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Hair Loss

Hair loss, medically known as alopecia, affects millions of people, and androgenetic alopecia (hereditary hair loss) is by far the most common form, affecting an estimated 80 million people in the United States. Inherited genes drive hair follicles to miniaturize until they stop producing a visible hair shaft. In men the pattern usually shows up as a receding hairline and thinning at the crown; in women it more often reads as diffuse thinning or a part that keeps widening. Onset can be as early as the teens, though it more commonly begins later in life. At Wall Street Dermatology the first appointment is diagnostic before it is anything else, because hereditary thinning, telogen effluvium after a stressor, thyroid disease and traction from styling can all look similar at a glance and respond to different treatment. Dr. Julia Tzu also offers scalp mesotherapy, which places minoxidil and dutasteride 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 hereditary hair loss (androgenetic alopecia), where inherited genes cause follicles to shrink over time. Other causes include hormonal changes, medical conditions, medications, stress, and nutritional deficiencies. The specific cause determines the best treatment approach.
How does hair loss differ between men and women?
Men typically experience a receding hairline and bald spot at the crown. Women usually notice overall thinning or a widening part, rarely developing complete baldness. Female pattern hair loss often begins after menopause. Both conditions result from genetic factors affecting hair follicles.
When should I see a dermatologist about hair loss?
See a dermatologist at the first signs of increased shedding or thinning. Early treatment yields the best results because it's easier to maintain existing hair than regrow lost hair. Also seek evaluation for sudden, patchy, or rapid hair loss, which may indicate underlying conditions.
What treatments are available for hair loss?
Treatments include topical minoxidil (over-the-counter), oral finasteride (prescription), mesotherapy (scalp injections) with minoxidil or dutasteride, platelet-rich plasma (PRP) therapy, low-level laser therapy, and hair transplant surgery. Women may also use spironolactone. Treatment must usually be continued to maintain results.
Is hair loss reversible?
It depends on the cause and timing. Early hereditary hair loss may respond to medications that slow loss and stimulate regrowth. However, once follicles have significantly shrunk, restoration becomes more limited. This is why early treatment is recommended.
Can hair loss be prevented?
Hereditary hair loss cannot be fully prevented, but early treatment can slow its progression. General hair health tips include eating a balanced diet, managing stress, avoiding tight hairstyles that pull on hair, and treating underlying medical conditions promptly.
What tests are done to find out why hair is thinning?
A scalp examination and a pull test come first, usually with dermoscopy to look at the follicles directly. Bloodwork covers thyroid function and hormone levels where the history points that way. If the pattern is ambiguous, a small scalp biopsy settles it. Dr. Tzu is board certified in dermatopathology, so the microscopic reading of that biopsy sits inside that same specialty.
What is scalp mesotherapy for hair loss?
Mesotherapy delivers minoxidil, dutasteride, or both into the scalp by localized injection. Sessions run 30 to 60 minutes, a course of several is typical, and visible change generally appears somewhere in the three-to-six-month range.
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 a harder problem.
Does hair loss treatment have to continue forever?
For hereditary hair loss, usually yes. Minoxidil, finasteride and mesotherapy keep working only while they are used, so stopping returns the scalp to its untreated trajectory over the following months. Hair loss from a correctable cause such as iron deficiency or thyroid disease is a different situation, 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: 2026-08-05