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.

The question that decides everything: scarring or not?

Before any treatment is worth discussing, one thing has to be established – whether the hair follicle is still alive. Everything else follows from that answer, and getting it wrong wastes months and money.

Non-scarring Scarring
What is happening The follicle is intact but not producing properly The follicle is being replaced by scar tissue
How the scalp looks Follicle openings still visible Smooth, shiny patches; openings lost
Common examples Patterned thinning, shedding after illness or childbirth, early traction Advanced traction alopecia, scalp lichen planus, other inflammatory scarring conditions
Realistic goal Regrowth Halt progression and protect what remains

This is why a scalp examination with dermoscopy matters more than any product recommendation, and why GFC is only offered once the follicles have been shown to be viable.

Hair loss patterns we see most in Nairobi

  • Traction alopecia – by some distance the most common, and the most preventable. Years of tension from braids, weaves, bonded extensions and tight ponytails pull on the follicles at the hairline and temples.
  • Patterned thinning in men and women, gradual and usually familial.
  • Telogen effluvium – sudden, alarming, diffuse shedding two to three months after illness, childbirth, surgery, rapid weight loss or a period of severe stress. It is frightening and it usually recovers.
  • Alopecia areata – well-defined smooth bald patches appearing over weeks.
  • Scalp conditions – seborrhoeic dermatitis, psoriasis and fungal infection, all of which cause shedding until the scalp itself is treated.
  • Chemical and heat damage – breakage from relaxers, dyes and heat styling, which is hair breaking rather than hair falling, and needs different advice entirely.

Catching traction alopecia while it is still reversible

This is the most useful thing on this page, because early traction alopecia recovers and late traction alopecia does not. Check for:

  1. A hairline that has quietly moved back over a year or two
  2. Short, fine, broken hairs along the margin where thicker hair used to be
  3. Small bumps or tenderness around the follicles in the days after a style is fitted
  4. Headache or soreness while a style is being installed – this is never normal, and is the clearest signal the tension is too high
  5. Thinning most obvious at the temples and above the ears

If two or more of those apply, book an assessment before changing anything else. Alternating styles, avoiding tension at the hairline and giving the scalp genuine rest between styles does more for long-term density than any product applied on top.

What to bring

  • Photographs from one, three and five years ago – the single most useful thing for judging rate of loss
  • A list of styles worn regularly and how long each is kept in
  • Any recent illness, surgery, childbirth, weight change or new medication in the last six months
  • Every product used on the scalp, including oils and treatments from a salon
  • Family history on both sides

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.

Why diagnosis comes before any hair loss treatment

Hair loss is the area of dermatology where people most often buy treatment before anyone has established what is actually happening. Oils, serums, supplements and clinic packages are sold on the assumption that hair loss is one condition. It is not, and the distinction matters enormously – because some types regrow fully and others do not regrow at all once the follicle is gone.

The single most important question is whether the loss is scarring or non-scarring. In non-scarring types the follicle survives and regrowth is realistic. In scarring types the follicle is progressively replaced by scar tissue, and the goal shifts to halting progression and protecting what remains. Treating a scarring alopecia as though it were ordinary thinning wastes the window in which something could have been preserved.

What an assessment involves

  • History – when it started, how fast, family pattern, styling practices, recent illness, childbirth, weight change, new medication.
  • Examination of the scalp itself, not just the hair. Redness, scaling, tenderness and loss of follicular openings all point in specific directions.
  • Dermoscopy of the scalp, which shows follicular detail the naked eye cannot.
  • Blood tests where indicated – thyroid function and iron studies among them, since both are common, treatable contributors.
  • A scalp biopsy occasionally, where the pattern is unclear or scarring is suspected. It is done here in the clinic.

Traction alopecia deserves its own paragraph

It is among the most common forms of hair loss we see, and among the most preventable. Persistent tension from tight braids, weaves, extensions and bonded styles pulls on follicles at the hairline and temples over years. Early on it is entirely reversible. Left long enough it becomes scarring, and at that point no treatment restores what has gone.

The early signs are worth knowing: a hairline that has quietly moved back, short broken hairs along the margin, small bumps around follicles after styling, or tenderness in the days after a style is fitted. Pain while a style is being fitted is not normal and should not be tolerated – it is the clearest signal that the tension is too high.

Changing styling practice is genuinely part of the treatment here, not an afterthought to it. Alternating styles, avoiding tension at the hairline, and giving the scalp real rest between styles does more for long-term density than any product applied on top.

Is my shedding normal or should I worry?

Losing some hair daily is normal. What is worth assessing is a sudden increase, hair coming out in handfuls, visible scalp where there was none, or a hairline that has moved. Bring photographs from previous years – they settle the question quickly.

Will hair oils help?

They can improve the feel and reduce breakage, which is worth something. They do not reverse patterned thinning or regrow a scarred follicle, and heavy oils under tight styles can aggravate scalp conditions. Use them for what they do, not for what they are marketed to do.

How long before I see a change?

Hair grows slowly, so any honest plan is judged in months. Reduced shedding usually comes first, often within a few months, with visible density taking longer. Anyone promising results in weeks is not describing how hair works.

Do I need blood tests?

Often, yes. Thyroid problems and iron deficiency are common, treatable contributors to hair loss and both are easily missed. Treating them can change the outcome on its own.

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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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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