ManCore | Men’s health | 5 min read
Are You Treating the Hair or Ignoring the Cause?
You tried all sorts of shampoos and products, oils, supplements and any and all tips on the internet. More and more hair accumulates on your pillow and in the drain. Why is my hair falling out? is a question that may be better asked when it’s why is my hair falling at all? Loss of hair is not necessarily a hair care issue, but may be an indicator of something else going on in the body. Without getting to the root of the problem, this can be months of trying to solve the wrong problem.
Hormonal and Nutritional Causes
Either an underactive or overactive thyroid may disrupt the growth cycle of the hair. In male pattern hair loss, the follicles are sensitive to a hormone called DHT, not necessarily abnormal levels of testosterone, causing them to shrink. Iron transports oxygen and aids in the growth of rapidly-dividing cells; iron deficiency and anaemia can be a factor in diffuse shedding. Other potential causes include low levels of vitamin D, zinc, B12 and low protein intake, as well as significant calorie deficit and rapid weight loss. Hair follicles grow quickly and are able to react early if there is a change in the body’s supply of nutrients.
Scalp Conditions That Can Contribute
Dandruff can be seen as mere flaking in mild quantities. However, it can over turn the normal cause in a long drawn condition as there are different inflammatory conditions. Dandruff can cause itching, redness and scaling with seborrheic dermatitis. It’s casual until it turns into fungal infection (tinea capitis), malassezia, or may cause the hair to be broken at the surface, resulting in patches of scaly hair, which may be inflamed. Some conditions like: scarring alopecia, can destroy the follicles causing permanent hair loss. It doesn’t matter the time of assessment as the follicles once gone will not regenerate.
How Physical Stress Affects Your Hair
It’s easy to imagine: in a state of stress, the body diverts its resources to repair itself first; hair isn’t a necessary thing. Many hairs may cease growing in response to a serious illness, high fever, surgery, or rapid weight loss, then come back into a resting state and then fall out together. This is called “telogen effluvium” by doctors. The delay is what causes people to be confused. Shedding typically starts around 2-4 months after the event. Imagine that a man gets a bad infection in the spring and is fine, then in the summer he’s fine but he starts to see little bits of hair in the shower. Though the illness has long passed, the impact of it on the hair is just starting to reveal its effects. Fortunately, this type of shedding is temporary and hair will regrow when the body recovers. If shedding is excessive for several months, it’s important to have a doctor check the person out.
Medication, Chronic Illness and Physical Damage
Some medications can trigger shedding, including certain antidepressants, retinoids, anticoagulants and blood pressure drugs. Never stop a medication without medical advice. Digestive disorders that interfere with nutrient absorption, and some chronic systemic illnesses, can also affect hair. So can physical damage: traction alopecia from tight hairstyles, harsh chemical treatments and repeated pulling. Trichotillomania, a recurrent urge to pull out hair, is another cause that deserves a compassionate response. A doctor or pharmacist can help judge whether a prescription is a plausible contributor.
What the Pattern of Hair Loss Might Tell You
Doctors distinguish temporary shedding, hair breakage, follicular miniaturisation (follicles gradually shrinking) and permanent follicle destruction. The pattern offers clues.
These are clues, not diagnoses, and more than one cause can coexist.
When Hair Loss Might Be a Sign of Something Bigger
If there are other physical changes or symptoms such as weakness, loss of weight, digestive or joint pain, and/or unusual rashes, then a medical investigation may be warranted. Your dermatologist will test your scalp, review your medical history and, if clinically indicated, perform tests such as a complete blood count (CBC), ferritin, and thyroid function. Tests should be selected based on your past and present symptoms, rather than used as a ‘tick list’ for everyone. It is very important to be assessed early if there is balding or if the skin appears to be scarred.
Stop Asking Only How to Stop It
Persistent hair loss can mean very different things: temporary shedding that resolves, progressive follicular miniaturisation, or permanent scarring. Each calls for a different response, and several can coexist. Hair loss in young men is often assumed to be purely genetic, but that assumption can hide causes worth investigating, and it can cost months and money on products never aimed at the real problem.
Frequently Asked Questions
Can hair loss in men in their 20s have causes other than genetics?
Yes. Male-pattern hair loss is common, but shedding can also come from thyroid problems, iron or other nutritional deficiencies, scalp conditions, autoimmune disease, medications, or physical stress. Several causes can occur together.
How long after illness or stress does shedding start?
In telogen effluvium, shedding typically begins about two to four months after the trigger. It is usually temporary, with gradual regrowth once the trigger has settled.
Do I need blood tests if my hair is falling?
Not automatically. A doctor decides based on your history, symptoms and scalp examination. Tests such as CBC, ferritin or thyroid function are used when they are clinically relevant.
This article is for general education and does not replace professional medical advice, diagnosis or treatment. See a doctor or dermatologist about persistent hair loss.
References
- Cleveland Clinic Journal of Medicine. Shedding: an updated guide to a common cause of hair loss. 2026;93(10):616-622. ccjm.org
- Cleveland Clinic Journal of Medicine. Diffuse hair loss: its triggers and management. 2009;76(6):361-367. mdedge.com
- Harvard Health Publishing. Hair loss A to Z. health.harvard.edu
- American Academy of Dermatology. Hair loss resources. aad.org
- DermNet. Hair loss and alopecia topics. dermnetnz.org
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