary, TSH stimulates the thyroid to produce T4 and T3. In primary hypothyroidism, reduced thyroid output results in a compensatory rise in TSH. UK guidelines from the Association of Clinical Biochemistry, the British Thyroid Association, and the British Thyroid Foundation recommend TSH as the frontline investigation, with FT4 automatically reflexed by the laboratory if TSH is abnormal.

A TSH of >10 mU/L combined with a free T4 below the reference range is consistent with overt primary hypothyroidism and warrants treatment.

Free Thyroxine (FT4)

Free T4 measures the amount of unbound (bioavailable) thyroxine circulating in the blood. It is essential when:

• TSH is elevated, to confirm the degree of thyroid failure
• Secondary (central) hypothyroidism is suspected (where TSH may be normal or only mildly raised despite low FT4)
• The patient is on thyroid hormone replacement therapy

Free Triiodothyronine (FT3)

FT3 is rarely requested as a first-line test in the UK context of suspected hypothyroidism, and its utility in diagnosis is limited due to high variability. However, it may be helpful in evaluating suspected secondary hypothyroidism, in patients on combined T3/T4 therapy, and in cases where T3 toxicosis is a differential diagnosis.

Thyroid Peroxidase Antibodies (TPOAb)

Used to identify Hashimoto’s thyroiditis. Research suggests a higher prevalence of these antibodies in patients with alopecia areata. Studies have found a significantly higher prevalence of antithyroid antibodies (25.7%) in patients with alopecia compared to healthy controls (3.3%), highlighting the shared autoimmune pathogenesis of certain hair loss conditions and thyroid disease (Kasumagić-Halilović et al., as cited in MDPI, 2023). Although anti-TPO testing seldom changes the initial treatment (levothyroxine), it identifies patients at higher risk of progression from subclinical to overt hypothyroidism, and those with potential co-existing alopecia areata.

Subclinical Hypothyroidism

In subclinical hypothyroidism, TSH is elevated but FT4 remains within the reference range, and symptoms may be present or absent. This is found in 8–10% of the UK population and is more common in women and older individuals. Hair loss may be a presenting symptom. Current NHS practice is to monitor rather than treat subclinical hypothyroidism in most cases unless the TSH exceeds 10 mU/L, symptoms are significant, or the patient is pregnant.

Practical Note on NHS Testing

In the UK, NHS GPs generally test only TSH as first-line. FT4 is measured reflexively in many, but not all, areas. Testing for FT3 and thyroid antibodies is not routinely undertaken but can be requested when there is clinical reason. Patients undergoing private thyroid screening may access a more comprehensive panel. Clinicians assessing hair loss should ensure thyroid function tests are performed in the appropriate clinical context, alongside other relevant investigations such as ferritin, full blood count, and vitamin D.

Nutritional Factors Contributing to Thyroid-Related Hair Loss

Nutritional deficiencies are both a consequence of hypothyroidism and an independent contributing factor to hair loss. Identifying and addressing these deficiencies alongside thyroid treatment is fundamental to optimising hair recovery.

Iron and Ferritin

Iron is required for the synthesis of thyroid hormones through its role as a cofactor for haem-dependent thyroid peroxidase (TPO), the enzyme responsible for producing T4. When iron stores are depleted, TPO activity is reduced, impairing thyroid hormone production and worsening hypothyroid symptoms. Critically, iron deficiency is independently associated with telogen effluvium even in euthyroid individuals, meaning the two conditions compound one another significantly.

Ferritin (the iron storage protein) is the most sensitive marker of iron status in the context of hair loss. Studies suggest that 25% of women with hypothyroidism experience hair loss partly attributable to low ferritin levels (Avant Medical Group, 2025). Low ferritin is especially prevalent in premenopausal women with heavy menstrual bleeding — a symptom which hypothyroidism itself can exacerbate — and in those following vegetarian or vegan diets. Patients should have both serum ferritin and a full blood count measured; clinicians are advised to request ferritin specifically, as standard iron panels may be normal despite suboptimal stores.

Selenium

Selenium is required for the deiodinase enzymes that convert the inactive T4 into the biologically active T3. Selenium deficiency impairs this conversion, perpetuating a state of functional hypothyroidism even when T4 levels appear adequate. It also plays a role in modulating the autoimmune response in Hashimoto’s thyroiditis: a Cochrane Review (2013) found that selenium supplementation reduced anti-TPO antibody levels by 20–40% in Hashimoto’s patients. Brazil nuts are among the richest dietary sources, with a single nut providing approximately 70–90 mcg.

Zinc

Zinc is required for thyroid hormone synthesis, the function of thyroid hormone receptors, and the production of keratin — the structural protein of the hair shaft. A study published in the Annals of Dermatology (2013) found that zinc deficiency was present in 66.7% of patients presenting with hair loss, underscoring its importance in trichological practice. Dietary sources include pumpkin seeds, oysters, lentils, and chickpeas.

Iodine

Iodine is the essential raw material from which thyroid hormones are constructed: approximately 70–80% of the body’s iodine is concentrated within the thyroid gland. Iodine deficiency can directly cause hypothyroidism and goitre. However, excessive iodine supplementation can paradoxically trigger or worsen thyroid dysfunction, particularly in those with existing autoimmune thyroid disease. Supplementation should only be considered when deficiency is confirmed, and should always be supervised.

Vitamin D

Vitamin D acts as a modulator of immune function and inflammation, and low levels have been associated with increased risk and severity of autoimmune thyroid disorders, including Hashimoto’s thyroiditis. Vitamin D deficiency is highly prevalent in the UK general population — particularly during the autumn and winter months — and is independently associated with hair follicle cycling dysfunction. Public Health England recommends that all adults in the UK consider vitamin D supplementation (10 mcg/day) during autumn and winter.

Biotin (Vitamin B7)

Biotin is widely marketed as a hair growth supplement, and while biotin deficiency can theoretically contribute to hair thinning, clinical deficiency is uncommon. Of greater clinical importance is that biotin supplementation can significantly interfere with thyroid function blood tests, producing falsely abnormal TSH and FT4 results. The MHRA has issued safety guidance on this issue. Patients should be advised to stop biotin supplementation at least 48 hours before thyroid blood tests and should inform their GP and laboratory if they are taking it.

Clinical Implications and Management

The management of hypothyroid-related hair loss centres primarily on adequate thyroid hormone replacement with levothyroxine, targeting a TSH within the normal reference range as per NICE guidance (NG145). Hair regrowth following the commencement of treatment typically begins within several months of achieving euthyroidism, though full restoration may take 6–12 months or longer, depending on the duration of untreated hypothyroidism.

Alongside pharmacological management, clinicians should:

• Assess and correct nutritional deficiencies, particularly ferritin, vitamin D, zinc, and selenium
• Evaluate for co-existing alopecia areata, female-pattern hair loss, or frontal fibrosing alopecia, which may require additional specialist trichological management
• Consider the hormonal context — particularly in perimenopausal and postmenopausal women — and liaise with menopause specialists where appropriate
• Advise patients that thyroid-related hair loss is typically reversible with timely and adequate treatment, provided nutritional status is optimised and concurrent conditions are excluded

As the author’s own landmark population-based study demonstrated (Ali & Wojnarowska, 2011), the subjective experience of hair change following the menopause is highly prevalent and takes distinct clinical forms — and the emotional and psychological burden of hair thinning in women should not be underestimated. Hair loss is deeply connected to identity and wellbeing, and patients benefit significantly from validation, a clear diagnostic framework, and a multidisciplinary approach integrating trichology, endocrinology, and — where relevant — menopause medicine.

Conclusion

Hypothyroidism is a common and rising condition in the UK, disproportionately affecting women — particularly in the perimenopausal and postmenopausal years. Hair loss is a frequently underappreciated manifestation of thyroid dysfunction, mediated through disruption of the hair follicle growth cycle and compounded by nutritional deficiencies that are themselves either caused or exacerbated by hypothyroidism. Diagnosis rests on a stepwise biochemical approach anchored by TSH measurement, with FT4, FT3, and anti-TPO antibodies deployed selectively. Nutritional assessment — particularly of iron/ferritin, selenium, zinc, vitamin D, and iodine — is integral to clinical management. When hypothyroidism coincides with menopause, the effect on hair is compounded, and a holistic, evidence-based approach is essential for effective patient care. If you are experiencing thyroid and hair loss, a multidisciplinary approach at our Harley Street clinic ensures all potential causes — from exercise and skin health to endocrine balance — are considered.

Key References

1. Leese GP et al. (2019). Trends, Determinants, and Associations of Treated Hypothyroidism in the United Kingdom, 2005–2014. Thyroid. doi:10.1089/thy.2018.0251
2. Thyroid UK. Overview of Hypothyroidism. Available at: thyroiduk.org [Accessed May 2026]
3. Hussein RS, Atia T, Bin Dayel S. (2023). Impact of Thyroid Dysfunction on Hair Disorders. Cureus, 15(8):e43266. doi:10.7759/cureus.43266
4. Al-Refu K. (2024). Is Thyroid Dysfunction a Common Cause of Telogen Effluvium? Medicine. doi:10.1097/MD.0000000000036706
5. Gupta AK et al. (2025). Menopause and Hair Loss in Women: Exploring the Hormonal Transition. Maturitas, 198:108378. doi:10.1016/j.maturitas.2025.108378
6. Rinaldi F et al. (2023). The Menopausal Transition: Is the Hair Follicle “Going through Menopause”? Biomedicines, 11(11):3041. doi:10.3390/biomedicines11113041
7. Ali I, Wojnarowska F. (2011). Physiological changes in scalp, facial and body hair after the menopause: a cross-sectional population-based study of subjective changes. British Journal of Dermatology, 164(3):508–513. doi:10.1111/j.1365-2133.2010.10156.x
8. British Thyroid Association / Association of Clinical Biochemistry (2006). UK Guidelines for the Use of Thyroid Function Tests. Available at: baets.org.uk
9. NICE (2019). Thyroid Disease: Assessment and Management. Guideline NG145. Available at: nice.org.uk
10. Bolt Pharmacy (2026). Vitamins for Thyroid Hair Loss: Nutrients, Supplements and NHS Advice. Available at: boltpharmacy.co.uk
11. Study of the Thyroid Profile of Patients with Alopecia. MDPI, 2023. PMC9918246.
12. Vincent M, Yogiraj K. (2013). A Descriptive Study of Alopecia Patterns and their Relation to Thyroid Dysfunction. International Journal of Trichology, 5(1):57–60.

Dr Iaisha Ali Consultant Dermatologist

Dr Iaisha Ali, MB ChB MRCP MSc(Oxon)

A London-based dermatologist, specialises in acne, hair loss, hormonal skin disorders, and skin cancer treatment.

Dr Ali has been practising dermatology since 2002, with over 25 years of medical experience delivering consultant-led dermatological care. She previously served as Consultant Dermatologist and Clinical Head of Dermatology at Imperial College Healthcare NHS Trust, where she led complex dermatology services and specialist referral clinics.

iadermatology.com/

What Are GLP-1 Medications?

Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of medicines widely prescribed for type 2 diabetes and obesity. You may know them by brand names such as Ozempic, Wegovy (semaglutide), Mounjaro, or Zepbound (tirzepatide). These medications work by mimicking a natural hormone that regulates blood sugar and appetite, helping people lose significant amounts of weight alongside other health benefits.

As their use has grown, so has awareness of their side effects. While nausea and digestive symptoms are the most commonly discussed, an increasing number of patients — and the research community — are paying closer attention to a less-expected concern: hair loss.

Is Hair Loss Really Linked to These Medications?

The short answer is: yes, there does appear to be a real association, though the picture is still developing.

A large real-world study using data from over 100 million patients found that GLP-1 users had significantly higher rates of non-scarring hair loss compared to matched controls, with the gap widening particularly from 2021 onwards as usage of these medicines surged. At 12 months, GLP-1 users were roughly 1.4 to 1.8 times more likely to experience certain types of hair loss than non-users.

Pharmacovigilance data from the FDA Adverse Event Reporting System has also flagged elevated reporting of hair loss associated with semaglutide and tirzepatide specifically.

It is important to note that not all studies have found the same signal — results vary depending on study design — and researchers are clear that more work is needed. But the evidence is substantial enough that patients and prescribers should be aware.

What Type of Hair Loss Occurs?

The most commonly reported pattern is telogen effluvium (TE) — a form of diffuse, temporary shedding across the whole scalp. This is often confused with other scalp problems, but you might notice:

• More hair than usual in the shower drain or on your pillow
• A brush that fills up faster than before
• Your ponytail feeling thinner, or a wider parting
• General reduction in volume rather than bald patches

Another pattern that has been reported is androgenetic alopecia (AGA). In women, this more often causes a diffuse thinning over the top of the scalp, similar to female patterned hair loss.
Importantly, these are non-scarring types of hair loss. This means the follicles are not permanently damaged, which is why most people see regrowth once the trigger resolves. If the loss is localized, it is vital to rule out alopecia areata or scarring hair loss through a professional consultation.

Why Does It Happen?

The precise mechanisms are still being investigated. Researchers have found GLP-1 receptors in hair follicles in animal studies, raising the possibility that these medications could have some direct influence on the hair growth cycle — though human evidence for this is currently lacking and the question remains open. What is better established is that several indirect mechanisms play a role:

1. Rapid Weight Loss

Hair follicles are surprisingly sensitive to physiological stress. When the body loses weight quickly, it can interpret this as a threat and redirect resources away from “non-essential” processes like hair growth. This pushes a larger-than-normal proportion of follicles into their resting phase (telogen) simultaneously. Two to three months later, all those resting hairs shed at once — which is why the timing of hair loss often lags a few months behind when you started the medication or increased your dose.

2. Nutritional Deficiencies

GLP-1 medications significantly suppress appetite. While this is the mechanism behind their effectiveness, eating substantially less food also means taking in fewer nutrients. The micronutrients with the best-established evidence as triggers for telogen effluvium are ferritin (iron stores), vitamin D, folate, B12, and zinc — and these are among those most likely to fall short when overall food intake drops significantly.

Protein is sometimes cited in this context, but it is worth being clear about what the evidence actually shows. Protein deficiency causing hair loss is documented mainly in people following crash diets, those with eating disorders, or those with severe malnutrition — in other words, people eating very little indeed. The daily amount needed to avoid deficiency is modest: around 50–60 grams for an average adult, roughly equivalent to a single chicken breast (which contains around 55g on its own), or smaller amounts spread across the day from eggs, fish, dairy, beans, or other sources. Most people on a GLP-1 medication who are eating regular, varied — if smaller — meals are unlikely to fall below this threshold. The evidence for protein supplementation specifically improving hair loss in people who are not genuinely deficient is weak. The stronger, more consistent message from clinical studies points to micronutrient deficiencies as the nutritional factors most worth identifying and correcting.

3. Hormonal Changes

Rapid weight loss can cause transient fluctuations in hormone levels. In some cases, these shifts may unmask an underlying PCOS-related hormonal skin or hair issue.

When Does It Start, and Will It Stop?

Most patients who experience hair shedding notice it two to three months after starting the medication or after a dose increase. This delay is simply how the hair cycle works — follicles that were pushed into a resting phase months earlier are only now shedding.

The good news: for most people, hair loss on GLP-1 medications is temporary. Once weight stabilises and nutritional status improves, regrowth usually follows. How long that takes varies between individuals but is typically several months.

You should speak to your doctor if:

• Shedding is severe or distressing
• Hair loss continues well after your weight has stabilised
• You notice patchy loss rather than diffuse thinning
• The hair loss is accompanied by other symptoms such as fatigue, cold intolerance, or skin changes (which could suggest thyroid or other issues)

What Can You Do?

GLP-1 medications significantly suppress appetite, which is central to how they work. But eating substantially less also means taking in fewer nutrients overall. Maintaining a varied, balanced diet — with adequate protein alongside a range of vegetables, whole grains, and healthy fats — supports hair health as part of overall wellbeing during weight loss.

Don’t Restrict Calories Too Aggressively

Eating too little — particularly below 1,200 calories per day — dramatically increases the risk of nutritional deficiencies that affect hair, bone, and muscle health. The goal is healthy, sustainable weight loss, not near-starvation. If your appetite suppression is so strong that you are struggling to eat enough, speak to your prescribing team about adjusting your approach.

Check Your Micronutrients

Ask your doctor to check your levels of ferritin (iron stores), vitamin D, folate, B12, and zinc before starting or early in your treatment. If you are deficient, targeted supplementation can make a meaningful difference. Don’t wait until your hair starts falling out — the first few months are the most important window for prevention.

Consider a Multivitamin — But Seek Proper Nutritional Guidance

A good-quality multivitamin can act as a useful safety net when overall food intake is reduced. However, a multivitamin alone is no substitute for proper nutritional assessment. Working with your doctor or a registered dietitian to review your diet and blood results means any deficiencies can be identified and addressed in a targeted, evidence-based way — far more effective than a generic supplement approach.

Don’t Stop Your Medication Without Talking to Your Doctor

It can be alarming to notice your hair thinning, but stopping a GLP-1 abruptly can cause its own problems — including rapid weight regain and another round of metabolic disruption that could trigger further shedding. Many patients successfully manage hair concerns while continuing their medication through nutritional support and, in some cases, dose adjustment.

Speak to a Dermatologist specialising in hair loss

If hair loss is significant, a dermatologist specialising in hair loss can confirm the diagnosis. We can also assess if other metabolic factors are at play, such as diabetes-related hair loss.

Key Takeaways

• Hair loss has been reported in a meaningful proportion of GLP-1 users, and research increasingly supports a real association.
• The most common type is telogen effluvium — diffuse, temporary shedding caused by the physical stress of rapid weight loss.
• The exact mechanisms are still being studied; indirect causes such as rapid weight loss, nutritional deficiencies, and hormonal changes are well established, and researchers are also investigating whether the medication may have some direct effect on hair follicles.
• The most effective steps you can take are eating a balanced, nutritious diet, avoiding extreme calorie restriction, and getting your micronutrient levels checked — ideally with proper nutritional oversight from your doctor.

Dr Iaisha Ali Consultant Dermatologist

Dr Iaisha Ali, MB ChB MRCP MSc(Oxon)

A London-based dermatologist, specialises in acne, hair loss, hormonal skin disorders, and skin cancer treatment.

Dr Ali has been practising dermatology since 2002, with over 25 years of medical experience delivering consultant-led dermatological care. She previously served as Consultant Dermatologist and Clinical Head of Dermatology at Imperial College Healthcare NHS Trust, where she led complex dermatology services and specialist referral clinics.

iadermatology.com/

What is PRP?

Platelet Rich Plasma (PRP) is blood plasma containing a high concentration of platelets, which act as the body’s “repairmen” for damaged tissue. These platelets contain vital growth factors and bioactive proteins that initiate connective tissue healing, promote the development of new blood vessels, and stimulate hair growth.

What is PRP Platelet Rich Plasma?

These platelets contain vital growth factors and bioactive proteins that initiate connective tissue healing, promote the development of new blood vessels, and stimulate the follicles. This hair plasma treatment is one of the most effective ways to address hair shedding or hair loss by triggering the body’s natural regenerative processes.

How the Advanced PRP Procedure Works

The entire process at our Harley Street clinic is designed for patient comfort and efficiency, typically taking around 30 minutes. We focus on delivering high-quality platelet rich plasma results through a precise four-step method:

• Blood Collection: A sample of your blood is taken.
• Centrifugation: The blood is placed in a machine that spins at high speed to separate the different types of blood cells.
• Concentration: This 15-minute preparation increases the concentration of platelets and growth factors by up to 500% (five times the normal level).
• Injection: The Consultant disinfects the skin and injects the concentrated plasma directly into the area of hair loss to stimulate the body’s ability to grow hair.

Benefits of PRP for Hair Regrowth

Many patients ask, “Does platelet rich plasma work?” or “Is PRP effective?” Clinical data and our own clinical outcomes suggest that it is highly effective. The primary benefits of PRP include increased hair density, reduced thinning, and a completely natural approach since it uses your own growth factors. It is a preferred hair loss treatment with plasma for those suffering from female patterned hair loss or alopecia areata.

For enhanced results, some patients choose to combine this with exosome therapy or polynucleotides to further stimulate the scalp environment.

Safety, Risks, and “Does PRP Hurt?”

The risk of complications following PRP is rare, but can include:

• Infection at the site of the injection.
• Bruising, bleeding, or skin discolouration.
• Increased inflammation or pain at the site.
• Failure to achieve a successful result or no relief of symptoms.

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“I can’t say enough good things about Dr. Ali when it comes to treating hair loss. From the moment you walk into the clinic, you’re met with warmth, professionalism, and a genuine sense of care. Dr. Ali is incredibly knowledgeable and truly takes the time to understand the root cause of your concerns.”

 Verified Patient Review from Doctify
Visited for Hair Treatment

Dr Iaisha Ali Consultant Dermatologist

Dr Iaisha Ali, MB ChB MRCP MSc(Oxon)

A London-based dermatologist, specialises in acne, hair loss, hormonal skin disorders, and skin cancer treatment.

Dr Ali has been practising dermatology since 2002, with over 25 years of medical experience delivering consultant-led dermatological care. She previously served as Consultant Dermatologist and Clinical Head of Dermatology at Imperial College Healthcare NHS Trust, where she led complex dermatology services and specialist referral clinics.

iadermatology.com/

What are Polynucleotides and How Do They Work?

Many patients ask, “What is a polynucleotide?” Simply put, they are biological molecules that help repair tissue and boost cell renewal. Unlike a skin booster or a filler, polynucleotides act as “biostimulators.”

• Stimulating Hair Follicles: It encourages the hair follicles, which may be dormant or producing fine, miniaturised hairs, to enter a growth phase.
• Improving Scalp Health: It enhances blood circulation in the scalp, delivering more oxygen and nutrients to the hair follicles.
• Reducing Inflammation: Crucial for conditions like Scarring Hair Loss or Alopecia Areata.

This process helps to improve hair density and the quality of the hair shaft, making it thicker and stronger. It is particularly useful for treating smaller, stubborn areas of hair loss that may not be responding as well to other treatments.

Experts in Hair Loss

At IA Dermatology, Dr Iaisha Ali can determine whether you’re experiencing hair shedding or a more serious form of hair loss. Early intervention is key when underlying hair loss is present.

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Shree helped me organise an appointment for my consultation among Dr Ali’s busy schedule due to the stress my health issue was causing me. Dr Ali was very understanding & listened to me. She explored all avenues regarding the cause of my hair loss & I walked away feeling positive about the potential outcome.

 Verified Patient Review from Doctify
Visited for Hair Loss

Polynucleotides for Hair Loss: What to Expect

During your consultation, Dr. Iaisha Ali will determine if you are a candidate for Vitaran or Plinest, two of the best polynucleotide brands we use for hair density.

• How many sessions of polynucleotides are needed? We generally recommend a course of 3 to 4 sessions.
• How often? Sessions are usually spaced 2–4 weeks apart.
• How long for polynucleotides to work? While some see improvements in scalp health early on, significant hair density changes usually take 3 to 6 months to become visible.

Can Polynucleotides be combined with Microneedling?

Yes. Using Polynucleotides for microneedling is a highly effective way to ensure the DNA fractions reach the deeper layers of the dermis. Combining this with Dermapen Microneedling or RF Microneedling can accelerate the “before and after” results by creating micro-channels that allow for better absorption of the treatment.

Polynucleotide Aftercare and Recovery

The polynucleotide recovery time is minimal. However, to get the most out of your session, follow these steps:

• Polynucleotide Aftercare: Avoid washing your hair for 24 hours to allow the polynucleotide injection points to heal.
• What to expect: You may see small bumps (papules) at the injection site; these are normal and usually disappear within 24 to 48 hours.
• Can you have Polynucleotides and Botox together? Yes, if you are also treating the forehead or brow area, these treatments do not interfere with each other. In fact, many patients treat their hair and face in the same visit.

Revive your hair at IADermatology, Harley Street.

Our Diagnostic Approach

We guide you with realistic timelines, ongoing monitoring, and emotional support.

Clinical examination: Dr. Iaisha Ali assesses hair shedding patterns and scalp health.

Trichoscopy: Non-invasive imaging to examine follicles and rule out other alopecias.

Blood tests or Scalp Biopsy whichever is necessary

Personalised plan: Includes lifestyle changes, treatments, and follow-up care.

FAQs

Dr Iaisha Ali Consultant Dermatologist

Dr Iaisha Ali, MB ChB MRCP MSc(Oxon)

A London-based dermatologist, specialises in acne, hair loss, hormonal skin disorders, and skin cancer treatment.

Dr Ali has been practising dermatology since 2002, with over 25 years of medical experience delivering consultant-led dermatological care. She previously served as Consultant Dermatologist and Clinical Head of Dermatology at Imperial College Healthcare NHS Trust, where she led complex dermatology services and specialist referral clinics.

iadermatology.com/

At our Harley Street dermatology clinic, we specialize in diagnosing the etiology of alopecia areata and providing advanced treatment for alopecia to help restore your confidence.

What is Alopecia Areata Hair Loss?

Alopecia areata is a skin condition where the immune system mistakenly attacks the hair follicle. It is a form of non-scarring hair loss, which is different from scarring hair loss alopecia, meaning the follicles remain alive and hair regrowth in alopecia areata is highly possible with the right intervention.
While it commonly presents as patchy hair loss (small, coin-sized round bald patches), it can progress into different types of alopecia areata:

• Alopecia totalis: Complete scalp hair loss.
• Alopecia universalis: Total hair loss on the scalp and body.
  It can affect all genders, ages, and ethnicities, with nail changes like pitting observed in some cases.
• Ophiasis: A specific alopecia areata regrowth pattern that occurs in a wave-like shape at the circumference of the head.

Common Signs & Symptoms

If you are wondering how does alopecia start, it often begins with a sudden bald spot on the head. In women and males, the symptoms are similar:

• Patchy hair loss that appears overnight.
• Exclamation mark hairs: Short, tapered hairs at the edge of patches (a key alopecia areata differential diagnosis feature).
• Nail changes: Alopecia areata in nails can cause pitting, brittleness, or “thimble dimples.”
• Scalp Sensations: Itching or burning before the hair falls out. If you have a red scalp and hair loss, a professional evaluation is essential.
• Thinning hair: Sometimes the condition starts as general alopecia areata hair thinning before patches appear.

What Causes Sudden Alopecia Areata?

The exact alopecia areata reason is an autoimmune response, but several factors act as triggers for alopecia areata:

• Genetic predisposition: About 20% of those affected have a family history.
• Other autoimmune conditions: Linked to thyroid disease, vitiligo, type 1 diabetes, or atopic conditions like eczema.
• Stress or infections: May act as triggers in some cases, though not consistently.
• We often see links between hair change during menopause and autoimmune responses.

Get Started with Alopecia Areata Recovery Journey

Discover personalised care and expert guidance to restore your confidence and hair health with elegance and precision.

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“Thanks goodness for Dr Ali, I certainly wouldn’t be where I am today without her. By far the best doctor I’ve ever come across in my life, so knowledgeable, calming, honest, professional, kind and down to earth. She saved me from being robbed of my hair through alopecia and I’ll be forever grateful.“

 Verified Patient Review from Doctify
Visited for Alopecia Areata

How to Treat Alopecia Areata at Our London Clinic

Oral treatments:

1. Immunosuppressants (e.g., methotrexate, ciclosporin, azathioprine)
2. JAK inhibitors (e.g., ritlecitinib, NHS-funded for severe cases; other JAK used off-licence)
3. Corticosteroid tablets for acutely progressive disease or severe cases (usually for short-term use only).
4. Oral minoxidil

Psychological support:

• Improve well-being and reduce stress factors

Each treatment plan is customised to your needs, balancing efficacy and safety.

What to Expect with Treatment

1. For single, solitary patches or limited patches (<5), the prognosis is generally good. Hair regrowth is usually seen six weeks after a course of scalp steroid injection. 
2. Larger areas of hair loss (30% of scalp or more) can take several months/years to recover fully, depending on the treatment regimen and the response rate. 
3. Beard alopecia generally responds rapidly to steroid injection

We guide you with realistic timelines, ongoing monitoring, and emotional support.

Our Diagnostic Approach

A careful medical history is taken to understand the course of alopecia, the speed of onset and additional medical factors such as thyroid disease, family history or nutritional deficiency

Intralesional steroid injection, supplements, minoxidil are the most common treatments. More complex cases will need tablet treatment to suppress the immune system. 

We guide you with realistic timelines, ongoing monitoring, and emotional support.

Clinical examination to assess hair loss patterns and symptoms.

Non-invasive Trichoscopy Scalp Imaging to evaluate hair follicles and scalp health. Clinical photos are taken to monitor and record progress. 

Blood tests are ordered if appropriate usually to test thyroid function, Vitamin D, B12, Folic acid, Ferritin, iron studies.

More tests are ordered if there is suspicion of coeliac disease or treatment with immunosuppressive drugs is planned. 

Scalp biopsy (if needed): required in rare occasion to confirm diagnosis in uncertain cases

A careful treatment plan is organised based on the clinical findings.

FAQs

Dr Iaisha Ali Consultant Dermatologist

Dr Iaisha Ali, MB ChB MRCP MSc(Oxon)

A London-based dermatologist, specialises in acne, hair loss, hormonal skin disorders, and skin cancer treatment.

Dr Ali has been practising dermatology since 2002, with over 25 years of medical experience delivering consultant-led dermatological care. She previously served as Consultant Dermatologist and Clinical Head of Dermatology at Imperial College Healthcare NHS Trust, where she led complex dermatology services and specialist referral clinics.

iadermatology.com/