Hair loss is not one condition. It is a symptom with at least a dozen different causes, and the treatments have almost nothing in common with each other. An oil that helps one type will do nothing for another; a supplement that works for a deficiency will not touch an autoimmune alopecia; and a scarring alopecia that is not caught early leaves permanent bald patches no treatment can reverse.

That is why the first appointment at SkinByDrNancy is about diagnosis – history, scalp examination, dermoscopy of the hair and follicles, a pull test, blood tests where indicated and occasionally a scalp biopsy.

The types of hair loss we see most in Nairobi

Traction alopecia

By far the most common preventable cause of hair loss in Kenyan women. Tight braids, cornrows, weaves, sew-ins, wigs fixed with strong adhesive, threading and heavy extensions pull on the follicle month after month. It starts at the hairline and temples with fine “fringe” hairs, small pustules and tenderness, and if the traction continues it becomes permanent scarring loss.

Caught early, it is reversible. That is the entire point of coming in when the hairline first starts thinning rather than three years later.

Central centrifugal cicatricial alopecia (CCCA)

A scarring alopecia that begins at the crown and expands outwards, often with tenderness, itching or burning. It is far more common in women of African descent, and because the follicle is destroyed, early treatment to halt progression is critical.

Alopecia areata

Sudden, smooth, round bald patches – on the scalp, beard or eyebrows – caused by the immune system attacking the follicle. It can regrow spontaneously and it responds well to treatment, particularly intralesional steroid injections, which are done here in the clinic.

Telogen effluvium

Diffuse shedding two to three months after a trigger: childbirth, surgery, a severe illness or fever, rapid weight loss, iron deficiency, thyroid disease or major stress. Hair comes out in handfuls but the follicles are intact, so it recovers once the trigger is addressed.

Androgenetic alopecia

Pattern hair loss – a receding hairline and crown thinning in men, widening of the parting in women. Progressive, but treatable, and treatment works far better at holding onto what you have than at regrowing what is long gone.

Scalp disease causing hair loss

Seborrhoeic dermatitis, scalp psoriasis, tinea capitis (scalp ringworm – especially in children), folliculitis and dissecting cellulitis all damage hair. These need the scalp disease treated first; the hair follows.

How hair loss is diagnosed

  1. History – when it started, how fast, the pattern, your styling history over the past few years, medication, diet, recent illness, family history and menstrual history.
  2. Scalp and hair examination – including dermoscopy (trichoscopy) to look at the follicular openings. The presence or absence of follicular openings is what separates a scarring alopecia from a non-scarring one, and it changes everything about the prognosis.
  3. Pull test – how many hairs come away with gentle traction.
  4. Blood tests where indicated – iron studies and ferritin, thyroid function, vitamin D, and hormonal tests where there are other features of androgen excess.
  5. Scalp biopsy where a scarring alopecia is suspected or the diagnosis is uncertain.

Treatments available at the clinic

  • Intralesional steroid injections – the mainstay for alopecia areata and useful in inflammatory scarring alopecias. Sessions are usually every four to six weeks.
  • Topical therapy – minoxidil, anti-inflammatory lotions and medicated shampoos, chosen for the diagnosis and for hair that is styled and covered.
  • Oral medication – anti-androgens, iron replacement, thyroid management or antifungals for tinea capitis, depending on the cause.
  • Treatment of underlying scalp disease – seborrhoeic dermatitis, psoriasis and folliculitis.
  • Styling advice that is actually usable – not “stop braiding forever”, but how to protect a fragile hairline while still wearing protective styles.

Protecting your hairline

  • If a style hurts, or you get bumps or headaches after it is installed, it is too tight. Pain is not “it’s just settling”.
  • Leave the very front hairline out of tight styles.
  • Give the scalp four to six weeks between long-wear protective styles.
  • Avoid combining chemical relaxers with tension styling.
  • Do not sleep in tight buns, hard bands or heavy wigs.
  • Take glue-fixed wigs off gently, with a proper remover.

How long before hair grows back?

Hair grows roughly a centimetre a month, so patience is unavoidable:

  • Telogen effluvium: shedding settles in three to six months once the trigger is corrected; visible thickness returns over six to twelve months.
  • Alopecia areata: regrowth often begins within six to twelve weeks of starting injections, frequently as fine white hairs first.
  • Traction alopecia: if follicles are intact, expect improvement over six to twelve months – provided the traction genuinely stops.
  • Pattern hair loss: six months of consistent treatment before judging, and treatment is long term.
  • Scarring alopecia: the goal is to stop progression. Lost follicles do not return.

Hair loss (alopecia) in Nairobi – questions patients ask

Can traction alopecia be reversed?

If the follicles have not scarred, yes – stopping the traction plus appropriate treatment gives good regrowth over six to twelve months. Once scarring has occurred it is permanent, which is why early assessment matters.

Do hair oils and supplements work?

Oils condition the hair shaft; they do not treat follicular disease. Supplements help only if you are genuinely deficient, which is why iron and thyroid testing is part of the workup rather than a guess.

Is hair loss after childbirth permanent?

No. Post-partum shedding is telogen effluvium and it recovers, though it can take six to twelve months. Iron deficiency and thyroid problems after delivery can prolong it, so both are worth checking.

Do you treat children with hair loss?

Yes. Scalp ringworm (tinea capitis) is a common and very treatable cause in children, and alopecia areata also occurs. See paediatric dermatology.

Can I still braid or wear a weave?

In most cases yes, with modifications – looser tension, smaller sections, leaving the front hairline free and taking proper breaks between styles. Blanket bans do not work; realistic adjustments do.

Do you do hair transplants?

Transplants are not performed at the clinic. We diagnose the cause, treat the underlying condition and stabilise the loss, which has to happen first anyway – transplanting into active, untreated disease fails.

Book hair loss treatment in Nairobi

If your hairline is receding, you have a bald patch, your parting is widening or your scalp is sore, itchy or flaking, get it looked at early. In hair loss, the difference between reversible and permanent is often just a matter of months.

SkinByDrNancy is at Landmark Plaza, 2nd Floor, Argwings Kodhek Rd, Nairobi. Call or WhatsApp 0728 566990, email info@skinbydrnancy.com, or use the online booking form. We are open Monday to Friday 7:00am – 6:30pm and Saturday 7:00am – 12:00pm, and most medical insurance schemes are accepted.

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Book hair loss treatment with Dr Nancy Omwenga

Landmark Plaza, 2nd Floor, Argwings Kodhek Rd, Nairobi. Same-day appointments and walk-ins are available where the diary allows, and most medical insurance schemes are accepted.

Book an Appointment WhatsApp Us Call 0728 566990

Book with Dr Nancy Omwenga

Same-day appointments and walk-ins are available. Most medical insurance schemes are accepted.

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Clinic details

SkinByDrNancy
Landmark Plaza, 2nd Floor, Argwings Kodhek Rd, Nairobi
0728 566990
info@skinbydrnancy.com

Mon – Fri 7:00am – 6:30pm
Sat 7:00am – 12:00pm
Sunday closed

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