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Hair Loss

Hair loss, medically known as alopecia, affects millions of people. Androgenetic alopecia, or hereditary hair loss, is by far the most common form, affecting an estimated 80 million people in the United States. Inherited genes cause hair follicles to miniaturize until they stop producing a visible hair shaft. Men usually notice a receding hairline and thinning at the crown, while women more often develop diffuse thinning or a widening part. Hair loss can begin in the teens, although onset is more common later in life. At Wall Street Dermatology, the first appointment is diagnostic before it is anything else. Hereditary thinning, telogen effluvium after a stressor, thyroid disease, and traction from styling can look similar at a glance, yet they respond to different treatment. Dr. Julia Tzu also offers scalp mesotherapy, which places minoxidil, dutasteride, or both directly into the scalp.

4 min read·Last updated: 2026-02-08·Reviewed by Dr. Julia Tzu, MD, FAAD, FACMS

At a Glance

  • Androgenetic alopecia affects an estimated 80 million people in the United States[1]
  • Early treatment can help prevent hair follicles from shrinking, making restoration more effective[6]
  • Minoxidil has been shown to reduce hair loss, stimulate hair growth, and strengthen existing hair[1]
  • Female pattern baldness is often reversible with treatment including medications and laser therapy[2]

What are the symptoms of Hair Loss?

  • Gradual thinning on top of head
  • Receding hairline (common in men)
  • Widening part (common in women)
  • Circular or patchy bald spots
  • Increased hair shedding
  • Smaller, finer hair strands over time
  • Bald spot at crown of head (men)
  • Overall decreased hair density

When should you seek care for Hair Loss?

  • Shedding clearly heavier than it was, particularly when it is measurable in the shower or on a pillow
  • A hairline that sits further back than it did, or a part that keeps getting wider
  • Patchy loss, or loss that arrived suddenly over weeks
  • Thinning that began after a new medication or childbirth
  • Hair loss alongside any other symptom, including fatigue, weight change, or a known thyroid or autoimmune condition
  • Early thinning you would like assessed while the follicles are still producing hair, because treatment holds existing hair more reliably than it regrows lost hair

Have questions about hair loss? Our team is here to help.

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What causes Hair Loss?

  • Hereditary factors (androgenetic alopecia)
  • Hormonal changes (pregnancy, menopause, thyroid)
  • Medical conditions (alopecia areata, infections, hypothyroidism)
  • Medications and treatments
  • Stress (telogen effluvium)
  • Nutritional deficiencies
  • Hairstyling damage (traction alopecia)
  • Aging

How is Hair Loss treated?

We offer a service to help manage this condition: Hair Mesotherapy.

Prognosis

  • Early treatment yields better results
  • Medications can slow hair loss and stimulate regrowth
  • Continuous treatment needed to maintain results
  • Hair transplants can provide lasting improvement
  • Once follicles shrink significantly, restoration may be limited
  • Female pattern hair loss is often reversible with treatment
Julia Tzu, MD, FAAD, FACMS, Triple board-certified cosmetic and surgical dermatologist

Julia Tzu, MD, FAAD, FACMS

Triple board-certified cosmetic and surgical dermatologistManhattan's Financial District

Trained at Stanford, Johns Hopkins, Penn & NYU

Minoxidil + dutasteride scalp mesotherapy, not widely available

Dr. Julia Tzu offers hair-loss mesotherapy that delivers minoxidil and dutasteride directly into the scalp – an option that isn't widely available. Patients seek it out when they want more effect than topical minoxidil and finasteride but fewer systemic side effects than the oral versions.

More About Dr. Tzu

Frequently Asked Questions

What causes hair loss?
The most common cause is androgenetic alopecia, in which inherited genes cause hair follicles to shrink over time. Other causes include hormonal changes, medical conditions, medications, stress, and nutritional deficiencies. The specific cause determines the appropriate treatment approach.
How does hair loss differ between men and women?
Men typically develop a receding hairline and a bald spot at the crown. Women usually notice overall thinning or a widening part and rarely develop complete baldness. Female pattern hair loss often begins after menopause. Both male and female pattern hair loss result from genetic factors affecting the follicles.
When should I see a dermatologist about hair loss?
See a dermatologist at the first signs of increased shedding or thinning. Results are most favorable when treatment begins early because maintaining existing hair is easier than regrowing hair that has been lost. Also seek evaluation for sudden, patchy, or rapid hair loss, which may indicate an underlying condition.
What treatments are available for hair loss?
Treatments include over-the-counter topical minoxidil, prescription oral finasteride, scalp mesotherapy with minoxidil, dutasteride, or both, platelet-rich plasma therapy, low-level laser therapy, and hair transplant surgery. Women may also use spironolactone. Treatment usually has to continue to maintain results.
Is hair loss reversible?
It depends on the cause and how early treatment begins. Early hereditary hair loss may respond to medications that slow further loss and stimulate regrowth. Once follicles have shrunk significantly, restoration becomes more limited.
Can hair loss be prevented?
Hereditary hair loss cannot be fully prevented, but early treatment can slow its progression. Measures that support general hair health include eating a balanced diet, managing stress, avoiding tight hairstyles that pull on the hair, and treating underlying medical conditions promptly.
What tests are done to find out why hair is thinning?
A scalp examination and pull test come first, usually with dermoscopy to examine the follicles directly. Bloodwork covers thyroid function and hormone levels where the history points that way. If the pattern remains ambiguous, a small scalp biopsy settles it. Dr. Tzu is board certified in dermatopathology, and microscopic interpretation of that biopsy falls within the same specialty.
What is scalp mesotherapy for hair loss?
Mesotherapy delivers minoxidil, dutasteride, or both into the scalp through localized injections. Sessions run 30 to 60 minutes, a course of several sessions is typical, and visible change generally appears within three to six months.
Is thinning hair reversible?
That depends on how far the follicles have miniaturized. Early hereditary thinning often responds well. Follicles that have shrunk substantially over many years are more difficult to restore.
Does hair loss treatment have to continue forever?
For hereditary hair loss, usually yes. Minoxidil, finasteride, and mesotherapy work only while they are being used, so stopping returns the scalp to its untreated trajectory over the following months. Hair loss caused by a correctable condition, such as iron deficiency or thyroid disease, is different and often resolves once that cause is treated.

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Sources & References

This article draws from 6 peer-reviewed sources.

Medical Institutions

Educational & General

Medically reviewed by Dr. Julia Tzu, MD, FAAD, FACMS · Last reviewed: 2026-08-31