Diagnostic-first approach — checking thyroid, ferritin, vitamin D, PCOS — before any procedure. Targeted treatment by Dr. Reena Sharma, MD Dermatology.
Female hair loss almost always has multiple drivers stacked — telogen effluvium from a stressor, plus iron deficiency, plus thyroid imbalance, plus genetic pattern. Treating only one (e.g., jumping to PRP) misses the others. We start with bloodwork.
Diagnostic bloods we order
CBC, ferritin, vitamin D3, B12
TSH, free T3, free T4 (thyroid panel)
For PCOS suspicion: free testosterone, DHEA-S, fasting insulin, AMH
ANA if autoimmune suspected
Treatment based on findings
Iron deficiency: oral iron + vitamin C, retest at 3 months
Common drivers in women: post-pregnancy/post-COVID telogen effluvium, iron deficiency, thyroid imbalance, vitamin D deficiency, PCOS, severe stress, crash dieting, female-pattern hair loss. Often multiple drivers. Bloodwork is the starting point.
Is female-pattern hair loss the same as male?
Same underlying mechanism (androgenetic) but pattern differs — diffuse thinning at parting and crown rather than temple recession. Treatment overlaps but anti-androgens used in women (spironolactone) differ from finasteride in men.
Will my hair grow back after pregnancy?
Postpartum telogen effluvium typically resolves at 6 to 9 months postpartum. If shedding continues past 12 months, we investigate other drivers (iron, thyroid, vitamin D).
Can I take finasteride?
Generally no for women of childbearing age (teratogenic). Spironolactone, oral minoxidil, or topical anti-androgens are safer alternatives. We discuss based on your specific situation.
Are hair vitamins worth it?
Only if you are deficient. Random multivitamins do not help non-deficient women. Test first, supplement only what is low.
When should I see a doctor?
Sudden noticeable shedding, more than 200 strands a day, visible scalp through parting, family history of female-pattern hair loss, or hair fall lasting over 3 months. Early intervention = better outcome.
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