Noticing more hair in your brush, a widening part line or a gradually receding hairline can be unsettling. Hair plays an important role in how we see ourselves, and changes in its thickness or appearance can affect confidence and wellbeing. Hair thinning and hair loss can happen for many reasons — genetics, hormones, stress, nutritional deficiencies, medical conditions and even inflammation of the scalp. Understanding what's causing the change is the first step towards choosing the right treatment.
But not all hair loss is the same. Some types develop gradually over many years, while others appear quite suddenly. Some are temporary and resolve once an underlying cause is addressed, while others are progressive and benefit from early intervention.
At Piko Laser Clinic, I believe understanding why hair loss is occurring is just as important as deciding how to treat it.
Understanding the Hair Growth Cycle
To understand hair loss, it helps to know how hair normally grows. Every hair follicle follows a natural cycle consisting of three main phases:
Anagen – The Growth Phase: This is when hair actively grows. Scalp hair can remain in this phase for several years, and approximately 85–90% of scalp hairs are normally growing at any given time.
Catagen – The Transition Phase: A short transitional period during which active hair growth stops and the follicle begins to shrink.
Telogen – The Resting Phase: The follicle enters a resting phase before the existing hair is eventually shed and a new growth cycle begins.
Losing approximately 50–100 hairs each day is generally considered normal. However, when the hair growth cycle becomes disrupted, excessive shedding or progressive thinning can occur (Asghar et al., 2020). The important distinction is that hair shedding does not always mean permanent hair loss.
1. Genetic Hair Loss – Androgenetic Alopecia
Androgenetic alopecia (AGA), commonly known as male or female pattern hair loss, is the most common cause of progressive hair thinning. It occurs when genetically susceptible hair follicles gradually become smaller through a process called follicular miniaturisation. Over time, affected follicles produce progressively finer, shorter hairs, resulting in reduced hair density and increased scalp visibility.
Male Pattern Hair Loss: In men, androgenetic alopecia commonly presents as:
A receding frontal hairline
Thinning around the temples
Reduced density at the crown
Gradual progression over several years
The hormone dihydrotestosterone (DHT) plays an important role in follicular miniaturisation in genetically susceptible men.
Female Pattern Hair Loss: Women often experience a different pattern, including:
Widening of the central part line
Diffuse thinning across the crown
Reduced overall hair volume
Increased visibility of the scalp
The frontal hairline is often relatively preserved. Female pattern hair loss is influenced by genetics and hormonal factors, although many affected women have normal circulating androgen levels (Ramos & Miot, 2015).
Can it be treated?
Yes. Although androgenetic alopecia is generally progressive, treatments may help slow further thinning and improve hair density in suitable individuals. Established medical treatments include minoxidil and, where appropriate, prescription medications.
Light-based treatments are also being investigated and used as supportive therapies. However, the strength of evidence varies considerably between technologies, and fractional laser treatment should not be considered equivalent to established medical treatments.
Early assessment is particularly valuable because follicles that have become miniaturised may retain the capacity to produce thicker hairs.
(Kuczara et al., 2024; Ramos & Miot, 2015)
2. Stress-Related Hair Shedding – Telogen Effluvium
Have you noticed increased hair shedding several months after an illness, surgery, stressful experience or significant change in your health? This may be a condition called telogen effluvium. It occurs when a larger-than-normal proportion of hair follicles prematurely enters the resting phase of the hair cycle.
Common triggers include:
Significant physical or emotional stress
Major illness or high fever
Surgery or hospitalisation
Childbirth
Rapid weight loss or restrictive dieting
Certain medications
Nutritional deficiencies
Interestingly, the shedding often begins two to three months after the triggering event, making the connection less obvious. Unlike genetic hair loss, telogen effluvium generally causes widespread shedding rather than thinning concentrated in one particular area.
Will the hair grow back?
In many cases, yes. Acute telogen effluvium is often temporary, particularly when the underlying trigger has resolved. However, recovery can take several months, and persistent shedding warrants further investigation. Importantly, telogen effluvium can also occur alongside androgenetic alopecia, making clinical assessment particularly useful.
(Asghar et al., 2020; Jimeno Ortega & Stefanato, 2023)
3. Hormonal Changes and Hair Thinning
Hormones influence the hair growth cycle, and changes in hormonal balance can contribute to increased shedding or progressive thinning. Hair changes may occur during:
Pregnancy and the postpartum period
Perimenopause and menopause
Thyroid dysfunction
Polycystic ovary syndrome (PCOS)
Changes in hormonal medications
For women, hormonal changes around menopause may coincide with increasing female pattern hair loss. However, not all hair thinning during menopause is directly caused by reduced oestrogen, and other contributing factors should still be considered.
Similarly, thyroid disorders can disrupt normal hair cycling and contribute to diffuse shedding.
Why does this matter?
Treating the scalp without recognising an underlying hormonal or medical condition may fail to address the main cause of hair loss. Where appropriate, I recommend GP assessment and further investigation before considering supportive laser treatments.
(Ramos & Miot, 2015; Asghar et al., 2020)
4. Nutritional Deficiencies and Hair Loss
Healthy hair growth requires adequate nutrition. Hair follicles are metabolically active structures, and deficiencies in essential nutrients can interfere with normal growth and cycling. Potential contributing factors include:
Iron deficiency
Inadequate protein intake
Zinc deficiency
Significant calorie restriction
Certain vitamin deficiencies
Iron deficiency is particularly relevant in people experiencing heavy menstrual bleeding, restrictive diets or other causes of reduced iron stores. However, the relationship between low ferritin levels and hair loss is complex, and there is no universally accepted ferritin threshold specifically for hair regrowth.
Do hair supplements help?
Not necessarily. Taking additional vitamins or minerals does not automatically improve hair growth if there is no underlying deficiency. In fact, excessive supplementation with certain nutrients can be harmful and may contribute to hair loss. Where nutritional deficiency is suspected, appropriate medical assessment and targeted correction are preferable to taking multiple supplements without a clear indication.
(Asghar et al., 2020; Ramos & Miot, 2015)
5. Autoimmune Hair Loss – Alopecia Areata
Alopecia areata is an autoimmune condition in which the immune system targets hair follicles. It commonly causes:
Sudden, well-defined patches of hair loss
Smooth areas of scalp without visible hair
Occasionally, more extensive hair loss
Changes involving eyebrows, eyelashes or other body hair
Unlike scarring forms of alopecia, the follicles are generally preserved, meaning regrowth may be possible. However, the course of alopecia areata is unpredictable, and some individuals experience recurrent episodes.
Is laser hair regeneration appropriate?
Alopecia areata requires medical assessment and, where indicated, dermatologist-directed treatment. It is not a condition I would routinely treat with cosmetic fractional laser hair regeneration.
(Pratt et al., 2017)
6. Scalp Inflammation and Scarring Hair Loss
Not all hair loss occurs because follicles become smaller or temporarily stop growing. Some inflammatory scalp conditions can progressively damage the hair follicle itself. These include conditions such as:
Lichen planopilaris
Frontal fibrosing alopecia
Discoid lupus erythematosus
Other forms of cicatricial (scarring) alopecia
Possible warning signs include persistent scalp redness, itching, burning, tenderness, scaling or areas where the normal follicular openings are no longer visible. Unlike many non-scarring forms of hair loss, these conditions can cause permanent follicular destruction.
Early diagnosis and treatment are important because once a follicle has been replaced by scar tissue, hair regeneration is generally not possible. Suspected scarring alopecia requires prompt medical or dermatological assessment rather than cosmetic laser treatment.
(Cummins et al., 2021)
7. Traction Alopecia – When Hairstyles Contribute to Hair Loss
Traction alopecia develops when repeated pulling or tension damages hair follicles over time. It may be associated with:
Tight ponytails or buns
Braids and extensions
Repeated tension along the hairline
Hairstyles that place prolonged stress on the follicles
Hair loss often begins around the temples or frontal hairline. In the early stages, reducing tension may allow recovery. However, prolonged traction can eventually cause permanent follicular damage. Recognising the cause early is therefore important.
Why Assessment Matters Before Hair Regeneration Treatment
With so many possible causes of hair loss, there is no single treatment that is suitable for everyone. At Piko Laser Clinic, my approach begins with a thorough clinical assessment rather than immediately recommending laser treatment. This includes reviewing your medical history, the pattern and duration of hair loss, possible contributing factors and the condition of your scalp.
Where appropriate, I also use clinical photography and dermoscopy to assess hair density, follicular characteristics and changes over time. Dermoscopy, also called trichoscopy when examining hair and scalp, allows closer assessment of features such as differences in hair shaft diameter, follicular miniaturisation and signs of inflammation. These findings can help distinguish common patterns of hair loss, although they do not replace a medical diagnosis where one is required (Kuczara et al., 2024). If I identify concerns suggesting an underlying medical condition, inflammatory scalp disease or another cause requiring investigation, I may recommend GP or dermatologist assessment before proceeding. Sometimes the most appropriate treatment is not laser treatment at all.
Where Does Laser Hair Regeneration Fit In?
Laser and light-based technologies are being investigated for their potential to support hair growth and follicular activity. At Piko Laser Clinic, I offer non-ablative fractional laser treatments as a supportive approach for selected patients experiencing hair thinning. The proposed mechanisms involve controlled stimulation of the scalp and biological pathways associated with tissue repair and follicular activity. However, it is important to distinguish between different technologies. Low-level light therapy (LLLT), photobiomodulation and fractional laser treatments use different mechanisms, and evidence supporting one technology cannot automatically be applied to another.
The clinical evidence for fractional laser treatment in hair regeneration remains emerging, particularly for picosecond fractional systems. For this reason, I approach treatment conservatively, with realistic expectations and ongoing assessment. Laser treatment cannot correct an untreated thyroid disorder, reverse significant nutritional deficiency or regenerate follicles that have been permanently destroyed by scarring. It is also not a substitute for established medical treatment where that is indicated.
The Takeaway: Understanding the Cause Comes First
Hair loss is not one condition, and it does not have one solution. For some people, increased shedding is temporary and resolves once an underlying trigger is addressed. For others, progressive follicular miniaturisation means early intervention may help preserve existing hair and potentially improve density. And for some, hair loss may be a sign of a medical condition requiring investigation and treatment.
The most important first step is understanding what is happening beneath the surface. At Piko Laser Clinic, my goal is to provide a careful, evidence-informed assessment, explain what may be contributing to your hair loss and help you understand which treatment options are appropriate.
Because successful hair regeneration starts with understanding the biology — not simply treating the symptom.
Considering Hair Regeneration?
If you're experiencing early hair thinning, a receding hairline or changes in hair density, I offer a complimentary initial consultation at Piko Laser Clinic. Together, we can review your concerns, assess your scalp and discuss whether laser hair regeneration may be appropriate.
Not every type of hair loss is suitable for laser treatment, and I will always recommend medical assessment where needed.
References
Asghar, F., Shamim, N., Farooque, U., Sheikh, H., & Aqeel, R. (2020). Telogen effluvium: A review of the literature. Cureus, 12(5), e8320.
https://doi.org/10.7759/cureus.8320
Cummins, D. M., Chaudhry, I. H., & Harries, M. (2021). Scarring alopecias: Pathology and an update on digital developments. Biomedicines, 9(12), 1755.
https://doi.org/10.3390/biomedicines9121755
Jimeno Ortega, I., & Stefanato, C. M. (2023). Telogen effluvium: A 360 degree review. Italian Journal of Dermatology and Venereology, 158(6), 457–466.
https://doi.org/10.23736/S2784-8671.23.07579-5
Kuczara, A., Waśkiel-Burnat, A., Rakowska, A., Olszewska, M., & Rudnicka, L. (2024). Trichoscopy of androgenetic alopecia: A systematic review. Journal of Clinical Medicine, 13(7), 1962.
https://doi.org/10.3390/jcm13071962
Pratt, C. H., King, L. E., Jr., Messenger, A. G., Christiano, A. M., & Sundberg, J. P. (2017). Alopecia areata. Nature Reviews Disease Primers, 3, Article 17011.
https://doi.org/10.1038/nrdp.2017.11
Ramos, P. M., & Miot, H. A. (2015). Female pattern hair loss: A clinical and pathophysiological review. Anais Brasileiros de Dermatologia, 90(4), 529–543.
https://doi.org/10.1590/abd1806-4841.20153370
Medical information disclaimer: This article provides general educational information and does not replace individual medical assessment, diagnosis or treatment. Hair loss can have multiple contributing causes, and treatment suitability should be determined following an appropriate clinical assessment.