Hair Loss & Diagnosis
Understand what's actually causing your hair loss before you plan anything.
Not every kind of hair loss is a transplant candidate. Here's how the different causes are told apart, and how a real assessment works.
Written by Sedef Özdemir · Content Specialist
Reviewed by Dr. Muhammet, Anatomist; Hair Transplant Specialist
Last medically reviewed: 13 August 2026
Source quality
Based primarily on clinical guidelines and peer-reviewed literature. Commercial sources are used only for labelled price observations. Where the evidence is limited or outcomes vary by individual, we say so in the text rather than stating a single number.
See our full source hierarchy →What's actually causing it
"Hair loss" is not one condition. The cause matters because it determines whether a transplant is even the right tool, some causes call for medication, some for dermatological treatment, and some resolve without any intervention at all. New here? Our Start Here guide walks through the decisions in order.
Androgenetic alopecia (pattern hair loss)
The cause behind the large majority of transplant consultations. Genetically sensitive follicles gradually shrink under the influence of DHT (dihydrotestosterone), a byproduct of testosterone converted by the enzyme 5-alpha reductase, in a process called miniaturisation: each growth cycle produces a slightly finer, shorter hair until the follicle stops producing a visible one. It typically follows the recognisable Norwood pattern in men and the more diffuse Ludwig/Savin pattern in women. This is the type a transplant is designed to address, since the occipital donor zone's follicles are naturally insensitive to DHT.
Telogen effluvium
Temporary, diffuse shedding triggered by stress, illness, surgery, rapid weight loss, or hormonal change, typically starting around two to three months after the triggering event, which is why patients often can't immediately connect the cause to the shedding. It affects hair broadly rather than in a pattern, and usually resolves on its own within months once the trigger passes. A transplant is rarely the right response to this type of loss.
Alopecia areata
An autoimmune condition where the immune system attacks hair follicles still in their active growth phase, typically producing well-defined round or oval patches rather than the gradual thinning of pattern loss. It requires dermatological management, not surgical transplantation, since the same immune process can affect newly transplanted follicles just as it affects native ones while the condition is active.
Scarring (cicatricial) alopecia
Hair loss from scarring, whether from injury, burns, or inflammatory conditions like lichen planopilaris or frontal fibrosing alopecia, where the follicle itself is destroyed and replaced with scar tissue. Can sometimes be addressed with a transplant, but only once the underlying condition is confirmed stable (not actively progressing), often requiring dermatological clearance or a scalp biopsy first, since transplanting into an area with active inflammation typically fails.
Classifying pattern hair loss: the Norwood scale
For androgenetic alopecia specifically, the Norwood-Hamilton scale is the standard way to classify how advanced the loss is, which directly shapes graft count estimates and whether one session is realistic. Tap a stage below to see what it involves.
Norwood 3
Deeper temple recession
The first stage generally considered clinically significant balding, with deep temple recession.
Typical grafts
800–1,200 grafts
Sessions
Usually achievable in a single session.
A graft isn't a single hair.
Each graft is a follicular unit that usually carries 1–4 individual hairs. A 2,000-graft session typically transplants somewhere around 3,000–5,000+ individual hairs, not 2,000.
How the diagnosis actually gets made
A proper diagnosis combines several tools rather than relying on a visual guess. Trichoscopy (a magnified, often digital, scan of the scalp) measures hair shaft diameter and can detect early miniaturisation before it's visible to the naked eye, distinguishing genuine androgenetic thinning from other causes. A hair pull test, gently pulling a small section of hair to see how many come away, helps identify active shedding consistent with telogen effluvium. Family history is taken seriously, since pattern hair loss has a strong genetic component and often mirrors a parent's or grandparent's progression. In less clear-cut cases, bloodwork (checking thyroid function, ferritin/iron levels, and hormonal markers) or a small scalp biopsy may be used to confirm a diagnosis before any surgical discussion begins.
How a real candidacy assessment actually works
A genuine assessment measures donor density and scalp laxity by hand, not from a photo, and discusses where the pattern is likely headed over the next 5–10 years rather than just today's snapshot. See our full candidacy guide for what makes someone a suitable candidate, and what doesn't.