If you’re losing hair and wondering what to do next, the most important first step is figuring out which type of alopecia you have, because that determines everything from treatment options to whether regrowth is possible. Some forms resolve on their own, others respond well to medication, and some cause permanent loss that calls for cosmetic solutions. Here’s a practical guide to navigating each stage.
Figure Out What Type You’re Dealing With
Hair loss isn’t one condition. It’s a category that includes several very different problems, and they don’t all respond to the same treatments. A dermatologist will start by looking at the pattern of your hair loss and checking whether your hair follicles are still intact or permanently damaged.
Androgenetic alopecia (pattern hair loss) is the most common type. In men, it shows up as a receding hairline and thinning at the crown. In women, it’s a gradual thinning across the center of the scalp while the front hairline stays mostly intact. This type is driven by hormones and genetics, and it progresses slowly over years.
Alopecia areata is an autoimmune condition where your immune system attacks hair follicles, causing sudden, smooth, circular patches of hair loss. It can strike at any age. In rare cases it progresses to total scalp hair loss or loss of all body hair. The follicles aren’t destroyed, which means regrowth is always possible. About 34% to 50% of people with patchy alopecia areata see hair come back on its own within a year without any treatment.
Scarring alopecia is the most urgent to catch. Conditions like lichen planopilaris and frontal fibrosing alopecia destroy hair follicles permanently through inflammation. You might notice itching, burning, or tenderness in the affected area, and the skin where hair has been lost looks smooth and shiny. Early treatment can stop the scarring from spreading, but hair already lost in these areas won’t grow back. If your scalp hurts or feels inflamed, get it evaluated sooner rather than later.
Get the Right Diagnosis
You can guess at your type based on the pattern, but a dermatologist can confirm it with tools you don’t have at home. They’ll examine your scalp under magnification (a tool called a dermatoscope) to look at follicle openings, hair shaft thickness, and signs of inflammation. A gentle pull test, where the doctor tugs a small section of hair, helps assess how actively you’re shedding.
Blood work is also worth requesting. People with diffuse hair loss have significantly lower iron stores and vitamin D levels compared to those without hair loss. In one study, nearly 80% of patients with diffuse thinning had low vitamin D, and about 20% had low iron stores. Correcting these deficiencies won’t cure genetic or autoimmune hair loss, but it removes a factor that could be making things worse. Ask your doctor to check your iron (ferritin), vitamin D, and thyroid function at minimum.
Treatments for Pattern Hair Loss
If your diagnosis is androgenetic alopecia, two medications form the backbone of treatment. Minoxidil (available over the counter as a topical liquid or foam) works by increasing blood flow to follicles and extending the growth phase of hair. Finasteride (prescription, typically 1 mg daily for men) reduces the hormone that causes follicles to shrink over time. A recent study of the two medications used together found that 92% of patients maintained or improved their hair over 12 months, with 57% showing clear visible improvement.
One practical note: many people start topical minoxidil and quit because applying it twice daily gets tedious. Oral minoxidil at low doses has shown comparable results to the topical version in clinical trials, so if the daily routine is a barrier, ask your dermatologist about the oral option. Finasteride is generally prescribed only for men, as it can cause birth defects and isn’t approved for women of childbearing age.
Treatments for Alopecia Areata
For patchy alopecia areata affecting less than half the scalp, steroid injections directly into the bald patches are the standard first-line treatment. Sessions are repeated every four to six weeks, and many people see regrowth within a few rounds. The injections can be uncomfortable, but the procedure is quick.
For more severe cases, a new class of medications called JAK inhibitors has changed the landscape. Three are now FDA-approved specifically for alopecia areata:
- Baricitinib (Olumiant), approved in 2022 for adults. In clinical trials, 35% to 40% of patients regained at least 80% of their scalp hair by 36 weeks.
- Ritlecitinib (Litfulo), approved in 2023 for patients 12 and older. About 32% reached 80% coverage by 24 weeks, rising to 61% after two years of continued use.
- Deuruxolitinib (Leqselvi), approved in 2024. Roughly 41% of patients achieved 80% scalp coverage by 24 weeks.
These are systemic medications that suppress part of the immune response, so they come with side effects and monitoring requirements your dermatologist will discuss. They’re typically reserved for people with severe hair loss who haven’t responded to other treatments. But for many people who previously had no effective options, they represent a genuine breakthrough.
When Hair Won’t Grow Back
Scarring alopecia destroys follicles permanently, and even with non-scarring types, some people don’t respond to treatment or prefer not to pursue it. That doesn’t mean you’re out of options.
Scalp micropigmentation uses tiny dots of cosmetic pigment tattooed into the scalp to mimic the look of hair follicles or create the appearance of a close-shaved head. It works for all types of hair loss, including alopecia areata, pattern baldness, and scarring. Compared to hair transplant surgery, it’s less invasive, less expensive, involves no downtime, and lasts four years or longer before touch-ups are needed. It doesn’t grow hair, but the visual result can be striking.
Wigs and hair systems have also come a long way. Modern options range from lace-front wigs that create a natural-looking hairline to bonded hair systems that stay in place for weeks at a time. Many people with alopecia areata choose wigs as a primary solution, especially during periods of active hair loss when treatment outcomes are uncertain. Insurance coverage for hair prosthetics varies, but some plans cover them with a prescription for a “cranial prosthesis.”
Platelet-Rich Plasma (PRP) Therapy
PRP involves drawing your blood, spinning it to concentrate the platelets, and injecting the concentrated solution into your scalp. The idea is that growth factors in platelets stimulate dormant follicles. Six out of nine studies in a recent systematic review found significant increases in hair density with PRP compared to controls, and five found significant increases in hair count. However, the quality of evidence is mixed. Study protocols vary widely in how many sessions are given, how the blood is processed, and how results are measured, making it difficult to draw firm conclusions. PRP is not covered by insurance, typically costs several hundred dollars per session, and usually requires three to four initial sessions plus maintenance visits.
Address the Emotional Side
Hair loss affects how you feel about yourself, and that’s not a small thing. Sadness, frustration, anxiety, and social withdrawal are all common responses. If you’re struggling, the National Alopecia Areata Foundation (NAAF) offers mental health resources including connections to support groups. Psychology Today’s Therapist Finder can help you locate a therapist in your area, and organizations like the National Alliance on Mental Illness (NAMI) provide broader mental health support. Talking to other people who’ve been through the same experience, whether in person or online, can make the process feel significantly less isolating.
Check Your Nutrition
Nutritional deficiencies won’t single-handedly cause pattern hair loss or alopecia areata, but they can accelerate shedding and slow regrowth. Iron and vitamin D are the two most commonly low nutrients in people with hair loss. If your blood work shows low ferritin (a marker of iron stores) or low vitamin D, supplementing can help create better conditions for whatever other treatment you’re using. This is especially relevant for women, who are more likely to have iron deficiency. Don’t mega-dose supplements without blood work first. Too much of certain vitamins, particularly vitamin A and selenium, can actually worsen hair loss.