Hair Loss Treatment in Ankara, Turkey

Hair loss treatment in women is a medical process applied to strengthen hair follicles and regain hair density. Hormonal imbalances, stress, nutritional deficiencies, or genetic factors may lead to hair loss. The treatment is planned individually by determining the underlying cause.

PRP (Platelet Rich Plasma) treatment is one of the most effective methods against hair loss in women. The plasma obtained from the person’s own blood is injected into the scalp to revitalize the follicles. This method supports the hair cycle with natural growth factors and stimulates new hair growth.

Hair mesotherapy is performed by applying special mixtures containing vitamins, minerals, and amino acids to the scalp. This treatment nourishes the hair follicles, reduces shedding, thickens the hair strands, and improves overall hair quality. With regular sessions, the volume and shine of the hair increase noticeably.

The use of medication also has an important place in the treatment of hair loss in women. Minoxidil and medications that regulate hormonal balance are used under the supervision of a dermatologist. In addition, healthy nutrition, stress management, and the use of appropriate hair care products increase the effectiveness of the treatment and help prevent recurrence of hair loss.

What Is Hair Loss?

Hair loss is a condition that occurs when hair sheds in greater numbers than normal and causes a decrease in hair density. Genetic factors, hormonal changes, stress, nutritional deficiencies, and certain diseases can lead to this condition. It may be temporary or permanent, and its treatment is planned according to the underlying cause. Early intervention is effective in preventing the progression of hair loss.

Why Does Our Hair Fall Out and What Is the Natural Life Cycle of Hair?

To understand hair loss, we first need to know the natural life cycle of hair. Each strand of hair goes through a three-stage cycle:

• Anagen (Growth) Phase: This is the long period, lasting 2 to 7 years, during which the hair actively grows and is nourished. In a healthy scalp, approximately 85-90% of the hairs are in this phase.
• Catagen (Transition) Phase: This is a short resting period of a few weeks during which growth stops and the hair follicle begins to shrink.
• Telogen (Shedding) Phase: This is a period of about 3 months during which the connection of the hair shaft with the follicle weakens and it waits to shed. At the end of this phase, the hair sheds and a new hair strand (new Anagen phase) begins to be produced from the same follicle.

The shedding of 50 to 100 hairs a day is a normal part of this cycle. The problem of hair loss begins when this natural cycle is disrupted, meaning when the growth phase shortens or an abnormally high number of hairs enter the shedding phase at the same time.

What Are the Most Common Types of Hair Loss?

Hair loss is basically divided into “scarring” and “non-scarring” types. In scarring types, the hair follicle is permanently damaged and unfortunately hair does not grow again from that area. Fortunately, the most common types of hair loss we encounter in society are in the “non-scarring” group, and in these types the chance of treatment is much higher.

The two most common types are:

• Androgenetic Alopecia (Hereditary hair loss)
• Telogen Effluvium (Diffuse shedding due to stress and metabolic causes)

What Is Hereditary Hair Loss (Androgenetic Alopecia)?

This is the form of hair loss we see most frequently in society, affecting both men and women. As the name suggests, it is based on two main factors: genetic predisposition and androgen hormones (especially dihydrotestosterone – DHT).

This condition is characterized by the weakening and “miniaturization” of hair follicles that are genetically sensitive to hormones over time. The growth (Anagen) phase gradually shortens, the hair strands become thinner, weaker, lighter in color, and eventually turn into fine vellus-like hairs and fall out.

The way this hair loss manifests differs by gender:

• In men: Recession of the hairline and marked thinning at the crown area (vertex).
• In women: Preservation of the frontal hairline, but widening of the parting at the crown area and diffuse thinning.

What Causes Telogen Effluvium (Sudden and Diffuse Hair Loss)?

Telogen Effluvium (TE) is the second most common type of hair loss after hereditary hair loss. Unlike hereditary loss, this condition starts suddenly and intensely.

Its basic mechanism is that after intense stress or a metabolic change that shocks the body, a large number of hairs that should normally be in the growth phase (up to 30-50%) suddenly pause and collectively enter the shedding (Telogen) phase.

Patients usually present with the complaint “my hair is falling out in handfuls.” This collective shedding generally occurs approximately 2 to 3 months after the triggering event.

The good news is that TE is usually self-limiting within six months once the underlying cause is resolved, and the shed hair largely grows back.

The main factors that can trigger this condition are:

• Severe febrile illnesses (flu, COVID-19, etc.)
• Major surgical operations
• Giving birth (postpartum shedding)
• Severe emotional stress or trauma
• Crash diets and rapid weight loss
• Protein, vitamin, and mineral deficiencies
• Iron deficiency anemia
• Thyroid dysfunctions
• Use of certain medications

What Methods Are Used to Understand the Cause of Hair Loss?

Correct treatment is only possible with the correct diagnosis. To determine the cause of hair loss, a dermatologist first takes a detailed medical history (anamnesis). Issues such as when the shedding started, whether there is a similar condition in the family, accompanying diseases, medications used, eating habits, and stress levels are questioned in detail.

What Does the “Hair Pull Test” Performed During Examination Show?

It is one of the simplest and most important steps of the physical examination. A small lock of hair (approximately 40-60 strands) is gently pulled from different areas of the head. Normally, 2-3 strands of hair are expected to come out, whereas if more than 4-6 strands come out and white bulbs (telogen roots) are seen at their roots, this suggests active Telogen Effluvium (diffuse shedding).

What Is Trichoscopy (Hair Dermoscopy) and Why Is It So Important in Diagnosis?

Trichoscopy is one of the strongest and most painless aids we have in the diagnosis of hair loss. It allows the scalp and hair follicles to be examined with 10 to 100 times magnification using a special camera and magnification system (dermoscope).

By revealing details that cannot be seen with the naked eye, this method enables us to distinguish the type of shedding (whether hereditary, alopecia areata, or another cause) with great accuracy. It often helps establish a diagnosis without the need for invasive procedures such as biopsy.

With trichoscopy, clues specific to the type of shedding are sought:

• Androgenetic Alopecia: Hairs of different thicknesses (miniaturization), empty follicles, brown halos.
• Alopecia Areata: Black dots, yellow dots, exclamation mark hairs.
• Scarring Alopecias: Loss of follicles, scar tissue, active inflammation areas.
• Telogen Effluvium: No obvious abnormality is seen, but increased telogen hairs or newly growing short hairs may be noticed.

Why Are Blood Tests Requested for Hair Loss?

Hair loss may sometimes be an external reflection of another problem in the body. Blood tests are requested to understand whether there is a systemic cause, vitamin deficiency, or hormonal imbalance underlying the shedding.

The following values are usually checked in blood tests:

• Serum Ferritin (Shows the body’s iron stores)
• Complete Blood Count (Hemogram)
• Thyroid hormones (TSH, T3, T4)
• Vitamin B12
• Vitamin D
• Zinc

Hormonal profile (If there are additional symptoms such as menstrual irregularity or excessive hair growth, hormones such as DHEA-s and Testosterone)

In Which Cases Is a Hair Biopsy Necessary?

A hair biopsy is the “gold standard” diagnostic method used in cases where the diagnosis cannot be clarified by other methods (examination, trichoscopy, blood tests). It is especially necessary for definitive diagnosis when scarring (cicatricial) alopecia types are suspected or when the shedding follows a very atypical course.

The procedure involves taking a small tissue sample from the scalp under local anesthesia with a small tool called a “punch biopsy” (usually 4 mm in diameter). This sample is sent for pathological examination, where the condition of the hair follicles and the type of inflammation are examined in detail.

Which Methods Are Used in the Treatment of Hereditary (Androgenetic) Hair Loss?

Since androgenetic alopecia (AGA) is a genetic and progressive condition, the goal of treatment is not to completely “eliminate” the shedding, but to slow and stop the process and, if possible, re-thicken the thinned hairs. Success generally requires long-term and combined approaches that merge more than one method.

Which Drug Treatments Are Proven for Androgenetic Alopecia?

• Minoxidil (Topical Solution/Foam):

This is the primary treatment method used externally (applied) to the scalp in both male and female pattern hair loss. It is thought to work by stimulating hair follicles and prolonging the Anagen (growth) phase, as well as increasing blood flow to the follicle. The 5% form is generally more effective than the 2% form. It must be used regularly for at least 4-6 months to see its effect, and when the treatment is stopped, its effect is gradually lost. As side effects, it may cause irritation, itching of the scalp, or rarely unwanted facial hair growth.

• Finasteride (Oral Pill):

This is an oral (systemic) medication approved especially for male pattern hair loss. It works by blocking the formation of DHT (dihydrotestosterone), which is the main hormonal cause of hair loss. It is very effective in slowing and reversing hair loss. Just like minoxidil, continuous use is required to preserve the treatment results. When the drug is stopped, the shedding starts again.

Important Warning: Finasteride should DEFINITELY NOT BE USED in women who have the potential to become pregnant because it may cause serious anomalies in the unborn baby (teratogenic risk).

The best results are achieved by combining these two treatments with different mechanisms (hormonal suppression and follicular stimulation).

How Is Stress-Related (Telogen Effluvium) Hair Loss Treated?

In TE treatment, the focus is on finding and treating the underlying trigger causing the shedding rather than the shedding itself.

The management strategy is as follows:

• Finding the triggering cause (iron deficiency, thyroid disorder, nutritional deficiency, etc.).
• Treating this cause (for example, iron supplementation to replenish iron stores).
• Creating a healthy and balanced nutrition program.
• Receiving support for stress management if necessary.
• Reassuring the patient that the shedding is temporary and the hair will regrow.

What Is “Alopecia Areata” and What Is Its Relationship with the Immune System?

Alopecia Areata is a disease caused by the person’s own immune system cells (T-cells) attacking their own hair follicles for an unknown reason (autoimmune). The hair follicle becomes inflamed and hair production stops.

It usually begins with coin-sized, well-defined, smooth-surfaced, patch-like areas of hair loss. However, it may sometimes progress and cause loss of all scalp hair (Alopecia Totalis) or all body hair (Alopecia Universalis). The course of the disease varies greatly from person to person; sometimes it improves spontaneously, while at other times it may recur or worsen.

What New Developments Are There in the Treatment of Alopecia Areata?

In mild cases, topical (applied) or intralesional (localized injection) corticosteroids are generally used. However, in severe and widespread cases, groundbreaking developments have occurred in treatment in recent years.

Foremost among these developments are systemic (oral) drugs called JAK Inhibitors. These drugs aim to stop the autoimmune attack and enable hair regrowth by blocking the immune system signaling pathway (JAK-STAT pathway) that attacks the hair follicle. These drugs (for example Baricitinib, Ritlecitinib), which have received FDA approval for the treatment of severe AA, offer promising results especially in patients with widespread hair loss.

Success in AA treatment is also related to the time elapsed since the onset of the disease. Rapid diagnosis and early initiation of treatment increase the chance of therapeutic success.

How Is the Management of Scarring (Cicatricial) Alopecias?

Scarring alopecias (such as Lichen Planopilaris – LPP or Frontal Fibrosing Alopecia – FFA) are serious conditions in which the hair follicle is permanently destroyed and replaced by scar tissue (fibrosis).

In these diseases, the goal of treatment is not to bring back the shed hair due to permanent damage but to reduce active inflammation and stop the progression of the disease (stabilization).

The main aims of treatment are:

• Stopping active inflammation.
• Stabilizing the progression of the disease.
• Relieving symptoms such as itching and burning.
• Treatments used for this purpose include:
• High-potency topical corticosteroids
• Intralesional corticosteroid injections
• Oral immunomodulatory medications (hydroxychloroquine, cyclosporine, etc.)

What Are the Procedural Methods Applied in Hair Loss?

When medical treatments (medications, solutions) are insufficient or when the aim is to increase hair density more rapidly, dermatological procedures come into play.

How Does PRP (Platelet-Rich Plasma) Treatment Help Hair Loss?

PRP is a special plasma product prepared from the person’s own blood (autologous), containing a much higher concentration of platelets (clotting cells) and growth factors (GF) than normal blood.

Platelets are part of the body’s natural healing mechanism and, thanks to the rich growth factors they contain, they stimulate hair follicles and encourage regrowth. Clinical studies have shown that PRP injections increase hair density, hair shaft diameter (thickness), and patient satisfaction, especially in the treatment of AGA (hereditary shedding).

Why Is the Quality of PRP Treatment Important and How Is It Applied?

The effectiveness of PRP depends on how it is prepared. The quality of the kit used, how much the platelets are concentrated, and the leukocyte (white blood cell) content of the plasma directly affect the outcome. To maximize regenerative potential, PRP preparation protocols that are generally “leukocyte-poor,” meaning purified from inflammation-causing cells, are preferred.

PRP is not a one-session miracle but a systematic course treatment.

A typical PRP treatment protocol has two phases:

• Loading Phase: Usually 3-4 sessions, once a month.
• Maintenance Phase: Reminder sessions every 3, 6, or 12 months depending on the patient’s condition to preserve the result obtained.

What Is LLLT (Low-Level Laser Therapy) and How Does It Work?

LLLT (Low-Level Laser Therapy), also known as “cold laser,” is a painless, safe, and non-invasive treatment option. It is thought to work by increasing the cellular energy (ATP) of the hair follicles in the scalp with low-energy-density laser light and stimulating the follicles. It may help follicles in the resting (Telogen) phase return to the growth (Anagen) phase.

LLLT may show a moderate effect when used alone; however, its real strength lies in combination treatments. When used together with standard treatments such as Minoxidil, Finasteride, or PRP, it may support hair growth by creating a synergistic effect.

In Which Cases Should Hair Transplantation Be Considered?

Hair transplantation is a surgical procedure. Usually, with the FUE (Follicular Unit Extraction) technique, healthy hair follicles from the nape (donor) area, which is resistant to shedding, are individually extracted and transplanted into the balding (recipient) areas.

It is important to emphasize that hair transplantation is not a treatment that stops hair loss, but a reconstructive procedure that camouflages areas where hair has already been lost.

What Determines Success in Hair Transplantation and Who Is a Good Candidate?

Hair transplantation should generally be considered as the final stage in hair loss treatment.

There are some criteria for the ideal hair transplant candidate:

• First of all, people who have tried medical treatment (Minoxidil, Finasteride, etc.) but have not obtained a sufficient response.
• People whose shedding has largely stopped and stabilized (it should not be performed on those with active, rapid shedding).
• Usually those over 25 years of age (for the shedding pattern to settle).
• Those who have sufficient hair density in the nape (donor) area.

One of the biggest mistakes made in hair transplantation is to have only the transplant without medically controlling the underlying shedding (that is, without using treatments such as Finasteride, Minoxidil, or PRP). In this case, the transplanted hairs remain permanent, but the surrounding original hairs continue to fall out. This leads over the years to an unnatural, “patchy,” and “island-like” hair appearance.