Restore Hair Density, Regain Confidence

Understanding Hair Loss in the Indian Context

Hair loss affects 60% of Indian men by age 50 and 40% of women due to genetic predisposition, hormonal imbalances (PCOS), nutritional deficiencies (iron, vitamin D), and stress. Unlike Western populations, Indians develop androgenetic alopecia (pattern baldness) earlier—often in the 20s and 30s—making early intervention critical.

Common hair loss patterns in India:

• Male pattern baldness: Receding hairline and crown thinning (DHT-driven)
• Female pattern hair loss: Widening central part with intact hairline (often PCOS-related)
• Telogen effluvium: Diffuse shedding after illness, childbirth, crash diets, or stress
• Alopecia areata: Autoimmune patchy bald spots (reversible with treatment)

At Ajuda Hospitals Dermatology, we deliver IADVL-aligned hair restoration protocols combining:

• Lab-rooted diagnosis: Thyroid, iron, PCOS screening to address root causes
• Medical therapy: Minoxidil, finasteride, spironolactone based on hair loss type
• Platelet-Rich Plasma (PRP): Growth factor injections for density boost
• Nutritional correction: Targeted supplementation for deficiencies

Our multilingual team (Telugu, Hindi, Urdu, English) provides personalized care rooted in evidence and empathy.

When to Consult Our Hair Loss Specialists

Schedule a consultation if you notice progressive thinning, family history of early baldness, or if OTC treatments haven't worked.

Our Diagnostic Approach

Pattern Recognition & Trichoscopy

Dermatoscopy (trichoscopy) magnifies the scalp to identify:

• Miniaturization: Progressive thinning of hair shafts (androgenetic alopecia)
• Exclamation mark hairs: Broken hairs at edges of bald patches (alopecia areata)
• Perifollicular scaling: Inflammation suggesting seborrheic dermatitis or psoriasis
• Scarring: Permanent follicle destruction (lichen planopilaris, lupus)

Classification:

• Male pattern: Norwood-Hamilton scale (I-VII)
• Female pattern: Ludwig scale (I-III central thinning)
• Patchy: Alopecia areata, tinea capitis (fungal), traction alopecia

Pull Test & Hair Count

Gentle traction on 50-60 hairs:

• Normal: <3 hairs pulled out
• Active shedding (telogen effluvium): >6 hairs easily dislodged

Hair wash collection: Count hairs lost during shampooing (>100 abnormal; normal 50-100 daily).

Hormonal & Nutritional Screening

Bloodwork identifies reversible causes:

• Thyroid: TSH, free T3, T4 (hypothyroidism slows hair cycle)
• Iron: Serum ferritin (target >70 ng/mL for optimal hair growth; many Indian women <30)
• Vitamin D, B12: Deficiencies common in vegetarian diets
• PCOS (women): Testosterone, DHEAS, LH/FSH ratio, pelvic ultrasound
• Anemia: CBC (hemoglobin, MCV)

Scalp Biopsy (Scarring or Uncertain Cases)

Punch biopsy differentiates:

• Non-scarring: Androgenetic alopecia, telogen effluvium, alopecia areata (follicles intact; reversible)
• Scarring (cicatricial): Lichen planopilaris, discoid lupus, folliculitis decalvans (permanent; requires aggressive treatment)

Treatment Pathways

Our hair loss management follows stepped protocols based on diagnosis:

Stage 1: Topical Minoxidil (First-Line for All Types)

Minoxidil 2%, 5%, or 10% solution/foam:

• Prolongs anagen (growth) phase; increases follicle size
• Apply 1 mL twice daily to dry scalp (crown, hairline, part)
• Initial shedding (3-4 weeks) is normal—miniaturized hairs shed to make room for thicker regrowth
• Results: Visible at 3-6 months; maximal at 12 months
• Maintenance: Lifelong use required; stopping reverses gains within 6 months

Effectiveness: Stabilizes shedding in 85%; promotes regrowth in 60-70%.

Side effects: Scalp irritation (switch to foam formulation); unwanted facial hair (apply carefully; wash hands).

Stage 2: Oral Finasteride (Male Pattern Baldness)

Finasteride 1mg daily:

• Mechanism: Blocks 5-alpha reductase enzyme, reducing DHT (dihydrotestosterone) by 70%
• Indications: Men with vertex or hairline thinning
• Effectiveness: Halts progression in 90%; regrowth in 65% (synergizes with minoxidil)
• Onset: 3-6 months for stabilization; 12-18 months for maximal regrowth
• Monitoring: PSA levels in men >50 years (finasteride lowers PSA by 50%)

Side effects: Sexual dysfunction (libido, erectile) in <2%; reversible upon stopping. "Post-finasteride syndrome" extremely rare; no strong evidence.

Contraindications: Women of childbearing age (teratogenic); pregnancy.

Stage 3: Hormonal Therapy (Female Pattern Hair Loss, PCOS)

Spironolactone 50-100mg daily:

• Mechanism: Androgen receptor blocker; reduces DHT effects on follicles
• Indications: Women with PCOS, elevated androgens, or finasteride intolerant
• Effectiveness: Reduces shedding; improves regrowth in 60-70% at 6-9 months
• Monitoring: Potassium, blood pressure (avoid if kidney disease)

Combined Oral Contraceptives (COCs):

• Regulate menstrual cycles; reduce androgen production
• Synergize with spironolactone for PCOS-related hair loss

Collaboration: Gynecology co-management for PCOS, irregular cycles.

Stage 4: Platelet-Rich Plasma (PRP) Therapy

Autologous PRP injections:

• Preparation: Draw patient's blood → centrifuge → concentrate platelets (5-10x baseline)
• Growth factors: PDGF, VEGF, IGF stimulate dormant follicles, prolong anagen, increase shaft thickness
• Protocol: Topical anesthetic → micro-injections into scalp (0.5 cm intervals) → 20-30 min procedure
• Schedule: 3 sessions monthly (initial induction); quarterly maintenance to sustain results

Effectiveness: Increases hair density by 30-40% when combined with minoxidil/finasteride (synergistic effect).

Best candidates: Early-to-moderate hair loss; active follicles present (PRP can't revive completely dead follicles).

Downtime: Mild scalp tenderness for 24 hours; avoid hair washing for 24 hours.

Stage 5: Nutritional Supplementation

Iron (if ferritin <70 ng/mL):

• Ferrous sulfate 325mg daily or IV iron infusion (severe deficiency)
• Recheck ferritin at 3 months; hair regrowth follows iron repletion by 2-3 months

Biotin 5-10mg daily: Strengthens hair shaft; anecdotal benefit (limited evidence)

Vitamin D 60,000 IU weekly (if deficient <30 ng/mL): Modulates hair cycling

Zinc, Omega-3: For chronic telogen effluvium

Effectiveness: Corrects telogen effluvium from nutritional deficits within 3-6 months.

Stage 6: Corticosteroid Injections (Alopecia Areata)

Intralesional triamcinolone 5-10 mg/mL:

• Inject into bald patches every 4-6 weeks
• Effectiveness: Regrows 60-80% of patches within 3-6 months
• Extensive disease: Topical immunotherapy (DPCP, SADBE) or systemic JAK inhibitors (baricitinib, tofacitinib)

Stage 7: Hair Transplant Referral (Advanced Baldness)

For Norwood V-VII or Ludwig III with stable donor area:

• FUE (Follicular Unit Extraction): Minimally invasive; no linear scar
• Combine with medical therapy: Finasteride + minoxidil post-transplant to prevent further native hair loss

We coordinate referrals to ISHRS-certified hair transplant surgeons when appropriate.

What to Expect: Your Care Journey

First Visit (60 min)

• Detailed history: onset, family history, triggers (illness, stress, diet)
• Scalp exam with trichoscopy
• Pull test and hair count estimation
• Baseline photography for tracking
• Labs ordered: Thyroid, ferritin, vitamin D, PCOS panel (women)
• Prescription: Minoxidil ± finasteride/spironolactone

4-Week Follow-Up (Telemedicine)

• Review lab results; address deficiencies (iron, thyroid, vitamin D)
• Assess minoxidil tolerance; counsel on initial shedding phase
• Nutritional supplementation guidance

3-Month Review (In-Person)

• Pull test reassessment; photography comparison
• Evaluate shedding reduction (most patients report 50-70% less fall)
• Plan PRP therapy if appropriate (synergy with medical treatment)

6-Month Milestone

• Visible regrowth assessment; trichoscopy shows increased hair density
• Continue medical therapy (lifelong for androgenetic alopecia)
• PRP maintenance sessions quarterly

12-Month Outcome

• Maximal regrowth achieved; compare before/after photos
• Transition to maintenance: minoxidil daily, finasteride/spironolactone ongoing, PRP quarterly

Technology & Innovation

Platelet-Rich Plasma (PRP) with Centrifugation Protocol

Our FDA-approved centrifuge system prepares high-concentration PRP (5-10x platelet baseline) with precise growth factor isolation. EMR-integrated photography tracks density changes objectively over serial PRP sessions.

Patient Benefits:

• Natural, autologous therapy (no rejection risk)
• Outpatient procedure with minimal downtime
• Synergizes with minoxidil/finasteride for additive results

Telemedicine Follow-Up

• Photo uploads (crown, part, hairline) for remote progress tracking
• Prescription refills without clinic visits for stable patients
• Lab result interpretation via video consult
• WhatsApp support for questions on shedding or side effects

Preventing Complications

Untreated hair loss causes:

• Permanent follicle miniaturization: Point of no return (follicles too small to revive)
• Psychological distress: Anxiety, depression, social withdrawal
• Delayed treatment = poorer outcomes: Early intervention critical (more follicles salvageable)

Our Prevention Strategy:

• Early treatment before extensive loss (more follicles = better regrowth potential)
• Address root causes (thyroid, iron, PCOS) to prevent recurrence
• Lifelong maintenance therapy to sustain gains
• Annual check-ups for recurrence monitoring

Why Ajuda for Hair Loss Care?

Take the First Step

Hair loss is progressive—early treatment saves more follicles. Whether you're battling genetic baldness, PCOS-related shedding, or patchy alopecia areata, personalized medical therapy and PRP can restore density and confidence.

Call 9010550550 or WhatsApp for comprehensive hair loss evaluations. Our dermatology specialists are available Monday-Saturday, 9 AM-7 PM, with telemedicine follow-ups for your convenience.

Thicker, fuller hair is within reach—let Ajuda Hospitals guide your restoration journey.