Types of hair loss — different causes and approaches
Not all hair loss is the same — and the right treatment depends on the cause. The doctor evaluates the pattern, speed, and characteristics of the hair loss to identify the most likely cause.
Androgenetic alopecia — genetic pattern baldness
The most common cause of hair loss in men and women. In men, it causes progressive baldness with a characteristic pattern — starting at the temples and on the top of the head. In women, it causes diffuse thinning especially on the top of the head, with preservation of the frontal hairline. It is genetic and progressive — the earlier it is treated, the more effective the treatment.
Telogen effluvium — diffuse stress-related shedding
Diffuse and sudden hair loss — often with handfuls of hair in the brush or drain. Caused by intense physical or emotional stress, severe illness, surgery, childbirth, a very restrictive diet, or nutritional deficiencies. Usually reversible when the cause is identified and treated.
Alopecia areata
Hair loss in well-defined circular patches — caused by an autoimmune reaction. It can affect the scalp, eyebrows, and other areas with hair. In some cases it progresses to total loss of scalp hair (alopecia totalis) or of the entire body (alopecia universalis).
Hair loss due to nutritional deficiency
Iron deficiency, low ferritin, vitamin D deficiency, vitamin B12, zinc — these are frequent and treatable causes of hair loss. Ordering laboratory tests is an essential part of the evaluation.
Hair loss due to hormonal changes
Hypothyroidism, hyperthyroidism, polycystic ovary syndrome (PCOS), postpartum changes, menopause, and other hormonal conditions can cause significant hair loss. Hormonal evaluation is a key part of the investigation.
Medication-related hair loss
Various medications can cause hair loss as a side effect — including anticoagulants, antidepressants, antihypertensives, thyroid medications in excessive doses, and others. The doctor assesses the current medication and its relationship to the hair loss.
Cicatricial alopecia
Hair loss with permanent destruction of the hair follicles — caused by inflammatory conditions of the scalp. Requires urgent specialized dermatological evaluation and possibly a biopsy. The doctor refers urgently when suspected.
Who this service is for
This hair loss evaluation consultation with a general practitioner is indicated for adults with:
- Progressive hair loss — in men with a baldness pattern or in women with thinning on the top
- Diffuse and sudden hair loss — handfuls of hair in the brush, in the drain, or on the pillow
- Hair loss after a stressful event — illness, surgery, childbirth, a period of intense stress
- Hair loss with suspected hormonal cause — menstrual irregularity, thyroid symptoms, weight gain, fatigue
- Hair loss with suspected nutritional deficiency — restrictive diet, vegetarianism, veganism without adequate supplementation
- Hair loss in patches — for evaluation and referral when indicated
- Those already using minoxidil or finasteride and wanting a treatment review
- Those who want to understand treatment options before starting any medication
- Foreign men and women and expats in Brazil with hair loss
What is included in the consultation
Clinical evaluation and image analysis
Before the consultation, send high-resolution photos of the scalp — showing the areas of greatest hair loss, the frontal hairline, the top of the head, and the temples. The doctor reviews the images before the call to assess the pattern of hair loss. During the video call, the doctor performs a complete clinical evaluation — including family history of baldness, duration of progression, speed of hair loss, and associated factors.
How to take good photos of the scalp:
- Take photos in good lighting — preferably natural light
- Include front, top, and temple photos
- Lightly wet the hair for better visualization of the scalp
- If you have old photos of your hair, include them for comparison
Laboratory test request
Laboratory investigation is an essential part of hair loss evaluation — especially to identify treatable causes such as nutritional deficiencies and hormonal changes. The doctor requests the tests indicated for your profile — ferritin, serum iron, TSH, free T4, complete blood count, vitamin D, vitamin B12, zinc, hormonal profile when indicated.
Differential diagnosis
Based on the clinical evaluation, the images, and the available tests, the doctor establishes the most likely differential diagnosis — identifying the most likely cause or causes of hair loss.
Treatment plan — at the doctor's discretion
Based on the complete evaluation, the doctor advises on the most appropriate treatment options for the individual profile — including treatment of the underlying cause when identified, pharmacological options where clinically indicated, and supplementation when a deficiency is documented.
Electronic prescription — at the doctor's discretion
Where clinically indicated after a complete evaluation, the doctor issues an electronic prescription with ICP-Brasil digital signature, valid at pharmacies throughout Brazil.
Referral to a dermatologist — when indicated
For extensive alopecia areata, suspected cicatricial alopecia, or hair loss that does not respond to usual treatment, the doctor refers to a dermatologist with complete clinical documentation.
Treatment options — what the doctor may evaluate
Minoxidil
Minoxidil — available as a topical solution and oral tablet — is one of the treatments with the strongest evidence for androgenetic alopecia in men and women. It is available in Brazil without the need for a prescription in standard topical formulations — but medical evaluation before starting ensures that it is the appropriate treatment for your type of hair loss and that you are using the correct concentration and formulation. Oral minoxidil — at low doses — is a more recent option with growing evidence and requires a prescription. The doctor evaluates the indication during the consultation.
Finasteride
Finasteride is one of the most effective treatments for male androgenetic alopecia — it works by blocking the conversion of testosterone into dihydrotestosterone (DHT), the main factor responsible for genetic baldness. It requires a prescription and evaluation of contraindications and potential side effects — including an impact on sexual function in a minority of patients — before starting. Dutasteride is an alternative to finasteride with a similar or superior efficacy profile — it also requires medical evaluation and a prescription.
Treatment of the underlying cause
When hair loss is caused by nutritional deficiency, hormonal change, or another treatable condition, treating the cause is the most important step — and often enough to reverse the shedding.
Supplementation
When ferritin, vitamin D, vitamin B12, or zinc deficiency is documented, appropriate supplementation may reverse the associated shedding. The doctor advises on doses and duration of supplementation based on the test results.
No treatment can be confirmed or guaranteed before a complete clinical evaluation. Results of hair loss treatment vary among individuals and depend on the cause, the type of alopecia, and adherence to treatment.
Hair loss in Brazil — specific context
Brazil has specific characteristics that influence hair loss:
Climate and sun exposure
The warm climate and high sun exposure in Brazil contribute to scalp dryness and may worsen some forms of hair loss — especially in regions with high UV index such as the North and Northeast.
Vitamin D deficiency
Paradoxically, despite high sun exposure, vitamin D deficiency is common in Brazil — especially in people with darker skin or who spend most of their time indoors. Vitamin D deficiency is associated with hair loss.
Excessive use of chemical procedures
Brazil has one of the highest rates of use of chemical hair procedures in the world — straightening, progressive straightening, dyes. Excessive use can cause hair loss due to damage to the hair shaft and scalp — the doctor evaluates whether the procedures are contributing to the hair loss.
Diet and nutritional deficiencies
The Brazilian diet has specific characteristics — with significant regional variation — that may contribute to nutritional deficiencies associated with hair loss. The doctor evaluates eating patterns as part of the investigation.
