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Hair & Scalp Physician Reviewed

Alopecia — diagnosed by dermatologists, not hair oil ads

Hair loss affects 1 in 4 Indian adults before age 30. DermaVue dermatologists identify the root cause with trichoscopy and labs — then treat with proven medical and procedural protocols across 7 clinics in Kerala & Tamil Nadu.

Hair Loss Alopecia Areata Androgenetic Alopecia Male Pattern Baldness Female Pattern Hair Loss
Affects Scalp, Eyebrows, Beard
Age Group 18 – 65 years
Contagious No
Treatment 4 – 8 sessions
Consultation ₹300
At a Glance
0%
of Indian men show noticeable hair loss by age 25
0%
of women experience hair thinning by age 50
0%+
DermaVue patient satisfaction across 7,400+ reviews
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7 clinics · Kerala & Tamil Nadu · ₹300 consultation

What Is It

Understanding Alopecia

Reviewed by Dr. Minu Liz Mathew, MBBS MD DVL — February 2026

Alopecia refers to hair loss from any part of the body — most commonly the scalp, eyebrows, and beard. It can be caused by genetics, hormonal changes, autoimmune reactions, nutritional deficiencies, or environmental stress. Left undiagnosed, many forms of hair loss progress silently until visible thinning or bald patches become difficult to reverse. DermaVue dermatologists use trichoscopy, lab panels, and evidence-based protocols — including PRP, medications, and hair transplant — matched to your specific diagnosis and hair loss pattern.

Alopecia encompasses a group of disorders characterised by partial or complete loss of hair from areas where it normally grows. Androgenetic alopecia (AGA) — the most prevalent form — results from 5-alpha reductase–mediated conversion of testosterone to dihydrotestosterone (DHT), which progressively miniaturises androgen-sensitive follicles via shortened anagen phase and follicular apoptosis.[1] Alopecia areata (AA), an autoimmune condition, involves CD8+ T-lymphocyte–mediated collapse of follicular immune privilege with peribulbar inflammatory infiltrate. Telogen effluvium represents premature transition of anagen follicles into telogen phase, commonly triggered by physiological stress, nutritional deficiency (ferritin, vitamin D, zinc), or thyroid dysfunction. Indian Fitzpatrick IV–VI phenotypes present with more visible scalp contrast against dark hair, making early detection and trichoscopic assessment critical for optimal outcomes.

M
Dr. Minu Liz Mathew, MBBS MD DVL
Consultant Dermatologist · RealSelf Recognised · DermaVue Kochi
Last reviewed: February 2026
Signs & Symptoms

What does Alopecia look like?

Symptoms range widely in severity. Identifying which type you have determines the right treatment.

Gradual Thinning on Crown
Progressive reduction in hair density at the vertex or frontal hairline. Most common presentation in androgenetic alopecia. Often noticed when scalp becomes more visible.
Mild
Receding Hairline
Temporal recession forming an M-shaped or V-shaped hairline — characteristic of male-pattern baldness (Hamilton–Norwood stages II–IV).
Moderate
Circular Bald Patches
Smooth, round, coin-sized patches of complete hair loss appearing suddenly. Hallmark of alopecia areata. May affect scalp, beard, or eyebrows.
Mod. Severe
Excessive Daily Shedding
Loss of more than 100 hairs per day — noticeable on pillow, shower drain, or comb. Common in telogen effluvium and diffuse alopecia.
Moderate
Widening Central Part
Progressive broadening of the central hair part — the hallmark pattern of female-pattern hair loss (Ludwig grade I–III). Frontal hairline usually preserved.
Moderate
Scalp Visibility Through Hair
Reduced hair volume makes scalp skin visible under normal lighting. Indicates significant follicular miniaturisation requiring intervention.
Mod. Severe
Eyebrow or Beard Thinning
Loss of hair density in eyebrows or beard area — can indicate alopecia areata, frontal fibrosing alopecia, or nutritional deficiency.
Moderate
Broken Hair Shafts
Short, broken hairs ("exclamation mark hairs") at patch borders. Pathognomonic for active alopecia areata. Indicates ongoing disease activity.
Mod. Severe
Root Causes

What actually causes Alopecia?

Multiple factors act together — understanding them helps prevent recurrence after treatment.

🧬
Genetic Predisposition (Androgenetic Alopecia)
The most common cause of hair loss worldwide. DHT-sensitive hair follicles progressively miniaturise due to inherited 5-alpha reductase activity. Strong family history component — both maternal and paternal lines contribute.
Autoimmune Attack (Alopecia Areata)
The immune system mistakenly targets hair follicles, causing sudden patchy hair loss. Triggered by stress, viral infections, or genetic susceptibility. Can progress to alopecia totalis or universalis in some cases.
Hormonal Imbalance
Thyroid disorders (hypothyroidism, hyperthyroidism), PCOD, post-pregnancy hormonal shifts, and menopause alter the hair growth cycle. PCOD-linked hyperandrogenism is a leading cause in young Indian women.
🍚
Nutritional Deficiency
Low ferritin (iron stores), vitamin D, zinc, and biotin directly impair keratinocyte proliferation and hair shaft integrity. Vegetarian diets prevalent in South India increase iron and B12 deficiency risk.
💧
Hard Water & Environmental Stress
Kerala and South Indian bore-well water with high calcium and magnesium content causes mineral buildup on the scalp, weakening hair shafts and accelerating breakage. Chlorinated water compounds the damage.
😰
Chronic Stress & Telogen Effluvium
Physiological or psychological stress pushes a large percentage of hair follicles prematurely into the telogen (shedding) phase. Common after illness, surgery, emotional trauma, or rapid weight loss.
🧴
Traction & Chemical Damage
Tight hairstyles (braids, buns), chemical straightening, excessive heat styling, and harsh hair dyes cause traction alopecia and structural hair shaft damage. Increasingly common among young professionals.
Who gets alopecia in India?
  • 25% of Indian men experience noticeable hair loss by age 25 — among the earliest onset globally
  • Female pattern hair loss affects up to 50% of women by menopause, often underdiagnosed due to diffuse presentation
  • Alopecia areata prevalence in India is estimated at 0.7–3.8% — higher in individuals with thyroid disorders or family history
  • Kerala's hard water (bore-well TDS 300–800 ppm) contributes to scalp mineral buildup and increased hair breakage vs. soft-water regions
  • Vegetarian diets common in South India are associated with higher rates of iron, zinc, and vitamin B12 deficiency — key nutritional triggers for hair loss
Diagnosis Process

What happens at your DermaVue consultation?

A structured clinical assessment — not a quick glance and a prescription pad. Here's exactly what to expect.

01
Trichoscopy & Scalp Examination
Dermatologist examines scalp under trichoscope (polarised dermoscopy) to assess follicular miniaturisation, hair shaft diameter variation, perifollicular signs, and vascular patterns — distinguishing androgenetic alopecia from areata and cicatricial types.
02
Hair Pull Test & Shed Count
Standardised hair pull test quantifies active shedding. More than 10% positive pull indicates telogen effluvium or active alopecia areata. Baseline photos and global hair density scores recorded.
03
Blood Panel & Nutritional Screening
Complete blood count, serum ferritin, vitamin D, zinc, thyroid profile (TSH, T3, T4), and hormonal panel (testosterone, DHEA-S, prolactin) ordered — identifying correctable metabolic and nutritional causes.
04
Hormonal & PCOD Assessment
For women with pattern thinning: LH/FSH ratio, free testosterone, HOMA-IR, and pelvic ultrasound if PCOD suspected. Androgen excess directly correlates with follicular miniaturisation pattern.
05
Personalised Treatment Protocol
Written protocol combining medical therapy (topical/oral), procedural interventions (PRP, mesotherapy), and nutritional supplementation — staged by severity and expected timeline. Hair transplant candidacy assessed if indicated.
Available at DermaVue

Alopecia treatments we offer

All procedures by board-certified MD DVL dermatologists. US-FDA approved equipment. No technician-only protocols — ever.

PRP Hair Treatment
Platelet-Rich Plasma injected into the scalp delivers concentrated growth factors (PDGF, VEGF, TGF-β) to miniaturised follicles, stimulating anagen re-entry and increasing hair shaft diameter over 3–6 sessions.
Androgenetic alopecia & thinning hair
Hair Transplant (FUE/FUT)
Follicular Unit Extraction or Strip method transplants DHT-resistant occipital follicles to thinning areas. Permanent, natural-looking results. DermaVue surgeons perform 1,500–4,000 graft sessions with high survival rates.
Advanced pattern baldness (Norwood III+)
GFC Hair Treatment
Growth Factor Concentrate therapy — a next-generation platelet-derived preparation with higher growth factor yield than standard PRP. Reduced sessions needed for comparable results.
Early-stage thinning & PRP non-responders
Prescription Medical Therapy
Dermatologist-prescribed finasteride, minoxidil (topical/oral), spironolactone, or immunomodulators — selected by diagnosis, gender, and severity. Not one-size-fits-all. Requires monitoring for side effects.
All alopecia types as baseline therapy
Scalp Mesotherapy
Microinjections of vitamins, peptides, and medications directly into the scalp dermis — bypassing systemic absorption for targeted follicular stimulation and improved local drug delivery.
Diffuse thinning & telogen effluvium
Low-Level Laser Therapy (LLLT)
FDA-cleared photobiomodulation at 650–670 nm wavelength stimulates mitochondrial ATP production in follicular cells, extending anagen phase and increasing hair count. Used as adjunct to medical therapy.
Mild thinning & maintenance therapy
Microneedling + Topical Agents
Controlled micro-injury to the scalp enhances topical minoxidil penetration by up to 40-fold and stimulates Wnt/β-catenin signalling pathway activation — promoting neogenesis in dormant follicles.
Androgenetic alopecia (adjunct to minoxidil)
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Treatment Journey

Your Alopecia treatment timeline

Results are gradual, progressive, and lasting with the right protocol.

Week 1
Consultation, trichoscopy, and baseline documentation. Blood panel ordered. Diagnosis confirmed and treatment protocol initiated.
Prescription therapy started. First PRP or mesotherapy session may be performed same visit.
Month 1–2
Medical therapy in progress. Shedding may temporarily increase (minoxidil-induced telogen release — normal and expected). Nutritional deficiencies being corrected.
Second PRP/GFC session completed. Scalp health improving. New vellus hairs may begin appearing on trichoscopy.
Month 3–4
Shedding stabilised. Early regrowth visible — fine vellus hairs transitioning to terminal hairs. 30–40% improvement in hair density expected.
Third and fourth PRP sessions. Hair transplant scheduling if indicated by treatment plan.
Month 5–8
Visible thickening and coverage improvement. 50–70% density improvement in responsive patients. Hair transplant grafts (if performed) entering growth phase.
Treatment frequency reduced. Protocol adjusted based on trichoscopic progress assessment.
Month 9+
Maintenance phase. Sustained improvement with ongoing medical therapy. Quarterly trichoscopy monitoring recommended for long-term stability.
Most patients on reduced-frequency maintenance PRP and continued topical/oral therapy.
FAQ

Frequently asked questions about Alopecia

No, alopecia is not contagious. It cannot be transmitted through physical contact, sharing combs, or any other means. Androgenetic alopecia is genetic, alopecia areata is autoimmune, and telogen effluvium is a physiological stress response. None of these involve infectious agents that can spread between people.

DermaVue consultation fee is ₹300 at most branches. PRP sessions typically range ₹3,500–6,000 per session, with 4–6 sessions recommended. Hair transplant costs depend on graft count — discussed transparently after assessment. Medical prescriptions vary by medication type. Full costs are outlined at your first consultation with no hidden charges.

Hard water (high calcium and magnesium content) does not directly cause androgenetic alopecia but significantly worsens hair breakage, dryness, and scalp irritation. Kerala bore-well water often has TDS levels of 300–800 ppm. DermaVue dermatologists may recommend shower filters and chelating shampoos as part of a comprehensive hair care protocol alongside medical treatment.

Most patients require 4–6 PRP sessions spaced 3–4 weeks apart for initial treatment, followed by maintenance sessions every 3–6 months. Results begin appearing after the third session in most cases, with peak improvement at 6–9 months. PRP works best when combined with medical therapy — it is not a standalone cure for progressive androgenetic alopecia.

Yes. Female pattern hair loss (FPHL) affects up to 50% of women by age 50. It presents as diffuse thinning over the crown with preserved frontal hairline — different from male pattern baldness. Causes include genetic predisposition, PCOD, menopause, and iron deficiency. Treatment options include topical minoxidil, spironolactone, PRP, and nutritional correction — tailored to the underlying cause.

Hair transplant results are long-lasting because transplanted follicles are harvested from the DHT-resistant occipital region and retain their genetic programming in the new location. However, native (non-transplanted) hair may continue thinning if medical therapy is not maintained. DermaVue surgeons recommend continued finasteride or minoxidil post-transplant to preserve overall density.

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