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Hereditary Hair Loss: Causes, Symptoms & Therapy

Hereditary Hair Loss: Causes, Symptoms & Therapy

Medical Director Dr. Hans-Georg Dauer

9 min

January 20, 2022

Do you already know the biggest enemy of our hair? It's called androgenetic alopecia, also known as hereditary hair loss.

This hair enemy number 1 doesn’t sneak up on our head all too rarely. On the contrary: A full 80 percent of all men and every second woman are affected by hereditary hair loss.

Once it gets hold of us, it doesn't let loose too quickly. Often it haunts us at a young age. It announces its intentions with a receding hairline. But it usually doesn't stop there.

Gradually, hair loss extends to the crown and back of the head. In the worst case, it leaves us with a conspicuous crown of hair.

But what’s actually behind this number 1 enemy of our hair? Why does it strike and how can we drive it away?

How is Hereditary Hair Loss Diagnosed?

Hereditary hair loss or no hereditary hair loss - that is the question here. And there is only one who can reliably determine this - the dermatologist.

First of all, an anamnesis takes place. The dermatologist paints a picture of the patient's symptoms in order to better assess the causes and further course of the hair loss. The focus lies especially on the family background. Does androgenetic alopecia run in the family?

The doctor will then take blood samples to check your iron, liver, zinc, kidney and thyroid levels. For women, he will also determine the testosterone level. This way he can rule out deficiency symptoms and thyroid diseases as potential causes of hair loss.

But how does the dermatologist know that it is exactly hereditary hair loss and not circular or diffuse hair loss? This is done with the following three examinations:

  • Determination of the hair weight: The removed hairs are weighed.
  • Histology: The dermatologist takes a small scalp sample and examines the hair follicles under the microscope.
  • Trichogram: The growth phases of the hair root are examined.

The Hamilton-Norwood scheme

The diagnosis is clear: it is hereditary hair loss. But how far has it progressed and what course can the patient expect? All this is revealed by the so-called Hamilton-Norwood scheme.

The Hamilton-Norwood scheme divides hair loss into 7 stages. May we introduce them to you?

  • Stage 1: The hair on the head is still full and strong. Only at the frontal hairline it thins out - mostly at the temple corners.
  • Stage 2: Gradually, the hair density in the forehead and temple area diminishes. A receding hairline is already slightly pronounced, but does not yet exceed the approx. 2 cm wide connecting line at the external auditory canal.
  • Stage 3: Now the corners of the receding hairline are already more visible. They cross the connecting line at the external auditory canal and extend towards the back of the head.
  • Stage 4: Temporal and frontal hair loss continues to progress.
  • Stage 5: The back of the head and temples continue to lose fullness. Thus, a horseshoe shape is slowly formed. The crown and temples are now only connected by a narrow strip of hair.
  • Stage 6: The bald patches on the crown and temples connect. Meanwhile, the sides of the skull are also affected by hair loss.
  • Stage 7: All that remains of the previous hair growth is a thin band of hair that wanders from the ears around the back of the head. In severe courses, this hair band shrinks to up to 3 cm.

Hereditary vs. Diffuse vs. Circular Hair Loss - What’s the Difference?

Is hair loss always hair loss? Not at all, it comes to us in different guises - namely:

  • Diffuse hair loss: There is no specific pattern observed here. The entire hair thins out. The causes of hair loss could hardly be more diverse. From hormonal changes to deficiency symptoms to incorrect hair care, everything comes into question.
  • Circular hair loss: Individual bald patches form, about the size of a coin. This is a relatively rare form of hair loss. The causes are not exactly known. Experts assume an autoimmune reaction of the body. It turns against itself, so to speak.
  • Hereditary hair loss: It follows a certain pattern. At the beginning, the crown and temples usually thin out, later the back of the head. The trigger is clearly the genes. In men, androgenetic alopecia often occurs at a young age; in women, it usually does not occur until menopause.

Let's keep in mind: the biggest difference between androgenetic alopecia and diffuse and circular hair loss lies in its progression. Hair loss follows a very specific pattern. In addition, the cause has been clearly identified.

Genetics is involved, that’s for sure. With the other forms it is not quite so clear. Various factors come into question.

What Are the Causes of Androgenetic Alopecia?

The hormone DHT, also known as dihydrotestosterone, is to blame for hereditary hair loss. It is not for nothing that we also call it the hair loss hormone.

The problem is that the hair roots are hypersensitive to DHT, a conversion of testosterone. They cannot tolerate the androgens (sex hormones).

And it is precisely this hypersensitive reaction to the sex hormone that upsets the natural growth phases of the hair.

Strictly speaking, the hormone shortens the growth phase of the hair follicles. If they come into contact with DHT, the blood vessels that supply the follicles with vital nutrients gradually recede.

And once the nutrient supply is cut off, the hair loses strength, fullness and vitality. They become thinner, finer and eventually fall out.

In women, there is another assumption: experts suspect that in the case of androgenetic alopecia, the enzyme aromatase is less active in the female body. It is in dormant mode, so to speak.

Actually, however, the female body urgently needs the enzyme. After all, it converts testosterone into estrogen, i.e. male hormones into female hormones.

However, if it is only working on the back burner, an excess of DHT accumulates in the scalp, which promotes hair loss.

But that's not all: due to the dormant phase of aromatase, there is also less estrogen, which is known to protect against hair loss. This makes it doubly difficult for our hair.

Hereditary Hair Loss – What Really Helps?

Unfortunately, a miracle cure for hereditary hair loss has yet to be invented. It can be delayed, but not yet stopped. Why don't we look at your options in peace?

Home Remedies

  • Nettle: a real powerhouse - and so beautifully natural. Because did you know that nettle is rich in magnesium, sodium, calcium, zinc, iron and phosphorus? It can even provide you with vitamins A, B, C and D.
  • Beer: Cheers to your hair roots, but please not in a glass, but in shampoo. Treat your head with vitamin B1, B2 and B6 as well as folic acid, niacin and biotin.
  • Onion: Not only in the pan, also on the head onions make a good figure. After all, the little wonder bulb has been proven to stimulate blood circulation. And the stronger the blood flow to the scalp, the stronger the hair growth.
  • Parsley: How about a nutrient package from Mother Nature? Whether used as a shampoo or conditioner, parsley always does a top notch job.
  • Coffee: That's right, coffee is also a real hair booster. Caffeine not only promotes blood circulation, but also makes the hair roots more receptive to nutrients and vitamins - jackpot.


How about a little anecdote? Because did you know that the two main hair loss medications, like minoxidil, wasdiscovered purely by accident? Originally, they were used for something else entirely.

It was a similar story with minoxidil. Originally, it was used to treat high blood pressure. But then came the astonishing discovery that hair growth improved in many patients. And that was the birth of the minoxidil-containing tincture for alopecia patients.

Meanwhile, minoxidil is also available in other forms. From shampoos to minoxidil capsules, everything is available.

By the way: Minoxidil is no longer the only miracle weapon against hereditary hair loss. Alfatradiol is also very popular. In both men and women, it brings progressive hair loss to an early halt.

But beware: medications against hereditary hair loss are only a temporary solution. As soon as you stop the preparations, the hair loss continues.

Autologous Blood Treatment

Fancy a bloody secret recipe against hair loss? Don't worry, we're not talking about a beauty secret from count dracula. No, we are talking about the autologous blood treatment.

The name can be taken literally: After all, it's your own blood we're talking about here. Exactly, our dermatologists take a small amount of blood from you. They then process it in a centrifuge.

Now all that remains is to get your precious, prepared blood into your hair follicles. This couldn’t be any easier: in no time at all, our experienced dermatologists inject it into your scalp.

Now, at the latest, it's the blood's turn. It immediately unpacks its magic powers and gives tired hair roots a leg up.

All you need now is a little patience. Give your hair 6 to 8 weeks and be amazed by noticeably thicker, stronger and fresher hair. It's worth the wait.

Special tip: You want a stunning result? Then our experts at HAIR & SKIN recommend that you have several autologous blood treatments in a row. With 4 sessions at intervals of 4 weeks you will soon experience your hairy miracle.

Hair Transplant

Are you not looking for a temporary solution, but one that lasts you an eternity? We can help you with that as well. After a hair transplant from HAIR & SKIN you will not have to worry about your head in the future.

How can we be so sure? Quite simply, once the transplanted hair roots have taken their proper place in your scalp, they will not go away. The vitality is permanent. From now on, you don't need home remedies, medications and diet plans.

For a great result, our experienced doctors swear by the FUE method, Follicular Unit Extraction. For many years it has been considered the best the transplant market has to offer. No wonder, because FUE is not only extremely precise, but also extremely gentle.

The recipe for success of this gentle method is the blade. It is so fine and narrow that it leaves only minimal traces on the scalp - no deep incisions or serious injuries. Tiny channels in the skin are quite enough.

And the lower the risk of injury, the better the chances of recovery. You may welcome amazingly many hair roots in the splendor of your hair, permanently.

The second set of aces of the FUE technique is its impressively natural results. The transplanted hair roots blend into the scalp hair in a wonderfully gentle and natural way. There is no trace of the feared foreign body effect.

Thus, the hair transplant remains your little secret. After the regeneration phase, no one will notice the procedure.

And this is what you have to expect during the FUE hair transplant:

First of all, our experienced surgeons need enough strong donor hair to thicken the thinning areas on the scalp. The back of the head comes in handy as a well-covered donor area.

Once they have taken enough suitable hair roots, they store them temporarily in a nutrient solution. In this way, they can also be optimally cared for outside the scalp.

In the next step, the physician opens tiny channels in the scalp with a fine blade and carefully inserts the hair roots just removed into them - one by one.

Can you imagine that? Perfect, then we look forward to your inquiry.