Q. How to treat and prevent asymmetrical hair loss on the scalp?

Answered by
Dr. Sandhya Narayanan Kutty
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 08, 2022 and last reviewed on: Nov 15, 2022

Hello doctor,

I have a query on asymmetrical hair loss on my head. My family has no history of hair loss, and this seems highly unusual.

I urgently need a feedback.



Welcome to

I understand your concern.

The report and image attached (attachment removed to protect the patient's identity) appears to be unpatterned hair loss or androgenetic alopecia, which may also lead to asymmetrical hair loss on one side of the scalp initially and may cause hair loss on the other areas subsequently. In some situations, it may lead to diffuse unpatterned hair loss affecting the other parts of the scalp. Telogen effluvium also sometimes leads to asymmetrical hair loss or hair loss in a diffuse pattern around the scalp due to any stressful condition undergone by the body post-viral infection, including COVID-19 infection, chicken pox, or any surgeries which cause the body to undergo stress. However, due to hair loss being temporary and reversible with the proper medication and procedures, hair regrowth may be stimulated. Hair loss mainly occurs due to multiple factors, including genetic factors; genetic susceptibility is passed on from the maternal end, including maternal uncles or siblings or ancestors; other factors include dietary factors, hormonal fluctuations, including androgenetic alopecia where male androgen hormone is imbalanced, due to fungal infections while wearing helmets, caps and spread from an infected individual while sharing belongings, due to dandruff or seborrheic dermatitis, vitamin deficiencies, hair procedures or treatments including smoothening, straightening, creams, gels or hair colors. As mentioned above, stress may also be an essential factor contributing to hair loss. In the absence of a genetic or family history of the same, the most probable cause, as mentioned, would be androgenetic alopecia due to androgen hormone fluctuations.

I would like to suggest on the following:

1. I suggest you to take all these tests such as complete blood count, hemoglobin, serum ferritin, iron, zinc, vitamin D3, vitamin B12, DHEAS (Dehydroepiandrosterone), thyroid function test, and ANA (anti-nuclear antibody) tests. These tests help diagnose any vitamin deficiencies and hormonal imbalances that may require additional treatment as supplements if present.

2. Multivitamin tablet once daily at night after dinner for two months. These tablets help in hair growth and reduce hair fall. They should only be started after providing blood samples for testing since starting the medication and then providing the blood samples may cause the actual readings of parameters to show false values.

3. Minoxidil 5 % and Finasteride 0.1 % of 5 percent solution to be applied on the area of hair loss in 1 ml quantity at night on a clean, dry scalp. Massage into the scalp and keep overnight. Wash off in the morning. Minoxidil with Finasteride helps increase blood supply and circulation to the hair follicles, stimulating their growth. However, they need to be used for years to show changes. Initially to be started once daily for one year, then reduced to six times per week for the next year, then five times per week the following year, and so on. They should not be abruptly stopped as they may lead to sudden cut off of blood supply to hair follicles leading to their loss. Therefore slowly tapering down of the solution each year is the way to go to let your scalp get accustomed to the solution. Oral Finasteride is not required as the solution is more helpful.

Avoid usage in case of migraine, seizures, significant medical conditions, and history of allergies.

4. Procedures including platelet-rich plasma (PRP), growth factor concentrate treatment (GFC), and mesotherapy done once a month may help stimulate hair growth. PRP and GFC are injectables done on the scalp superficially using one's blood revolved in a centrifugal machine to extract growth factors helping to stimulate hair growth. Mesotherapy is injections of vitamins done similarly to stimulate hair growth. Kindly consult a dermatologist for undergoing the procedure.

5. Avoid oily food, sweets, dairy products, and red meat. Make sure to include protein, like eggs, in your diet.

6. Ensure hydration with at least 13 glasses of water a day.

7. Laser techniques are also helpful in sessions of at least three times every four weeks. They help with hair regrowth stimulation. However, they may be relatively expensive and are done at a dermatologist's clinic.

8. Hair transplant procedures are also available in the absence of follicles for stimulation, where new follicles may be transplanted to the frontal area of your scalp after extracting grafts from the occipital area of the scalp. This procedure may be avoided if follicles are present and only needs stimulation via the above procedures mentioned.

Kindly follow up with the reports for further assessment and management.

Hope the details were informative and provided clarity.

I hope it will help.

Hi doctor,

Thank you for the reply.

I appreciate your feedback. My maternal grandfather did lose a bit of hair, but only on the front of his head, and even in his mid-80s, he still has hair. My dad has very thick hair, which I also had. I can 100 % assure you that nobody in my family has the same history as mine, which means it is improbable that it is genetic.



Welcome back to

I understand your concern.

As you mentioned, the absence of genetic susceptibility, the cause may be due to hormonal imbalances or other underlying conditions, including stress or vitamin or mineral deficiencies.

The blood tests will help diagnose any vitamin and hormonal fluctuations.

The medications and procedures mentioned will also help with hair restoration with hair follicle stimulation. Hope they help you regain hair growth soon.

Kindly follow up with the reports for further management options depending on the findings in the report. I would be happy to help.

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