This morning I’ve been reflecting on the weekend, and on a topic that comes up repeatedly in clinic: hair thinning and hair loss.
Over the past week alone, I received another question about hair loss. It’s an incredibly common concern—particularly among women, though men experience it too—and it can have a significant impact on confidence and wellbeing. That reaction is completely understandable.
I read an excellent article over the weekend that explained the issue clearly, and the key takeaway was an important one: hair thinning isn’t a single condition. There are many possible causes, and identifying the underlying driver is essential to choosing the right approach.
Below are some of the most important points worth understanding.
Hair Thinning Has Many Possible Causes
1. Always consider an underlying medical cause first
Conditions such as iron deficiency (anaemia), thyroid disorders, autoimmune disease, and other health issues can contribute to hair thinning or hair loss. If shedding is persistent, sudden, or worsening, a proper medical assessment is essential.
2. Stress plays a significant role
Physical and emotional stress—including illness, surgery, childbirth, grief, or ongoing daily pressure—can push hair into a shedding phase known as telogen effluvium. This often appears several months after the trigger, which can make the connection easy to miss. The reassuring news is that this type of hair loss is often temporary once the cause is addressed.
3. Hormones and genetics matter
Hormonal changes (such as after pregnancy or during menopause) and genetic factors can lead to gradual thinning over time, including female pattern hair loss.
4. Hair care practices can worsen thinning
Excessive heat styling, frequent bleaching or colouring, and tight hairstyles can all contribute to breakage or traction-related hair loss.
5. Know the early signs
Common warning signs include increased hair shedding in the shower or on your pillow, a widening parting, or noticing more scalp than usual.
A Practical Step-by-Step Approach
Step 1: Start with your GP
If hair thinning or shedding feels excessive—particularly if it is sudden or progressive—a medical review should always be the first step.
Step 2: Blood tests worth discussing
Depending on your symptoms and circumstances, it may be appropriate to check:
Full blood count (to assess for anaemia)
Ferritin (iron stores), which are frequently low in women
Thyroid function tests
Vitamin B12 and folate
Vitamin D
Hormone levels (depending on age, symptoms, post-pregnancy or menopausal status)
These tests are not necessary for everyone, but they are often a sensible starting point.
Step 3: Reflect on recent triggers
I often ask patients to look back over the previous 3–6 months and consider:
Illness, surgery, or Covid
Significant stress, grief, or emotional strain
Weight loss or restrictive dieting
Pregnancy or stopping hormonal contraception
Hair loss often occurs months after the trigger rather than immediately, which can make it harder to identify the cause.
Step 4: Be kind to your hair
While investigating the underlying issue:
Reduce heat styling where possible
Avoid tight ponytails, braids, or extensions
Be cautious with frequent bleaching or harsh chemical treatments
Brush gently and avoid excessive pulling
Step 5: Be patient
Hair growth is slow. Even once the cause is identified and treated, visible improvement usually takes months rather than weeks. This can be frustrating, but it is entirely normal.
The Key Message
Hair thinning is common, distressing, and deserves to be taken seriously. In many cases, once we understand why it’s happening, we can improve or stabilise it. It’s important not to ignore changes or assume they are simply part of ageing.
The overall message is reassuring: many causes of hair thinning are manageable once properly identified. If you’re concerned, don’t suffer in silence—start with a thorough health check, and from there we can explore the most appropriate next steps.
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