Hair loss treatment begins with working out which type of hair loss is present. Gradual pattern thinning, heavy shedding after illness or childbirth, and patchy loss have different causes and need different plans. For some people with pattern thinning, scalp microneedling may be considered after assessment. The aim is to support hair density over months, not to promise regrowth.
Key takeaways
Hair loss has several causes, and pattern thinning, shedding after a trigger and patchy loss each follow a different path.
An assessment looks at timing, health history and the scalp itself, because some hair loss reflects an underlying medical issue.
For pattern thinning, options a physician may discuss include topical minoxidil, prescription medicines and scalp microneedling.
The strongest published evidence for microneedling is in pattern hair loss, mostly when it is combined with minoxidil.
Improvement in hair density is gradual and varies between people; a realistic aim is to support thickness over months, not to promise regrowth.
Sudden, patchy or painful hair loss, or loss with scalp redness or scarring, needs medical assessment before any cosmetic treatment.
If you have noticed a wider part, more scalp showing under bright light, or more hair in the brush, you are probably trying to work out whether this is temporary, whether it needs medical attention, and what may help. Our guide to why hair thins covers the common causes in more detail. This page explains how hair loss is assessed, the options a physician may discuss, and where Merrion's Hair Growth Microneedling Program fits.
What you may noticeGradual thinning over the crown or a widening part; finer hairs
First prioritiesConfirm the pattern; check for contributing health factors
Options a physician may discussTopical minoxidil; prescription medicines; scalp microneedling, often in combination
At MerrionYes: assessment and the Hair Growth Microneedling Program. Discuss at assessment: minoxidil and prescription options
Shedding after a trigger (telogen effluvium), including after childbirth
What you may noticeMore hair falling out all over, often around three months after illness, stress, childbirth or a diet change
First prioritiesIdentify and address the trigger; check iron and thyroid where relevant
Options a physician may discussUsually time and treating the cause; regrowth is common once the trigger settles
At MerrionDiscuss at assessment
Patchy loss (alopecia areata)
What you may noticeSmooth, round bald patches; sometimes eyebrows or lashes
First prioritiesMedical assessment
Options a physician may discussTreatment directed by a physician, sometimes with referral
At MerrionDiscuss at assessment; microneedling is not the starting point
Loss with scalp symptoms or scarring
What you may noticeItching, burning, tenderness, redness, scaling or shiny areas with no hair openings
First prioritiesPrompt medical assessment, as some forms are permanent if untreated
Options a physician may discussInvestigation and treatment of the scalp condition, often with referral
At MerrionDiscuss at assessment; cosmetic treatment is deferred
Breakage or traction
What you may noticeShort, broken hairs; thinning at the hairline from tight styles
First prioritiesChange styling habits; protect the hair shaft
Options a physician may discussGentle hair care; time
At MerrionDiscuss at assessment
Mixed patterns are common; a period of shedding can make underlying pattern thinning more noticeable, for example. This overview is a basis for discussion, not a way to diagnose yourself.
Pattern thinning is different from shedding
Pattern thinning
Pattern thinning develops slowly, as affected follicles produce finer, shorter hairs over successive cycles. People often describe it as needing to change where they part their hair, a ponytail that feels thinner, or more scalp showing in photographs, with the hairline itself largely unchanged.
Shedding after a trigger
Shedding after a trigger tends to feel more sudden: handfuls of hair in the shower or brush, while the scalp may look fairly normal.
Both can happen at once, which is one reason the history matters.
Why assessment comes first
Hair loss is often cosmetic in its effect but not always in its cause. Iron deficiency, thyroid disease, recent illness, rapid weight loss, hormonal changes and some medicines can all contribute, and treating the scalp without addressing them may limit any benefit.
During an assessment, Dr. Kate considers when the hair loss started, whether it is gradual or sudden, any recent triggers, family history, menstrual or menopausal changes, medicines and styling habits. She also examines the scalp, looking at the pattern of thinning, the width of the part and any signs of inflammation or scarring. As a Family Physician with focused training in medical aesthetics, she considers general health alongside the hair itself.
Depending on the history, blood tests such as iron studies or thyroid function may be suggested before treatment is planned. Tests are chosen to answer a specific clinical question rather than ordered as a broad panel, and they are not needed for everyone with a typical pattern.
When a different pathway is needed
Some hair loss needs medical care rather than a cosmetic course. Sudden patchy loss, loss of eyebrows or lashes, a painful, itchy or inflamed scalp, scaling, or areas where the scalp looks smooth and shiny all warrant prompt assessment. In these situations, Dr. Kate may recommend investigation or referral, including to a dermatologist, before any procedure is considered. Delaying that care may allow some types of hair loss to progress.
Hair loss treatment options a physician may discuss
For pattern thinning, treatment usually aims to slow further loss and support the density of existing hair. More than one approach may be combined.
Topical minoxidil
Topical minoxidil is the most established treatment for pattern hair loss in both women and men, and it is available without a prescription in Canada. It needs to be used consistently, and benefit tends to fade if it is stopped. Some people notice temporary extra shedding in the first weeks. It is not recommended during pregnancy or breastfeeding.
Minoxidil is not part of Merrion's Hair Growth Microneedling Program, but Dr. Kate can discuss whether it may suit you alongside a course of treatment.
Prescription options
Prescription medicines for pattern hair loss, such as finasteride for men, spironolactone for some women may be considered. These need to be selected individually and reviewed over time. They are considered only after an assessment, and several are not suitable during pregnancy or when trying to conceive.
Scalp microneedling
Microneedling uses fine needles to create controlled micro-injuries in the scalp. This is thought to stimulate wound-healing signals around the hair follicle and may help topical products penetrate the skin.
The published evidence is strongest for pattern hair loss, and mostly for microneedling combined with minoxidil. In a 2023 network meta-analysis of 27 trials, minoxidil plus microneedling was associated with the greatest improvement in hair density at six months; microneedling on its own showed a smaller effect. These trials used a range of protocols, and Merrion's eight-session course has not been studied as a whole, so their results describe what microneedling can do rather than predict an individual response. Our article on microneedling for hair loss looks at the evidence in more detail. Microneedling does not address shedding caused by a medical trigger, and it is not a treatment for scarring hair loss.
Light therapy and PRP
Low-level light therapy and platelet-rich plasma (PRP) are also used for pattern hair loss, with evidence that is promising but less consistent. Our comparison of PRP, microneedling, minoxidil and red light therapy for hair sets out how they differ. Note: Merrion Medical Aesthetics does not offer PRP treatment.
Surgical hair restoration
Hair transplantation is a surgical option for some people with established pattern loss. Merrion does not offer surgical hair restoration; if it may be relevant, Dr. Kate can talk this through with you at your assessment.
This information is educational and does not replace personalised medical assessment.
What causes hair loss and thinning?
Genetics and hormones
Pattern thinning often runs in families and develops gradually as follicles produce finer, shorter hairs.
A recent trigger
Illness, childbirth, stress or a crash diet can cause heavy shedding, often around three months later.
Iron, thyroid and general health
Low iron, thyroid disease and some medicines can contribute, so they are worth checking where relevant.
Scalp and immune conditions
Patchy loss, or loss with an inflamed or scarred scalp, needs medical assessment before any cosmetic treatment.
Styling and breakage
Tight styles, high heat and chemical treatments can break hair or pull it out, especially at the hairline.
Non-surgical, assessment-led care for thinning hair.
How hair loss is treated at Merrion
The right plan depends on the type of hair loss you have, so treatment begins with an assessment rather than a standard package. Depending on what that shows, the plan may include one or more of the following.
Assessment first
Treatment begins with a consultation with Dr. Kate. She asks when the hair loss started, whether it is gradual or sudden, and about recent triggers, family history, hormonal changes, medicines and styling habits. She also examines the scalp, looking at the pattern of thinning and any signs of inflammation or scarring.
Blood tests may be suggested when the history raises a specific question. Sudden or patchy loss, or loss with an inflamed or scarred scalp, may need investigation or referral before any cosmetic treatment is considered.
The Hair Growth Microneedling Program
Merrion offers non-surgical hair restoration through the Hair Growth Microneedling Program: a complete course of eight in-office treatments, with a home-care routine between visits. Single treatments are not available.
Each session combines scalp microneedling with the TWIST by Dermaroller, a microneedling device licensed by Health Canada as a Class II medical device, at a fixed, shallow needle depth; Healite LED light therapy as supportive scalp care; and an XcellarisPro scalp ampoule, alternating between two formulations across the course.
Home care between visits
Between visits, the home-care routine uses a 0.2 mm Dermaroller, a roller cleaner and an XcellarisPro scalp lotion. The written aftercare you are given explains when to restart each step after a session.
Topical minoxidil has the most established evidence for pattern hair loss, and some people may be suited to prescription medicines. These are not part of the Program, but Dr. Kate can discuss whether they may suit you alongside a course of treatment.
Several of these options are not suitable during pregnancy, while breastfeeding or when trying to conceive, so they are considered only after an assessment and reviewed over time.
The most appropriate treatment depends on the type of hair loss. For pattern thinning, topical minoxidil has the most established evidence, and combining it with microneedling has shown the greatest improvement in density in pooled studies. Shedding after a trigger usually improves once the cause is addressed.
Can thinning hair grow back?
It depends on the cause. Shedding after a trigger often recovers on its own over months. Pattern thinning tends to progress, and treatment aims to slow it and improve density rather than restore hair completely.
How long does it take to see results from hair loss treatment?
Hair grows in cycles, so change is slow. Studies of microneedling for hair loss typically assess results after three to six months, and it can take longer to judge the full response. Some people see an improvement in density and hair quality; others see little change, and results are not guaranteed.
After each session, redness, warmth, tightness, tenderness or mild swelling are common for one to three days. Pinpoint bleeding during treatment and mild flaking afterwards are normal. Our guide to scalp microneedling sessions, results and aftercare covers the course step by step.
Pattern hair loss tends to progress over time. Any benefit usually depends on continued care, so what happens after the course is part of the conversation before it begins.
How can I look after my scalp and hair during treatment?
Day-to-day care will not reverse pattern thinning, but it can reduce breakage and keep the scalp comfortable while other treatment takes effect. Wash with a gentle shampoo, limit high heat and tight styles, and be cautious with chemical treatments on fragile hair. Exposed areas of scalp can burn, so a hat or a gentle sunscreen is worthwhile outdoors.
A balanced diet with enough protein and iron matters, because crash dieting and low iron are recognised triggers for shedding. Supplements are more useful when guided by blood tests than taken without a clear reason, since some can cause harm in excess.
If you are having a course of treatment, follow the written aftercare you are given; it includes when to restart any home-care steps after each visit.
Is hair loss treatment different for women?
Women more often notice diffuse thinning over the crown and a widening part, rather than a receding hairline. Hormonal changes after childbirth, around menopause, or with conditions such as polycystic ovary syndrome can contribute, and shedding and pattern thinning often overlap. These factors shape which options are appropriate, particularly where pregnancy is possible.
When should I see a doctor about hair loss?
Seek assessment promptly if hair loss is sudden, patchy, painful or itchy, if the scalp looks red, scaly or shiny, or if you feel unwell.
An assessment is also worthwhile if your hair has been thinning for several months, if shedding has not settled, or if you are considering a procedure and want to know whether it suits the type of hair loss you have. At Merrion in Oakville, a consultation with Dr. Kate begins with that assessment, before any course is recommended. For a plan matched to the type of hair loss you have, book a complimentary consultation with Dr. Kate.
MB BCh BAO, MICGP, CFPC, Family Medicine
Dr. Kate Healy
“Thinning hair can feel very personal, and it rarely has just one cause. I start by working out which type of hair loss is present, because when the plan fits the cause, we can set realistic expectations and judge progress honestly over months.”
Thank you Fiona - much appreciated. If you have any questions or need further assistance, feel free to reach out!
M
Laser Resurfacing - Face Mary Wood
First Treatment
I had my first treatment and was happy with it. I feel like it’s already working even though I will have a few more treatments. Dr. Kate explained the process thoroughly and is knowledgeable and caring.
Thanks Mary for your kind words - they mean a lot to us.
