Why Does Hair Loss Happen, and How Is It Treated?

The treatment of hair loss depends on its type: in hereditary hair loss the aim is to slow the process and protect the hair you still have; in diffuse shedding after stress, childbirth or a nutritional problem, the picture largely recovers on its own once the underlying cause is corrected. On this page I explain the causes of hair loss, the tests I use to assess it, the steps of treatment, and how the injection methods differ from one another. In hair loss I make the diagnosis first and choose the treatment second.

I am a specialist in anaesthesiology and reanimation; blood sampling, sterile technique and injection safety are core areas of my training. I perform hair treatments within this framework, carrying out every step of preparation and application myself. My training and experience are described on the about me page.

Causes of hair loss

Hereditary (androgenetic) hair loss. This is the most common type of hair loss ¹. It progresses as the hair shaft gradually thins (miniaturisation); in men it shows at the crown and front hairline, in women as a widening part line. It is a chronic process: treatment slows it down, it does not remove the condition.

Diffuse shedding (telogen effluvium). It begins after a febrile illness, surgery, childbirth, severe stress, rapid weight loss or nutritional deficiency, usually a few months after the event. The hairline does not recede; shedding is spread across the scalp. It mostly recovers on its own once the cause is corrected.

Nutritional and hormonal causes. Low iron stores (ferritin), thyroid disorders, and vitamin B12 and D deficiency can accompany hair loss; this is why I check them in the diagnostic step.

Scalp conditions. In conditions such as seborrhoeic dermatitis, itching and flaking are in the foreground. Alopecia areata is a separate condition in which the immune system targets the follicles; it appears as well-defined round patches. The diagnosis and primary treatment of these two conditions belong to dermatology. I do not give injections during an active phase; once the condition has settled, I consider them as support.

The diagnostic step

I do not start injections before finding the cause. At consultation I assess the type of hair loss, the condition of the scalp and the duration. When I consider it necessary, I check iron stores (ferritin), thyroid function, and vitamin B12 and D levels; I also ask about stress, because periods of intense stress can trigger diffuse shedding, and I assess this further when needed.

I correct any deficiencies I find with oral supplementation in parallel with the treatment. The general framework of this approach is on the functional medicine page.

Steps of treatment

First step — drug treatment. In hereditary hair loss, the treatments with the highest level of evidence are topical and oral drug treatments. I plan injection methods alongside these treatments, not instead of them; we assess the suitability and follow-up of drug treatment together at consultation. The European evidence-based guideline also builds its recommendations for hereditary hair loss on these drug treatments ¹.

Second step — injection methods. Considered in areas where the follicle is alive and the hair has thinned but not disappeared. The table below sets out which method comes to the fore in which situation.

Third step — hair transplantation. In areas where the follicle has been lost completely and the skin is smooth, injections will not produce hair; in that situation a hair transplant is considered. I do not perform hair transplantation at the clinic; I refer when needed. If you are considering a transplant, we decide on it and on the timing together with the team that will perform it.

Which method for which situation?

With injections into the scalp, the decision depends on the content: when replacing missing nutrients and building blocks is the aim, mesotherapy with vitamins, minerals and peptides comes to the fore; when stimulating the follicle with its own growth signals is the aim, platelet-rich plasma does. The final choice is made at consultation.

With hair treatments the decision also depends on time: when a regular schedule of visits can be arranged, injections given as a series come to the fore; when single-session completion is preferred, tissue-derived treatments or human-derived exosomes do. The final choice is made at consultation.

The skin applications and mechanisms of these methods are on the cellular therapies page.

Being honest about the level of evidence

The evidence in scalp injections is not evenly distributed. Among the methods on this page, PRP is the one whose randomised trials have been assessed in meta-analyses; the certainty of that evidence is low. These studies report an increase in hair density compared with placebo, while no significant difference has been shown in hair thickness ²³; the studies are heterogeneous and there are signs of publication bias ². For micrografts there is a small, half-head, placebo-controlled study of 27 people ⁴. A recent systematic review that also covers exosomes, SVF and micrografts reports that the studies on these methods are few, small and of differing designs, and that long-term data remain limited ⁵. I have not found controlled studies of hair mesotherapy or of Sanakin on the scalp; for these methods I rely on my clinical practice, and I say so on each page. I do not claim that any injection method “stops hair loss”, and I give no percentages without a source.

What to expect, and what not to

• In an area where the follicle has been lost completely, injections will not produce hair.
• The effect is not immediate: a reduction in shedding is reported in the weeks following the first sessions, and thickening and density within months; it varies from person to person.
• Hereditary hair loss is chronic; when treatment ends, the process continues from where it left off. This is why a maintenance plan is discussed.
• Hair dye, styling and care products are not the cause of hair loss, nor do they resolve it on their own.

The procedure and pain management

Because I am an anaesthesiologist, I treat pain management as a separate part of the procedure.

Topical anaesthetic cream is not used routinely on the scalp; for very sensitive people it is applied before the treatment. What you feel is a brief sting. The blood draw is a standard venous access; tissue and fat harvesting are done under local anaesthesia.

Aftercare

First 24 hours

• Do not wash your hair (you can wash it the next day)
• No hot showers, sauna, hammam or steam
• Avoid heavy exercise
• No alcohol
• Do not touch the injection points; do not squeeze or massage the bumps

First 48 hours

• Avoid direct and prolonged sun exposure; wear a hat outdoors

Expected findings Mild redness and tenderness at the injection points are expected and settle the same day. Small bruises may last 1–2 days.

Additional advice

• Wait 2–3 days before hair dye and similar chemical treatments
• If redness increases, or warmth or fever develops, contact the clinic

Additional advice for blood, tissue and fat harvest sites is on the relevant page.

Safety and anatomy

Because allergic reactions can occur rarely, treatments are carried out under medical supervision.

Temporary redness, tenderness and small bruises may occur at the injection points. Treatments are performed with sterile technique and are postponed if there is an active infection on the scalp. The risks at blood, tissue and fat harvest sites are described separately on the relevant pages.

Regulatory status: The closed-system kits used for treatments prepared from blood and tissue, and the products used in hair mesotherapy, are products assessed under CE and TİTCK frameworks. Approval belongs to a product and to a specific indication, not to a technique or to a physician.

Who is not suitable

Treatment is not performed, or is postponed, in the following situations:

• Active infection or inflammation in the treatment area
• Autoimmune disease in an active phase
• Pregnancy and breastfeeding
• Known hypersensitivity to the product components
• Uncontrolled chronic illness
• Untreated bleeding disorder or unregulated anticoagulant use

I do not perform these treatments during active cancer treatment. For a person with a history of cancer, I make the decision together with the treating specialist.

Treatment is postponed if there is an open wound or an active flare of seborrhoeic dermatitis on the scalp, and in the early period after a hair transplant; injections are not given in alopecia areata during an active phase.

Contraindications specific to blood, tissue or fat harvesting are listed on the relevant page.

Without being a medical contraindication, I also consider expectation and treatment to be mismatched in these situations:

• People expecting hair to grow in an area where the follicle has been lost completely and the skin is smooth — a hair transplant is considered in that situation
• People expecting a marked change from a single session or within a short time
• People asking for injections straight away for undiagnosed hair loss — the diagnostic step comes first
• People who do not want drug treatment and expect injections alone to be more effective

Suitability is determined by consultation in every case.

Pricing

Under the applicable regulations, price information cannot be published on our website. The cost of a treatment depends on the product used, the technique chosen and the extent of the treatment. You can call the clinic for detailed information.

Frequently asked questions

Is my hair loss normal, and when should I see a doctor?

A certain amount of daily shedding is a natural part of the hair cycle. I recommend an assessment if shedding continues for weeks, if there is thinning across the scalp, if the part line widens, or if the scalp becomes visible. Because a follicle that has been lost cannot be brought back, an early assessment matters.

Which tests are needed for hair loss?

When I consider it necessary, I check iron stores (ferritin), thyroid function, and vitamin B12 and D levels. I decide on testing at consultation, according to the type and duration of the hair loss.

Should I use drugs or have injections for hair loss?

In hereditary hair loss, the treatments with the highest level of evidence are topical and oral drug treatments. I plan injection methods alongside these treatments, not instead of them; we assess the suitability and follow-up of drug treatment together at consultation.

Will hair grow on a bald area?

No. In areas where the follicle has been lost completely and the skin is smooth, no injection method will produce hair. These methods aim to thicken existing but miniaturised hairs and to slow the shedding.

Is hair loss different in women?

The hairline usually does not recede; loss appears as diffuse thinning and a widening part line. In women, iron stores, thyroid and hormonal causes can also accompany hair loss, which is why I place particular weight on the diagnostic step.

Planning your visit

My clinic is in Nişantaşı, Şişli, on the European side of Istanbul, approximately 45 minutes from Istanbul Airport.

For hair loss treatments I suggest planning a stay of two to three days: arrival, consultation and treatment, and departure. Some of these treatments are planned as a series. The first session takes place in Istanbul, and we plan the schedule of the following sessions together according to your travel arrangements, with remote follow-up in between. If you have had a hair transplant, the timing of supportive treatment is planned together with the team that performed it. Flying is generally appropriate 24 hours after an injectable treatment.

Consultations are conducted in English. Follow-up after you return home is arranged remotely, and I remain reachable for any questions during the period in which the result develops.

Dr. Ömer Fatih Şahin — Specialist in Anaesthesiology and Reanimation Diploma Registration No: 113606

Published: 2026-09-21 · Last updated: 2026-09-28 This content has been medically reviewed by Dr. Ömer Fatih Şahin.

References

1. Kanti V, Messenger A, Dobos G, et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men – short version. J Eur Acad Dermatol Venereol. 2018;32(1):11–22. https://pubmed.ncbi.nlm.nih.gov/29178529/
2. Kieling L, Konzen AT, Zanella RK, Valente DS. Is autologous platelet-rich plasma capable of increasing hair density in patients with androgenic alopecia? A systematic review and meta-analysis of randomized clinical trials. An Bras Dermatol. 2024;99(6):847–862. https://pubmed.ncbi.nlm.nih.gov/39013743/
3. Zhang X, Ji Y, Zhou M, et al. Platelet-rich plasma for androgenetic alopecia: a systematic review and meta-analysis of randomized controlled trials. J Cutan Med Surg. 2023;27(5):504–508. https://pubmed.ncbi.nlm.nih.gov/37533146/
4. Gentile P, Scioli MG, Cervelli V, Orlandi A, Garcovich S. Autologous micrografts from scalp tissue: trichoscopic and long-term clinical evaluation in male and female androgenetic alopecia. Biomed Res Int. 2020;2020:7397162. https://pubmed.ncbi.nlm.nih.gov/32071919/
5. Behrangi E, Amiri S, Zeinali R, et al. A systematic review of clinical evidence on the efficacy and safety of conditioned media, platelet-rich fibrin, stromal vascular fraction, extracellular vesicles, and stem cells in androgenetic alopecia. Stem Cell Res Ther. 2026;17:194. https://pubmed.ncbi.nlm.nih.gov/41987228/