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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Photo and video assessment, prescription when appropriate.
- Alopecia is an umbrella term: pattern loss, alopecia areata, telogen effluvium and scarring types behave differently, and scalp photos plus history usually tell them apart.
- Call 112 only if a treatment triggers signs of a severe allergic reaction: swelling of the face, lips or throat, or difficulty breathing.
- Losing up to around 100 hairs a day is normal, because each follicle cycles through growth, rest and shedding independently.
- Sudden patchy loss (alopecia areata) often regrows within a year, which changes how aggressively it is treated.
Most hair loss can wait for a routine appointment. Book promptly rather than eventually if you have bare patches that are red, scaly, sore or pustular, or patches where the skin looks shiny and smooth with the follicle openings gone: possible scarring alopecia destroys follicles permanently, and early dermatology referral protects the hair you still have. Hair loss alongside fever, weight change or feeling unwell needs in-person assessment of the underlying illness, not a hair consultation.
Can an online doctor diagnose hair loss?
Often, yes. Clear scalp photographs plus a structured history can often provide enough information to distinguish the common causes of hair loss: pattern thinning, post-trigger shedding (telogen effluvium) and patchy alopecia areata each have a recognisable presentation.[1] Patchy, inflamed or possibly scarring types still need in-person dermatology, and the doctor tells you plainly when yours does. Treatment availability varies by country.
How an online consultation helps with alopecia
? Before your appointment, photograph your scalp in bright natural light: the top of the head from above, the parting or any patch close up, your hairline, and the back of the head (a mirror or a second person helps). Dry, product-free hair shows density honestly. Our guide to photographing a skin problem for an online doctor applies to scalps too.
? Before your appointment, photograph your scalp in bright natural light: the top of the head from above, the parting or any patch close up, your hairline, and the back of the head (a mirror or a second person helps). Dry, product-free hair shows density honestly. Our guide to photographing a skin problem for an online doctor applies to scalps too.
The treatment for pattern loss is useless for areata, and vice versa. The consultation exists to put the right name on your hair loss before anyone discusses products.
Where hair is missing tells the story: temples and crown, a widening parting, discrete round patches, or thinning everywhere. Good photos let the doctor read that map properly.
Diffuse shedding gets trigger-hunting and, when indicated, iron and thyroid tests arranged locally; pattern loss gets a treatment conversation; patches get a referral done properly.
Some alopecia recovers by itself, some responds to treatment, some needs a specialist quickly. You leave knowing which category you are in, not with a generic serum recommendation.
How much hair shedding is normal?
Losing up to around 100 hairs a day is normal. Each follicle cycles independently through growth (which lasts years), a brief transition, and a resting phase ending in shedding, so a scattering of hairs on the pillow, brush and shower drain is the system working, not failing.[1] Shedding becomes worth assessing when it clearly increases for weeks, when hair comes out in clumps or patches, or when overall density visibly drops. One practical benchmark: noticeably more hairs in the plughole every wash for over a month, or a ponytail that has lost real thickness, says assess; a bad hair day says nothing.
What are the main types of alopecia?
Four groups cover most hair loss, and they differ in cause, urgency and treatment:
- Pattern hair loss (androgenetic alopecia): gradual, hormone-driven thinning; temples and crown in men, a widening parting in women. The most common type by far, with evidence-based treatment available.[5]
- Telogen effluvium: sudden diffuse shedding across the whole scalp, typically two to three months after a trigger such as illness, childbirth, surgery, crash dieting or major stress. Usually recovers once the trigger has passed.[2]
- Alopecia areata: an autoimmune condition causing round, smooth bare patches, sometimes affecting nails; it can progress or regrow unpredictably and is a dermatology-led diagnosis.[3]
- Scarring (cicatricial) alopecias: inflammation destroys follicles permanently, leaving shiny patches without follicle openings, often with redness, scaling or soreness. These need prompt specialist care.
- Also worth naming: traction alopecia from years of tight hairstyles, and fungal scalp infection (tinea capitis), common in children, which needs confirmed diagnosis and prescription antifungal treatment.
Pattern loss: the everyday majority
Most hair loss that brings adults to a doctor is androgenetic: genetically sensitive follicles miniaturise under hormonal influence over years. It is gradual, symmetrical and spares the back of the head, and it has dedicated pages here for the male and female versions, because staging scales and treatment options differ. If your photos and history point this way, the consultation continues into an honest treatment discussion: minoxidil for most, finasteride where appropriate for men, reviewed against comparison photos at realistic intervals.[4][5]
Telogen effluvium: the great impostor
The alarming version of hair loss, handfuls in the shower, is usually the most benign. A significant physical or emotional event pushes a wave of follicles into their resting phase together, and the shed arrives two to three months later, long enough after the trigger that most people never connect the two. The history question that solves it: what happened around three months before the shedding started? Fever, COVID or another illness, an operation, childbirth, rapid weight loss, a bereavement. Recovery is the norm over 6–12 months once the trigger has passed, though iron deficiency and thyroid problems can sustain shedding and are worth testing for when the story fits.[2]
Alopecia areata and scarring types: where dermatology takes over
Alopecia areata is an autoimmune attack on follicles: hair falls in defined round patches with otherwise normal skin, and short broken exclamation-mark hairs at the edges are characteristic. Around half of people with limited patches regrow within a year without treatment, but relapse is common and extensive forms exist, so diagnosis and treatment planning belong with a dermatologist; treatments range from potent topical and injected steroids to newer specialist-initiated immune treatments for severe disease.[3] Scarring alopecias are rarer and more urgent: because destroyed follicles never regrow, redness, scaling, soreness or shiny follicle-free patches justify a prompt referral, not a wait-and-see plan. In both cases, the value of the online consultation is speed of recognition and a proper referral letter, not treatment promises.
Which type of hair loss fits your picture?
This is the decision framework our doctors use in hair loss consultations:
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Gradual, symmetrical thinning: temples and crown, or a widening parting | Pattern loss pathway: staging from photos, evidence-based treatment discussion | Usually yes | If photos and history leave genuine diagnostic doubt |
| Sudden diffuse shedding, roughly 2–3 months after illness, childbirth, surgery or major stress | Telogen effluvium work-up: trigger review; iron and thyroid tests locally when indicated | Often yes | Shedding beyond 6–12 months, or no trigger found, warrants examination |
| Round, smooth bare patches, skin otherwise normal | Likely alopecia areata: initial assessment and dermatology referral | Initial assessment only | Dermatology confirms and leads treatment, especially if patches spread |
| Patches with redness, scale, pustules, soreness, or shiny skin without follicle openings | Possible scarring alopecia or scalp infection: prompt referral | Recognition and referral only | Promptly, because scarring loss is permanent once established |
| Child with a scaly patch and broken hairs | Possible tinea capitis: needs confirmation and prescription antifungals | Initial assessment only | In-person confirmation; household checks often needed |
Availability of individual medicines and who may prescribe them vary by country; your doctor confirms what applies where you are.
Not sure which type of hair loss is yours? A doctor can tell you in one consultation. €47, exact price shown before payment.
See available times →What the doctor checks in an online hair loss consultation
The assessment is structured around separating the types, because the types decide everything:
- The distribution in your photos: patterned, diffuse or patchy, and whether the back of the head is spared, the single most informative observation.
- Onset and pace: years of slow change reads as pattern loss; weeks of heavy shedding points to telogen effluvium; discrete patches appearing over days to weeks suggest areata.
- The three-months-ago question: illness, fever, childbirth, operations, crash diets, new medicines or major stress preceding a shed.
- Scalp symptoms: itch, burning, scale, pustules or soreness, which move the assessment towards infection or scarring types and towards examination.
- Medicines and health background: drugs associated with shedding (some anticoagulants, retinoids, beta blockers and others), thyroid symptoms, iron-deficiency risks including heavy periods and restrictive diets, and family history of pattern loss.
- Hair practices: tight braids, extensions, relaxers and heat, which produce traction damage with its own telltale edge pattern.
- Impact on you: hair loss carries genuine psychological weight, and how much it is affecting you legitimately shapes how actively to treat.
Treatment options for hair loss (alopecia)
What you can do yourself
Whatever the type, handle thinning hair gently: loosen tight styles, cut back heat and chemical processing, and treat wet hair kindly. Eat enough protein and iron; crash diets are a classic shedding trigger. Ignore the supplement aisle unless a deficiency is actually found; biotin and vitamin blends do not change hormone-driven or autoimmune hair loss.[1] For pattern thinning, over-the-counter minoxidil is the evidence-based self-start option in many countries, used consistently for months, not weeks. And cosmetic honesty: fibres, concealing sprays, clever cuts and wigs are legitimate tools, not defeat.
Prescription treatment
A prescription is never issued without a consultation, and for alopecia the prescription depends entirely on the diagnosis. Confirmed pattern loss opens the evidence-based options discussed on our dedicated pages: minoxidil for men and women, finasteride for men, judged over 6–12 months.[4] Telogen effluvium is treated by fixing the trigger, correcting any iron or thyroid abnormality found, and time; prescriptions play a small role. Alopecia areata treatment is dermatology-led, from potent topical steroids to specialist-initiated options for extensive disease, and scarring alopecias need specialist anti-inflammatory treatment started early. Tinea capitis needs prescription oral antifungal treatment after the diagnosis is confirmed. Prescribing rules vary by country; your doctor confirms what applies to you.
When we assess alopecia online, and when we refer you
We assess and treat online: pattern hair loss in men and women, through to prescription and photo-based reviews on the male pattern baldness and female pattern baldness pathways; telogen effluvium, including trigger review and locally arranged blood tests; traction-related loss, with practical styling advice; and second opinions when a clinic or influencer has sold you certainty the evidence does not support.
We refer or redirect you: suspected alopecia areata goes to dermatology for confirmation and treatment planning, with the online assessment buying you a faster, better-aimed referral; anything suggesting scarring alopecia is referred promptly, because follicles lost to scarring do not return; suspected tinea capitis needs in-person confirmation before oral treatment; and shedding that comes with systemic symptoms, or resists explanation after work-up, earns an examination rather than another remote opinion.
When to get in-person care
Hair loss itself is almost never an emergency. Call 112 only if a treatment triggers signs of a severe allergic reaction: swelling of the face, lips or throat, or difficulty breathing. See a doctor promptly in person if hair loss comes with fever, drenching sweats, unexplained weight change or feeling generally unwell, or if a bald patch is painful, boggy or discharging.
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Listen · 23 Feb 2026 →How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm, often the same day, with the exact price, €47, shown before you pay.
- Upload your scalp photos, then speak to a licensed doctor: a private video consultation, from anywhere in Europe.
- Leave with a named likely diagnosis and a plan: treatment, tests, or a well-aimed referral. If we can’t help you online, you get a full refund.
Frequently asked questions about hair loss (alopecia)
Can an online doctor really tell what type of hair loss I have?
Usually, yes: the common types of hair loss have recognisable patterns, gradual patterned thinning, diffuse shedding after a trigger, or discrete round patches. Good photos plus a careful history separate them in most cases. Where genuine doubt remains, or the scalp itself looks inflamed or scarred, the doctor says so and refers you for examination instead of guessing.
How much does a hair loss consultation cost, and how fast can I be seen?
A video consultation costs €47. The exact price is shown before payment, and there is no subscription. Appointments are available daily from 7am to 11pm, often the same day; upload your photos when you book so the doctor can review them before the call.
How many hairs a day is it normal to lose?
Up to around 100 hairs a day is normal shedding from a healthy scalp. Assessment is worth it when shedding clearly increases for weeks, hair comes out in clumps or patches, or overall thickness visibly drops, and photos comparing months apart beat daily plughole counts.
Will the bald patches of alopecia areata grow back?
Often, yes: with limited patches, around half of people regrow within a year even without treatment. But the course is unpredictable, relapses are common and extensive forms exist, which is why areata is confirmed and managed by a dermatologist rather than treated on spec online.
Can stress really make your hair fall out?
Yes, through telogen effluvium: a major stress, illness, operation or childbirth pushes many follicles into their resting phase at once, and the shed arrives two to three months later. It usually recovers over 6–12 months once the trigger has passed, which is genuine reassurance most sufferers never get told.
Do I need blood tests for hair loss?
Sometimes. For diffuse shedding, iron studies and thyroid function are the usual checks, arranged at a laboratory near you when your history suggests them. Testing everything as a routine is not evidence-based; testing what the history points to is.
Which hair loss treatments actually work?
The treatments that work depend entirely on the type of hair loss: pattern loss has evidence-based medicines, minoxidil, and finasteride for men. Telogen effluvium recovers by treating the trigger and waiting. Areata and scarring types need dermatology-led treatment. Supplements, laser combs and caffeine shampoos are marketed far beyond their evidence for all of them.
- Hair loss, DermNet New Zealand Trust, accessed August 2026.
- Telogen effluvium, DermNet New Zealand Trust, accessed August 2026.
- Alopecia areata: Clinical Knowledge Summary, NICE, National Institute for Health and Care Excellence, accessed August 2026.
- Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men, short version, European Dermatology Forum, published with the EADV in the Journal of the European Academy of Dermatology and Venereology, 2018.
- Male pattern hair loss (androgenetic alopecia), DermNet New Zealand Trust, updated 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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Listen · 23 Feb 2026 →Speak to a doctor about alopecia today
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