In a society where appearance and confidence often go hand-in-hand, hair loss remains a deeply personal yet widely misunderstood concern. As Hair Loss Awareness Month, marked in August, shines a spotlight on this issue, it offers an opportunity to move beyond cosmetic anxieties and delve into the root causes, treatments, and lived experiences surrounding hair and scalp health.
In India, where urban stressors, misinformation, and rising self-image pressures intersect, hair loss is no longer a condition confined to middle age; it increasingly affects young adults too. According to Aseem Sharma, director and chief dermatologist at Skin Saga Centre for Dermatology, Mumbai, and founder of ADMIRE Academy, the most common cause of hair loss in Indian patients is androgenetic alopecia, a condition largely driven by genetics and hormones that manifests in both men and women. “This is followed closely by telogen effluvium, which is hair shedding triggered by stress, illness, or nutritional deficiencies like vitamin D, B12, and iron,” he explains. While acute telogen effluvium may resolve in a few months, chronic forms can persist and require sustained attention.
One form of hair loss that’s especially distressing among younger patients is alopecia areata – an autoimmune condition that results in sudden, patchy hair loss and can, in more severe cases, progress to complete body hair loss, including eyebrows and eyelashes. Dr. Sharma stresses that early intervention in these cases can be pivotal in preventing progression.
Pathological loss
But how does one distinguish between normal hair shedding and pathological loss?
“On average, losing 50 to 100 strands a day is part of the hair’s natural growth cycle,” Dr. Sharma notes. “The red flags are when shedding increases suddenly, becomes localised to specific areas, or is accompanied by visible scalp patches, redness, scaling, or hair loss in places like eyebrows or the beard.”
A simple hair pull test, which examines how many strands come away when gently tugged, can provide a quick clinical clue: if more than 10–15 strands are shed, further evaluation is warranted.
A significant complicating factor in hair loss today is the surge in over-the-counter treatments, many of which are aggressively marketed on social media. “There’s a boom in hair loss ‘solutions’ that often make exaggerated claims without scientific backing,” warns Dr. Sharma. “Many of these contain irritants, unlabelled hormones, or even steroids, and not only fail to work but can worsen the condition or delay correct treatment.”
He further cautions against the vilification of evidence-based treatments like minoxidil and finasteride, which have decades of safety data and remain cornerstone therapies in dermatology. “Unfortunately, influencers without medical training often dissuade their followers from using these drugs, leading to a mistrust of medical treatments and reliance on gimmicky fixes. This is why evidence-based medicine (EBM) is key as hair loss is a medical condition, not a beauty trend.”
Psychological toll
Equally important, but often under-discussed, is the psychological toll that hair loss takes, particularly among women. “Hair is strongly tied to self-esteem and identity,” Dr. Sharma says. “Hair loss can cause anxiety, depression, and social withdrawal, especially in young women who face societal expectations around beauty and femininity.” He emphasises the importance of empathetic care, holistic support, and referrals to mental health professionals when needed. “It’s not just about regrowing hair. It’s about restoring confidence and mental well-being.”
Future treatments
When asked about the future of hair loss diagnosis and treatment, Dr. Sharma shares cautious optimism. Technologies like trichoscopy, which allow non-invasive scalp and follicle analysis, are now routine in dermatology clinics. “We also have exciting targeted therapies such as oral minoxidil, injectables, and topical anti-androgens alongside newer innovations like JAK inhibitors, which have shown promise in alopecia areata.” On the procedural front, regenerative therapies such as PRP, exosomes, and stem-cell-derived treatments are being explored.
However, he stresses that success depends on accurate diagnosis and personalised medicine, not just trendy interventions. “In the future, genetic and biomarker-based customization may allow dermatologists to offer tailored regimens, but for now, choosing a qualified provider is critical.”
Adding a global perspective to this discussion is Roxanna Sadoughifar, an internationally recognized trichologist and professor at the University of Rome G. Marconi, the Editor of Springer Nature’s ‘Clinical Cases in Hair and Scalp Disorders.’ Prof. Sadoughifar brings particular attention to the emerging role of the scalp microbiome in maintaining hair and scalp health. “We now know that dysbiosis or microbial imbalance on the scalp can contribute to inflammation, barrier damage, and ultimately, hair thinning,” she explains. She advocates for microbiome-friendly care, including the use of postbiotic-infused shampoos, anti-inflammatory botanicals, and gentle cleansing routines, especially for women with sensitive or flaking scalps.
When asked about hair care for textured or curly hair types, Prof. Sadoughifar stresses the need for hydration-centric routines, gentle detangling practices, and protective styles that reduce mechanical stress. “Hair loss in curly-haired individuals is often worsened by tight hairstyles, excessive straightening, and poor scalp cleansing. Scalp care must be proactive and culturally aware.” She adds that international research must reflect hair diversity, as much of the current trial data still centres on Western hair types and climatic conditions. “The future of trichology must be globally inclusive, considering the biological and cultural differences in hair care needs.”
Social media impacts
Prof. Sadoughifar also addresses the impact of social media trends, many of which promote quick fixes or home remedies. While some platforms have helped de-stigmatise hair loss, the proliferation of unverified advice is concerning. “Trichology is not one-size-fits-all. What works for one person may not work for another and may even cause harm,” she says. “While there are promising natural ingredients like rosemary oil or caffeine that show early potential, we must base claims on controlled studies, not just anecdotes.”
Together, Dr. Sharma and Prof. Sadoughifar offer a powerful reminder that hair loss is a clinical, emotional, and social issue, not a vanity complaint. It deserves empathy, medical rigour, and nuanced care. Their insights align on one crucial point: hair health is health.
As Hair Loss Awareness Month draws attention to the millions quietly struggling with hair loss, the takeaway is clear: seek science, not shortcuts. Consult certified dermatologists. Question miracle cures. And remember that caring for your hair is not just about aesthetics: it’s about agency, identity, and holistic well-being.
(Dr. Monisha Madhumita is a consultant dermatologist at Saveetha Medical College, Chennai. mail.monisha.m@gmail.com)
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