Menu
Book an appointment

Noticing more hair on the pillow or shower drain? Or are your friends joking about “going botak”? Hair loss and scalp issues are one of the most common health concerns that men face, and can begin as early as the 20s. Not all hair loss is permanent, and some conditions are treatable with early intervention.

The Baseline: What is ‘normal’ hair shedding?

Before jumping to conclusions at the sight of hair in the shower drain, it helps to understand how the hair cycle works. Every hair follicle on your scalp grows independently across three main phases:

  1. Anagen:The active growth phase, lasting two to seven years.

  2. Catagen:A brief, transitional phase lasting a couple of weeks.

  3. Telogen:A resting phase lasting a few months, culminating in the hair shedding so a new one can grow.

Because of this constant cycle, losing 50 to 100 hairs a day is entirely normal.

Common Types of Alopecia (Hair Loss) Seen in Singapore

When hair thinning goes beyond standard daily shedding or a maturing hairline, it generally falls into a few primary categories of non-scarring alopecia.

1.     Male Androgenetic Alopecia (Male Pattern Hair Loss)

Commonly known as male pattern baldness, this is the most prevalent form of hair loss in men, affecting roughly 30% to 50% of men by the age of 50.

  • The Mechanism: Male pattern hair loss is a common inherited hair loss condition,driven by a genetic sensitivity to Dihydrotestosterone (DHT). DHT binds to susceptible hair follicles, causing follicular miniaturization, resulting in gradual thinning and shortening of the hair growth cycle. Over successive cycles, the growth phase shortens and the anagen hairs gradually transition into fine, barely visible hairs until the follicle stops producing hair altogether, resulting in a reduction of hair density.
  • The Pattern:Unlike diffuse hair thinning, male pattern hair loss follows a highly reproducible pattern, typically starting with bitemporal recession (a deep “M” shape at the temples) and thinning at the crown of the head.

2.     Telogen Effluvium (TE)

If you notice your hair coming out in sudden, alarming clumps rather than a slow, years-long recession, you may be experiencing Telogen Effluvium.

  • The Mechanism:A significant physical or psychological shock can result in a large percentage of your actively growing (anagen) hairs going into the resting (telogen) phase abruptly. Approximately two to three months after the triggering event, these hairs shed all at once.
  • Common Triggers:Severe illnesses, major surgeries, sudden extreme weight loss, nutritional deficiencies, chronic metabolic disruptions, or even severe psychological trauma. The good news? TE is temporary and usually resolves on its own once the underlying stressor is corrected.

3.     Alopecia Areata

  • The Mechanism:An autoimmune condition causing discrete ‘coin shaped’ areas of rapid hair loss, that can fluctuate with periods of regrowth and recurrence.
  • Treatment: Intralesional steroid injections, and systemic immunosuppressants in recalcitrant cases.

The Foundation: Scalp Conditions that Men Often Ignore

Healthy hair cannot grow from an inflamed, unhealthy foundation. Many men mistake chronic inflammatory conditions for simple “dry skin”, leading to improper treatment that can exacerbate hair shedding. Chronic work stress, poor sleep, the heat and humidity in Singapore, poor dietary and lifestyle habits as well as the use of frequent styling and hair/scalp treatment products can all compound to result in an irritated and inflamed scalp.

Dandruff vs. Seborrheic Dermatitis

These two conditions exist on the same continuous spectrum of skin inflammation. They are primarily driven by an inflammatory response to an overgrowth of Malassezia, a harmless yeast that naturally lives on everyone’s skin and feeds on sebaceous (oil) secretions.

  • Dandruff:This is the mild, non-inflammatory end of the spectrum. It is characterized by loose, white-to-light-yellow flakes on the scalp without visible redness or skin swelling.
  • Seborrheic Dermatitis:This is the more severe, active inflammatory variant. It presents as well-defined, red patches covered in greasy, thick, yellowish scales. Because it thrives in oil-rich areas, it frequently migrates off the scalp to affect the eyebrows, sides of the nose, behind the ears, and even the beard region.

Scalp Psoriasis

Often confused with severe seborrheic dermatitis, scalp psoriasis is a distinct autoimmune condition where skin cells multiply far too quickly. It is characterized by raised, sharply defined plaques covered in thick, powdery, silvery-white-pink scales. Unlike seborrheic dermatitis, it can extend past the hairline as a solid plaque and may be accompanied by characteristic “pitting” on your fingernails or joint pain.

Tinea Capitis

This is a result of a fungal infection on the scalp, it can be infectious and is treatable with topical antifungals but often also requires oral antifungal treatment.

🚨 The Dermatology Red Flags

Seek a specialist dermatologist consult if you experience any of the following:

  • Signs of Scarring Alopecia:If the skin where your hair used to be looks smooth, shiny, and lacks visible pore openings (follicular ostia), the hair loss could be scarring. The hair loss can be permanent if the underlying inflammation isn’t stopped quickly, and might require a diagnostic scalp biopsy.
  • Scalp Pain or Distress:Severe burning, pain, constant itching that disrupts sleep, or weepy crust.
  • Zero Progress:Failure to see any stabilization or improvement after six months of consistent compliance with first-line over-the-counter treatments.

Evidence-Based Management Strategies

Early and accurate assessment allows for appropriate treatment options and better long-term management. Some suggestions for first line treatment include:

Condition

Primary First-Line Interventions

Active Ingredients to Look For

Male Pattern Baldness

• Topical or oral minoxidil (promotes blood flow/extends growth cycle)

• Oral finasteride (blocks the conversion of testosterone to DHT)

• Minoxidil

• Finasteride

Dandruff & Seb Derm

• Medicated over-the-counter shampoos used 2–3 times weekly during the treatment phase

• Avoid applying heavy raw oils which feed the yeast

• Ketoconazole

• Zinc Pyrithione

• Selenium Sulfide

Scalp Psoriasis

• Targeted topical anti-inflammatory solutions

• Scale-softening agents

• High-potency topical corticosteroids

• Salicylic acid (for descaling)

References

Borda, L. J. (2016). Seborrheic Dermatitis and Dandruff: A Comprehensive Review. Journal of Clinical and Investigative Dermatology, 3(2)

Iyengar, L. (2025). Male and female pattern hair loss. Australian Prescriber, 48,12187474

Kaliyadan, F., Nambiar, A., & Vijayaraghavan, S. (2013). Androgenetic alopecia: An update. Indian Journal of Dermatology, Venereology, and Leprology, 79(5), 613-625. https://doi.org/10.4103/0378-6323.116730 Indian Journal of Dermatology, Venereology and Leprology

Bolognia, J. L., Schaffer, J. V., & Cerroni, L. (2025). Dermatology (Fifth edition.). Elsevier. Chicago Style

Begin Your Hair Journey with Confidence

If you have been experiencing hair loss or scalp concerns, struggling with shedding, thinning, or flare-ups, you do not have to navigate it alone.

We are here to help.

Begin Your Skin Journey with Confidence