Hair & Scalp Condition · Kensington, London

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Hair Loss and Scalp Problems: Types, Causes and How They Are Diagnosed

Name: Faciem Dermatology & Medical Clinic
Price range: $$$

Hair loss is not one condition but several, and the type decides the treatment. Male and female pattern loss, alopecia areata, telogen effluvium and the scarring alopecias each thin the hair in a recognisable way, so examination of the scalp comes before any prescription. Dr Prasad diagnoses hair and scalp problems at our Kensington clinic.

This page describes how hair loss and scalp problems are assessed at Faciem, and is checked for clinical accuracy.
Last reviewed: 15 September 2026.
Patient information only. Hair loss cannot be diagnosed from a photograph, and treatment follows a face-to-face consultation and examination of the scalp with Dr Prasad.

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TL;DR

Hair loss is not one condition. Pattern hair loss thins gradually along a predictable distribution, alopecia areata produces smooth round patches, telogen effluvium causes diffuse shedding a few months after a trigger, and the scarring alopecias destroy the follicle itself. That distinction decides everything: non-scarring types can often be improved, while a follicle lost to scarring does not come back, so an early diagnosis changes the outcome. Hair and scalp assessment is available at Faciem Dermatology & Medical Clinic on Kensington Church St, London, led by Dr Prasad, a GMC-registered doctor, and usually involves scalp examination, dermoscopy and blood tests. The hair cycle is slow: change is judged at two to three months, not weeks.

About the Condition

What Is Hair Loss?

Hair loss is a reduction in the density, thickness or coverage of hair, and it happens through several separate mechanisms. Follicles can miniaturise gradually, shed early in large numbers, be attacked by the immune system, or be destroyed by inflammation and replaced with scar tissue. Scalp problems such as eczema, seborrhoeic dermatitis and folliculitis sit alongside these and are treated in their own right. Each pattern points to a different diagnosis and a different treatment.

The main types of hair loss and how each presents

Male pattern hair loss recedes at the temples and thins over the crown, while female pattern hair loss widens the central parting and thins diffusely over the top, with the frontal hairline usually preserved. Alopecia areata causes smooth, round, completely bald patches that appear over a few weeks, sometimes in the beard or eyebrows, with normal-looking skin underneath. Telogen effluvium is diffuse shedding that begins two to three months after a trigger such as illness, surgery, childbirth or severe stress; people notice handfuls of hair in the shower, not a bald area. Scarring alopecias, including lichen planopilaris and frontal fibrosing alopecia, destroy the follicle and leave smooth, shiny skin with no visible follicle openings, often after weeks or months of itching, burning or tenderness. Inflammatory scalp conditions such as seborrhoeic dermatitis and folliculitis are separate again, and can coexist with any of them.

Who tends to get hair loss

Pattern hair loss is the most common form, affects both sexes, becomes more likely with age, and a family history on either side raises the chance of it. Alopecia areata often starts in childhood or young adulthood and is more common in people with thyroid disease, vitiligo, eczema or a family history of autoimmune conditions. Telogen effluvium can affect anyone after a sufficient trigger and is particularly common in the months following childbirth or a significant illness. Frontal fibrosing alopecia, a scarring type, is seen mainly in women after the menopause and often takes the eyebrows with it. Traction alopecia follows years of tight braids, weaves and extensions, disproportionately affects women with textured hair, and is often mistaken for pattern loss.

What hair loss is often confused with

Hair loss is frequently put down to stress when something else is happening, and the delay costs most in the scarring types. Telogen effluvium is the shedding people expect after stress, but it settles within months, so loss that continues beyond that points elsewhere. Early scarring alopecia is regularly mistaken for pattern hair loss, particularly when the hairline is receding, yet the loss of follicle openings and a tender or itchy scalp distinguish it. Untreated scalp eczema and seborrhoeic dermatitis cause flaking and some shedding without destroying follicles. In children, fungal infection of the scalp causes patchy loss with scaling and needs oral treatment, not creams. Shedding and thinning are also confused with each other: shedding means more hairs leaving the scalp than usual, while thinning means the hairs still there are growing finer. The two have different causes and different treatments.

Causes & Contributing Factors

What Causes Hair Loss?

Hair loss has several separate causes, and more than one can operate at the same time in the same person. Each leaves a recognisably different pattern on the scalp, which is what an examination is looking for.

Inherited sensitivity to androgens

In pattern hair loss the follicles inherit a sensitivity to circulating androgens, and each hair cycle produces a finer, shorter hair until the follicle stops producing a visible one. The tendency comes down either side of the family.

Autoimmune attack on the follicle

In alopecia areata the immune system targets the hair follicle, causing hair to fall in discrete round patches. The follicle survives, which is why regrowth is possible, though the course is unpredictable and relapses are common.

Disruption of the hair cycle

Illness, high fever, surgery, childbirth, rapid weight loss and severe emotional stress can push large numbers of follicles into the shedding phase at once. The shedding typically starts two to three months after the event and usually recovers.

Nutritional, hormonal and medical factors

Low iron stores, thyroid disease, poorly controlled diabetes, polycystic ovary syndrome and some medicines all affect hair growth. Blood tests exclude them, because correcting a medical cause can improve hair where nothing applied to the scalp would.

Inflammation that scars the follicle

In the scarring alopecias, inflammation destroys the follicle and replaces it with fibrous tissue, so loss in that area becomes irreversible. Itching, burning, tenderness or redness of the scalp are the warning signs, and early treatment aims to halt progression.

Treatments We Offer

How Hair and Scalp Problems Are Treated at Faciem

Treatment for hair and scalp problems starts with the diagnosis, because what helps one type does nothing for another. The order is deliberate: slow or stop further loss first, encourage regrowth where the follicle is still intact, and settle any inflammation on the scalp alongside both.

Dermatology Consultation

A full history, examination of the scalp and dermoscopy establish the pattern, supported by blood tests where a medical cause is possible. If the diagnosis remains unclear, or a scarring type is suspected, a small punch biopsy taken under local anaesthetic and sent for laboratory histology settles it.

Best for: establishing which type of hair loss you have

Read about Dermatology Consultation

Prescribed and In-Clinic Treatment

Depending on the type, treatment may involve prescribed lotions, foams or tablets, treatment of scalp inflammation, or injected treatment for patchy loss. Platelet-rich plasma and scalp mesotherapy are discussed where the diagnosis makes them a reasonable option.

Best for: acting once the type of loss is known

Read about Prescribed and In-Clinic Treatment

Scalp and Skin Care

The scalp is skin, and flaking, itching and inflammation need managing whatever the underlying diagnosis. A suitable regime settles irritation and makes it far easier to judge whether hair-directed treatment is doing anything.

Best for: flaking, itching and inflamed scalps

Read about Scalp and Skin Care

Where a follicle has been destroyed, no medical treatment restores it; surgical hair restoration or a high-quality hairpiece may be the sensible route, and referral can be arranged. Timescales are long: change in the hair itself usually takes two to three months to show, while scalp eczema or infection often responds within a few weeks, and how much improvement follows differs from person to person. Suitability is decided at a face-to-face consultation with Dr Prasad.

When to Seek Medical Advice

When Should You See a Doctor About Hair Loss?

See a doctor about hair loss early, without waiting to find out whether it settles, because the types that respond best to treatment are also the ones doing the most damage while untreated. A scalp that itches, burns or feels tender alongside the loss is a particular reason not to delay.

Worth getting checked

Conditions that can look similar

Thyroid disease, iron deficiency, polycystic ovary syndrome and some medicines all cause hair loss and are identified by blood tests, not by the appearance of the scalp. Fungal scalp infection, trichotillomania and traction from tight styling each have a distinct look, and firm bumps or raised scarring at the nape and beard line can destroy follicles in the same way a scarring alopecia does. Any scalp change that is spreading, bleeding, ulcerating or simply not settling should be seen in person, and the loss of visible follicle openings needs assessing promptly, because that change cannot be undone.

Self-Care & Prevention

Caring for Your Hair and Scalp Between Appointments

Home measures will not treat pattern hair loss or alopecia areata, but they protect the hair you still have and stop avoidable damage adding to the problem. Gentle handling and control of scalp inflammation are what make the difference.

Do

Detangle with a wide-toothed comb from the ends up, and let hair dry for 10 minutes before brushing
Wash at least twice a week — washing does not cause hair loss and settles an inflamed scalp
Photograph the same areas of scalp every 4 weeks in the same light, since change takes two to three months to show
Eat protein at every meal and iron-containing food daily through the six to nine months a shedding phase takes to settle

Avoid

Tight braids, weaves, extensions and ponytails — leave the hairline at least 4 weeks free between protective styles
Chemical relaxing or bleaching more often than every 8 to 12 weeks, and daily high-heat styling on fragile hair
High-dose supplements taken without a blood test — stop biotin at least 3 days before any test, as it distorts thyroid results
Assuming it is stress: shedding still going on 6 months after a trigger, or any scalp pain or itch, needs examining

This is general guidance and does not replace individual assessment. What helps depends entirely on which type of hair loss is present, and some types need treating within months, not years.

Why Patients Choose Faciem

The Diagnosis Comes First

Hair loss is where a wrong assumption costs the most. Treatments for pattern loss do nothing for a scarring alopecia, and the months spent trying them are months in which follicles are lost for good.

Experience & Expertise

Why Hair Loss Needs a Diagnosis Before Treatment

Hair loss is one of the few dermatological problems where delay changes what is possible. Non-scarring types such as pattern hair loss, alopecia areata and telogen effluvium leave the follicle intact, so hair can regrow. Scarring alopecias destroy it, and once the follicle openings have disappeared from an area, treatment can only protect what is left. Separating the two is a clinical judgement made by examining the scalp, supported by dermoscopy and, where the picture is unclear, a small punch biopsy taken under local anaesthetic and sent for laboratory analysis. Dr Prasad also looks for the medical causes that no scalp treatment addresses, thyroid disease and low iron stores among them.

Dr Anamica Prasad — MBChB (1999), Dip Dermatology (2001), MRCGP, DFFP, DRCOG · a GMC-registered doctor
Member of the Joint Council for Cosmetic Practitioners (JCCP), British Medical Laser Association (BMLA), Royal Society of Medicine and the Aesthetic Complications Group
Clinic operated by Derma Medical UK Ltd, registered with the Care Quality Commission for diagnostic and screening procedures, surgical procedures, and treatment of disease, disorder or injury · CQC Location ID 1-25573003746
Scalp examination with dermoscopy and, where needed, biopsy and blood tests
20 years’ experience in dermatology, including hair and scalp disorders

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Hair Loss FAQs

Your Questions, Answered

The hair and scalp questions that come up most in clinic, answered here. Anything specific to your own scalp is covered at your appointment.

Can hair loss be treated while pregnant or breastfeeding?

Hair loss can be assessed during pregnancy and breastfeeding, but the treatment options narrow, because several of the standard prescribed treatments for pattern hair loss are not used at either time. Tell Dr Prasad if you are pregnant, trying to conceive or breastfeeding. Shedding after a birth is usually telogen effluvium: it begins two to three months after delivery and settles within six to nine months, so blood tests for iron and thyroid, plus gentle handling of the hair, are often all that is needed until then.

Will hair grow back after hair loss?

That depends on the type of hair loss. Shedding after illness, childbirth or stress — telogen effluvium — usually recovers within six to nine months once the trigger has passed. Alopecia areata often regrows, although it can relapse. Pattern hair loss tends to progress slowly if it is left alone. Where a scarring alopecia has destroyed the follicle, hair does not return to that area.

Can hair loss treatments be combined with each other?

Hair loss treatments are often combined, once the diagnosis is known. A prescribed topical or oral treatment for pattern loss can run alongside treatment for scalp inflammation, and injected treatment may be added where the diagnosis supports it. The order and the timescale are what matter: usually one change is made at a time and reviewed at two to three months, because starting three things together makes it impossible to tell which is working.

How is hair loss diagnosed?

Hair loss is diagnosed by history and examination, never from a photograph. Dr Prasad asks about triggers, medicines and family history, examines the scalp with dermoscopy, and arranges blood tests where thyroid, iron or hormonal causes are possible. If the picture is unclear or a scarring alopecia is suspected, a small punch biopsy of the scalp is taken under local anaesthetic and sent for laboratory histology.

How long does hair loss treatment take to work?

Allow two to three months before any change in the hair itself becomes visible, because the hair cycle is slow and scalp health returns more slowly than skin does. Scalp eczema or infection is the exception and often settles within a few weeks of treatment. How much improvement follows differs between individuals.

Does PRP help with hair loss?

Platelet-rich plasma, or PRP, concentrates growth factors from a sample of your own blood and injects them into the scalp. The evidence in hair loss is emerging rather than settled, so PRP is discussed only where the diagnosis makes it a reasonable option, as is scalp mesotherapy. Neither replaces identifying the type of loss first, and neither helps a follicle that has already scarred.

What determines the cost of hair loss treatment?

Three things: the consultation itself, whether investigations such as blood tests or a scalp biopsy are needed, and which treatment the diagnosis calls for. Hair conditions are followed over months, so review appointments form part of the plan. Consultation fees are published on our private doctor appointments page; anything beyond that is confirmed once your scalp has been examined.

Sources & Further Reading

Hair loss — NHS
Frontal fibrosing alopecia patient information leaflet — British Association of Dermatologists
Alopecia areata — DermNet NZ

These are general sources of patient information and do not replace individual medical assessment. Which type of hair loss you have, and what can be done about it, is established at consultation.

Hair Loss in Kensington, London

A Doctor-Led Clinic in the Heart of Kensington

Kensington Church St puts the clinic between two Underground stations: High Street Kensington is a few minutes’ walk, Notting Hill Gate around ten, and there is council underground parking close by. That makes it a short trip from Chelsea, South Kensington, Holland Park and much of West London. Because hair is followed over months, the review appointments matter as much as the first one — Faciem Dermatology & Medical Clinic is open Monday to Saturday, 10am–7pm, and closed on Sunday.

Plan Your Visit

Faciem Dermatology & Medical Clinic
Phone: +44 20 7131 3539
7 Kensington Church St, London W8 4LF, United Kingdom
Tube: High Street Kensington (few minutes’ walk) · Notting Hill Gate (~10 minutes)
Parking: Kensington council underground car park nearby
Open Monday–Saturday, 10am–7pm · Sunday closed
Hair and scalp consultations bookable online; reviews arranged once the diagnosis is known
Consultation-first — no treatment without medical assessment
Serving Kensington, Chelsea, Notting Hill & Central London

Continue Exploring

Related Conditions & Treatments

Eczema & Dry Skin

Scalp eczema and seborrhoeic dermatitis flake, itch and shed without scarring the follicle — and respond faster than hair loss does.

Keloid & Raised Scarring

Firm raised scars at the nape and beard line, where inflammation can destroy follicles if it is left to run.

Ingrowing Hair

Painful bumps in the beard and along the scalp margin caused by hairs curling back into the skin after shaving.

Faciem Dermatology & Medical Clinic · Kensington

Find Out Which Type of Hair Loss You Have

Book a consultation with Dr Prasad for examination of the scalp, dermoscopy and any blood tests needed, so treatment is matched to the diagnosis instead of guessed at.

Prefer to talk? +44 20 7131 3539

Monday – Saturday	10am – 7pm
Sunday	Closed