Hair Loss Causes Guide Malaysia: Types, Tests, and Treatment

Male pattern baldness (androgenetic alopecia) is the most common cause of hair loss in men, affecting approximately 50% of men by age 50. It is caused by a combination of genetic predisposition and the effect of dihydrotestosterone (DHT) — a derivative of testosterone — on hair follicles in susceptible individuals. DHT causes hair follicles to shrink progressively, producing shorter, finer hairs until the follicle stops producing hair altogether. The pattern is characteristic: hair recedes at the temples and thins at the crown, eventually merging. It is graded using the Norwood-Hamilton scale. Family history is the strongest predictor — check both maternal and paternal sides. Treatment options: Minoxidil (Rogaine): topical solution or foam applied twice daily to the scalp. Also available in oral low-dose form. Stimulates hair growth and slows loss. Works best in early stages. Must be used indefinitely — hair loss resumes when stopped. Finasteride (Propecia): oral tablet taken daily. Blocks 5-alpha-reductase enzyme that converts testosterone to DHT. Very effective (85% of men see stabilisation or regrowth). Not for use in women of childbearing potential (teratogenic). Side effects include reduced libido in a small percentage of users. Low-level laser therapy (LLLT): some evidence for mild benefit. Hair transplant: surgical option for advanced pattern loss. At Klinik Muhibbah, we prescribe topical minoxidil and finasteride for male pattern baldness. Early treatment is more effective — do not wait until significant loss has occurred.

Telogen effluvium is a form of diffuse hair shedding that occurs 2-3 months after a significant physiological or psychological stressor. It works like this: normally, about 10% of hairs are in the resting (telogen) phase at any given time. After a major stressor, a much larger proportion of hairs simultaneously enter the telogen phase, leading to dramatic shedding 2-3 months later when these resting hairs are shed. Common triggers: COVID-19 infection (one of the most frequently reported post-COVID symptoms — often occurs 2-3 months after infection, can be alarming in volume). Post-partum hair loss — occurs 3-6 months after delivery as pregnancy oestrogen levels drop. Very common and expected. Severe illness (fever, surgery, hospitalisation). Crash dieting or severe nutritional deficiency. Extreme psychological stress. Major surgery. Hypothyroidism. Telogen effluvium is typically self-limiting — hair regrowth occurs once the triggering factor resolves, usually over 3-6 months. However, chronic telogen effluvium can occur with ongoing nutritional deficiency, chronic illness, or persistent stress. Blood tests to rule out contributing causes: FBC (anaemia), ferritin (iron stores — ideally above 70 ug/L for hair growth), thyroid function (TSH), vitamin D, zinc, and B12. At Klinik Muhibbah, these blood tests are available. Address the identified deficiency — iron, vitamin D, or thyroid — and hair regrowth typically follows.