Types of Hair Loss: What Is Your Pattern?
Hair loss (alopecia) has many causes. Identifying the pattern and likely cause guides appropriate treatment:
Telogen Effluvium (Diffuse Shedding)
What it looks like: Sudden, generalised hair shedding — handfuls in the shower, thinning all over the scalp, hair on pillows and clothes. Usually begins 2–3 months after a trigger event.
Common triggers in Nepal:
- Major physical illness (post-COVID hair loss is widely reported)
- High fever
- Major surgery or hospitalisation
- Significant emotional stress or trauma
- Crash dieting or sudden weight loss
- Childbirth (postpartum telogen effluvium — very common)
- Thyroid dysfunction (hypo- or hyperthyroidism)
- Sudden stop of hormonal contraception
Prognosis: Telogen effluvium is usually temporary. Once the trigger is resolved, regrowth begins within 3–6 months. Full recovery typically occurs within 6–12 months. Treatment is primarily treating the underlying cause.
Androgenetic Alopecia (Pattern Hair Loss)
What it looks like:
- In men: receding hairline at the temples, thinning crown (Hamilton-Norwood scale)
- In women: diffuse thinning at the crown, widening of the centre parting — without receding hairline (Ludwig scale)
Cause: Genetically inherited sensitivity of follicles to dihydrotestosterone (DHT). DHT shortens the hair growth cycle, causing follicles to produce progressively shorter, finer hairs until they stop producing visible hair altogether.
Treatment: Minoxidil (topical — available OTC) and finasteride (oral — prescription, for men). This is a chronic condition that requires ongoing treatment to maintain results.
Alopecia Areata
What it looks like: Discrete, round or oval patches of complete hair loss on the scalp, eyebrows, or body. The skin appears normal with no scale or inflammation.
Cause: Autoimmune — the immune system attacks hair follicles.
Treatment: Requires dermatological evaluation. Options include topical, intralesional, or systemic corticosteroids; JAK inhibitors for severe cases.
Traction Alopecia
What it looks like: Hair loss at the hairline, temples, and central part — specifically where hair is repeatedly pulled tightly.
Cause: Chronic mechanical tension from tight hairstyles (tight braids, ponytails, extensions). Common in women who wear hair tightly pulled back consistently.
Treatment: Discontinue the traction style. If caught early, follicles can recover.
Nutritional Causes of Hair Fall in Nepal
Nutritional deficiency is an important and treatable cause of hair loss, particularly in Nepal where dietary diversity may be limited and certain deficiencies are endemic:
Iron deficiency anaemia: Very common in Nepali women due to vegetarian diets, menstrual losses, and repeated pregnancy. Ferritin (iron storage protein) below 30–40ng/ml is associated with hair shedding. Correction with iron supplementation typically requires 3–6 months before hair loss improves.
Vitamin D deficiency: Despite Nepal's sunshine, vitamin D deficiency is widespread due to indoor lifestyles, conservative clothing, and darker skin that requires more UV for synthesis. Vitamin D receptors are expressed in hair follicles — severe deficiency is linked to hair loss.
Thyroid dysfunction: Both hypothyroidism and hyperthyroidism cause hair loss. Thyroid conditions are common in Nepal (iodine sufficiency varies by region). A simple TSH blood test can rule this out.
A blood test panel (serum ferritin, CBC, TSH, vitamin D, zinc) is recommended for any patient with unexplained hair shedding before starting treatment.
Scalp Health and Hair Loss: The Dandruff Connection
Dandruff and seborrhoeic dermatitis — driven by Malassezia yeast overgrowth — cause scalp inflammation that can accelerate hair shedding by damaging follicle function and creating a hostile follicular microenvironment.
If hair loss is accompanied by visible dandruff, scalp itch, or flaking, treating the scalp condition is the priority:
Kezil SL Anti-Dandruff Shampoo — contains ketoconazole (antifungal against Malassezia) and salicylic acid (removes dandruff scale). Reduces scalp inflammation that contributes to hair shedding. Use 2–3× per week.
Scalp health is the foundation of hair health. A clean, non-inflamed scalp provides the optimal environment for hair follicle function.
Evidence-Based Hair Loss Treatments
| Treatment | Evidence Level | Available In Nepal |
|---|---|---|
| Minoxidil (topical 2–5%) | Strong — FDA-approved | OTC pharmacies |
| Finasteride (oral, men only) | Strong — FDA-approved | Prescription |
| Ketoconazole shampoo | Moderate (dandruff-related alopecia) | Kezil SL via Stellar Healthcare |
| Iron/vitamin D correction | Moderate (if deficient) | Supplementation |
| PRP (platelet-rich plasma) | Moderate | Some clinics in Kathmandu |
| Low-level laser therapy | Moderate — FDA-approved for pattern alopecia | Limited availability |
When to See a Dermatologist
Seek dermatological evaluation if:
- Hair shedding is severe (filling the drain, clumps in the brush)
- There is visible, progressive thinning or a widening parting
- Patchy hair loss is present (suggests alopecia areata)
- Hair loss is accompanied by other symptoms (fatigue, weight changes, period irregularity — could indicate thyroid or hormonal cause)
- Hair loss has persisted for more than 6 months without improvement
A dermatologist can confirm the diagnosis, order appropriate blood tests, prescribe minoxidil or finasteride, and provide trichoscopy examination.
Summary
Hair fall in Nepal has multiple common causes — telogen effluvium after illness/stress, nutritional deficiencies (iron, vitamin D), androgenetic alopecia, and scalp inflammation from dandruff. Addressing the root cause is essential. For scalp-health-related hair loss, Kezil SL Shampoo provides ketoconazole antifungal treatment. For nutritional causes, appropriate supplementation and dietary correction are needed. Progressive pattern hair loss requires minoxidil and/or finasteride prescribed by a dermatologist.
Contact Stellar Healthcare via WhatsApp (+977 9766453795) or browse haircare products.
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