Medically reviewed by Dr. Giovanni Scornavacca — Hair Restoration Specialist, Carisma Hair Clinic, St Julian's, Malta. 20+ years clinical experience, trained in Rome and Bologna.

Medically reviewed by Dr. Giovanni Scornavacca — Hair Restoration Specialist, Carisma Hair Clinic, St Julian's, Malta. 20+ years clinical experience, with advanced training at universities in Rome and Bologna.

Why Is My Hair Falling Out? Malta's Complete Guide to Causes and When to Seek Help

Hair loss has more than 50 recognised causes. The most common in adults are androgenetic alopecia (genetic pattern hair loss), telogen effluvium (stress- or illness-triggered shedding), iron deficiency, thyroid dysfunction, and alopecia areata. Because causes overlap in presentation, accurate diagnosis requires both a blood panel and scalp assessment — not one or the other.

You noticed it at some point — in the shower drain, on the pillowcase, or in the bathroom mirror at an angle you don't usually look. Perhaps it was a handful rather than a few strands. Perhaps it has been building quietly for months and you've only just acknowledged it to yourself. Either way, you're searching for an answer.

Hair loss in Malta affects a significant portion of the adult population. Clinical data shows approximately 50% of men will experience measurable androgenetic hair loss by age 50, rising to roughly 70% by age 70. Female pattern hair loss is substantially under-diagnosed: approximately 40% of women will experience meaningful thinning by age 50. Beyond these figures, dozens of other conditions — some entirely treatable within weeks — can cause the same visible shedding. The question is not simply whether hair is falling out, but why.

The answer changes everything about what happens next. This article walks through the most common causes of hair falling out for people in Malta, what distinguishes them, what a proper assessment involves, and when it is time to stop waiting and seek clinical input.

Contents

• ›The Most Common Cause: Androgenetic Alopecia
• ›Telogen Effluvium: When the Cause Was Months Ago
• ›Nutritional Causes: The Most Treatable Category
• ›Thyroid Disorders: A Blood Test Resolves This
• ›Alopecia Areata, Traction, and Medication-Induced Loss
• ›Postpartum Hair Loss: Why It Happens and When to Seek Help
• ›When Hair Loss Is Not "Just Seasonal" or "Just Stress"
• ›The Diagnostic Process: Why You Need Both a Blood Test and a Scalp Assessment
• ›Frequently Asked Questions About Hair Falling Out in Malta

The Most Common Cause: Androgenetic Alopecia

Androgenetic alopecia — commonly called male pattern baldness or female pattern hair loss — is the single most prevalent cause of hair loss in adults worldwide, and Malta is no exception. It is driven by a genetic sensitivity to dihydrotestosterone (DHT), a hormone derived from testosterone. In susceptible follicles, DHT shortens the active growth phase and gradually miniaturises hair shafts over successive cycles until they stop producing visible hair entirely.

The process is slow, and that slowness is part of why it goes unrecognised for so long. Visible thinning typically represents a process that began five to ten years earlier. By the time someone notices a noticeably higher hairline or thinner crown in photographs, the underlying follicular change has been ongoing for years.

In men, the pattern follows the Norwood classification — receding at the temples and thinning at the crown, eventually merging. In women, the presentation is different: diffuse thinning across the central parting, with the frontal hairline typically preserved. This distinction matters because female hair loss is often misdiagnosed or dismissed as "normal" by general practitioners unfamiliar with the female pattern.

Clinical studies indicate that androgenetic alopecia is a permanent progressive condition without treatment. Medical therapies — particularly finasteride and minoxidil — can slow progression and, in many patients, restore meaningful density. Evidence suggests results depend heavily on how early treatment begins. For an overview of available hair loss treatment Malta options, scalp imaging at initial assessment helps establish a baseline that makes measuring treatment progress possible.

According to research published in PMC on androgenetic alopecia, the genetic and hormonal mechanisms driving this condition are well established — making early intervention particularly important for preserving viable follicles.

Telogen Effluvium: When the Cause Was Months Ago

Telogen effluvium is the second most common cause of hair loss and the most frequently misunderstood. It is a diffuse shedding event triggered by a physiological or psychological stressor — but the shedding does not occur at the time of the stressor. It occurs two to three months later.

This delay is the reason so many people cannot identify what caused their hair loss. They are shedding in March from an illness they had in December. They are losing hair in autumn from the surgery they had in summer. The connection between cause and effect is invisible without knowing the mechanism.

The biology: in response to significant systemic stress — illness, surgery, rapid weight loss, extreme emotional stress, childbirth, anaesthesia, high fever — a disproportionate number of hair follicles simultaneously enter the resting (telogen) phase. These hairs sit dormant for approximately two to three months before being shed all at once. The result is a sudden, diffuse increase in daily hair fall, often alarming in quantity.

The important clinical context: acute telogen effluvium is almost always self-limiting. Once the triggering stressor resolves, follicles return to active growth and hair density recovers — typically over three to six months. However, chronic telogen effluvium (defined as shedding persisting beyond six months without an identified and resolved trigger) requires formal investigation. It can co-exist with androgenetic alopecia, and distinguishing between the two requires clinical assessment, not guesswork.

Normal daily hair fall is 50 to 100 hairs. Losing more than 150 hairs per day consistently over three or more months warrants a medical assessment. Results may vary for each individual depending on the underlying trigger and overall health status.

Nutritional Causes: The Most Treatable Category

Several nutritional deficiencies are associated with hair shedding, and they represent the most straightforwardly treatable category of hair loss causes — provided the deficiency is identified.

Iron deficiency is the most clinically significant. It is particularly prevalent in women of reproductive age in Malta and across the Mediterranean, where dietary iron absorption can be impaired by high-phytate diets. Ferritin (stored iron) below approximately 30 ng/mL is consistently associated with hair shedding in clinical literature, even in the absence of frank anaemia. The hair may grow normally in texture but sheds prematurely, resulting in diffuse thinning. Correcting iron stores — which can take three to six months even with supplementation — may resolve the shedding in many patients.

Vitamin D deficiency is a counterintuitive finding for a Mediterranean island with sustained sun exposure, but Malta's indoor work culture and high SPF use mean subclinical deficiency is common. Vitamin D receptors are expressed in hair follicles, and clinical studies indicate deficiency is associated with increased follicle cycling disruption and shedding. Repletion is straightforward with supplementation.

Biotin deficiency is frequently marketed as a primary cause of hair loss but is actually rare in adults eating a normal diet. The association between biotin and hair largely derives from cases of severe deficiency or specific metabolic disorders, not from general supplementation in people with adequate dietary intake. Biotin supplementation is not harmful, but its clinical role in most hair loss cases is limited.

Zinc and protein deficiency are more relevant in the context of extreme dieting or specific eating patterns. Severe caloric restriction — particularly rapid weight loss of more than one kilogram per week — can trigger both telogen effluvium and compromise the structural protein available for hair shaft formation.

A targeted blood test panel will identify or exclude nutritional causes efficiently. For detail on exactly which tests to request in Malta, the post on blood tests your doctor should order covers the panel in full.

Thyroid Disorders: A Blood Test Resolves This

Both underactive thyroid (hypothyroidism) and overactive thyroid (hyperthyroidism) can cause diffuse hair loss. The mechanism differs: hypothyroidism slows the metabolic rate and extends the resting phase of the hair cycle, producing gradual diffuse thinning across the scalp, including the outer third of the eyebrows in some patients. Hyperthyroidism accelerates metabolic processes, which can disrupt the hair cycle in the opposite direction but with a similar visible outcome.

Thyroid-related hair loss is entirely reversible once thyroid hormone levels are stabilised with appropriate medical treatment. It does not respond to hair-specific interventions — applying minoxidil or starting finasteride in the presence of undiagnosed hypothyroidism will produce no meaningful improvement.

This is one of the primary reasons that a proper diagnostic workup matters before beginning any treatment. A thyroid-stimulating hormone (TSH) test is simple, inexpensive, and should be among the first investigations ordered for any patient presenting with new or worsening hair loss — particularly if accompanied by fatigue, weight changes, sensitivity to cold, or changes in heart rate.

The NHS guidance on hair loss also highlights thyroid conditions as a key reversible cause worth investigating early — reinforcing why a blood test is always a sensible first step.

A targeted blood panel can identify or exclude several common and treatable causes of hair loss. Photo: www.kaboompics.com / Pexels

Alopecia Areata, Traction, and Medication-Induced Loss

Alopecia areata is an autoimmune condition in which the immune system attacks hair follicles, producing characteristically smooth, coin-shaped bald patches. It presents differently from androgenetic or nutritional loss — the patches are well-defined, the surrounding scalp appears normal, and the onset can be rapid. It can affect the scalp, beard area, eyebrows, eyelashes, or any body hair. Alopecia areata is not caused by stress, though stress may be a trigger in genetically predisposed individuals. It requires dermatological assessment and has its own treatment pathway, separate from androgenetic alopecia management.

Traction alopecia results from sustained mechanical tension on the hair follicle — from tight braiding, high ponytails, weaves, or extensions worn consistently over months or years. The pattern follows the hairline or the areas of tension, presenting as a receding frontal or temporal hairline with broken hairs at the margins. It is particularly relevant in Malta's culturally diverse population. In early stages, traction alopecia is reversible if the styling practice is discontinued. In advanced cases, permanent follicle damage may result.

Medication-induced hair loss is more common than most patients realise. Several classes of medication can trigger telogen effluvium or direct follicle toxicity:

• ›Anticoagulants (blood thinners): heparin and warfarin are among the most commonly implicated
• ›Beta-blockers: used for hypertension and cardiac conditions
• ›Some oral contraceptives: particularly those with higher androgenic progestins, which can accelerate androgenetic loss in susceptible women
• ›Isotretinoin (acne treatment): triggers telogen effluvium in a proportion of users
• ›Antidepressants and mood stabilisers: a subset of patients report hair changes
• ›Chemotherapy agents: cause direct anagen effluvium (loss of actively growing hairs) — a distinct mechanism from most other drug-induced loss

If hair loss began or worsened shortly after starting a new medication, this temporal relationship is significant and should be raised with the prescribing doctor. Never discontinue a prescribed medication without medical guidance based on a suspected hair loss connection.

Postpartum Hair Loss: Why It Happens and When to Seek Help

Postpartum hair loss is among the most common presentations seen at hair clinics in Malta and globally, yet it is still routinely under-addressed in primary care settings.

During pregnancy, elevated oestrogen levels prolong the anagen (growth) phase of the hair cycle. Many women notice thicker, fuller hair during the second and third trimesters. After delivery, oestrogen levels fall sharply. A large proportion of follicles that had been held in the growth phase simultaneously enter the resting phase and begin shedding approximately two to three months postpartum — the same delayed-response mechanism as telogen effluvium from any other cause.

The shedding can be substantial — some women lose noticeably more hair than they expected — and it tends to peak around months three to four postpartum. For the majority of women, the process resolves on its own by six to twelve months after delivery, as the cycle restabilises.

However, postpartum hair loss that does not resolve within twelve months, or that is accompanied by persistent fatigue, brain fog, or weight changes, warrants investigation. Postpartum thyroiditis — an autoimmune thyroid condition that affects approximately 5 to 10% of postpartum women — can present with hair loss and is frequently missed. Iron deficiency is also common in the postpartum period due to blood loss during delivery and the nutritional demands of breastfeeding.

Waiting for postpartum hair loss to resolve without investigation is reasonable for the first six months. Waiting beyond twelve months without a proper assessment is not.

When Hair Loss Is Not "Just Seasonal" or "Just Stress"

There is a persistent cultural tendency — reinforced by well-meaning comments from family and general practitioners — to attribute hair loss to stress, seasonal change, or a passing phase. This framing delays diagnosis and, in conditions like androgenetic alopecia, costs time that cannot be recovered. Follicles that have undergone irreversible miniaturisation cannot be restored by medical therapy — only preserved follicles can be treated effectively.

The following are clinical indicators that hair loss warrants formal assessment, not a period of observation:

• ›Daily hair fall that appears to exceed 150 hairs, sustained for more than three months
• ›Visible changes in hair density or scalp visibility when the hair is parted
• ›A hairline that has moved since a reference photograph (passport, wedding, social media)
• ›Patches of hair loss — sudden, smooth, or well-defined
• ›Hair loss accompanied by scalp symptoms: itch, pain, tenderness, scaling, or redness
• ›Hair loss in a woman under 30, particularly with irregular periods, acne, or unexplained weight changes (which may indicate a hormonal cause such as PCOS)
• ›Hair loss that began or accelerated within weeks of starting a new medication
• ›Any hair loss that is distressing enough to affect daily decisions — hairstyle choices, photography avoidance, social withdrawal

None of these criteria are absolute — some can apply to minor, self-resolving conditions. But they each suggest that watchful waiting is not the appropriate response.

The Diagnostic Process: Why You Need Both a Blood Test and a Scalp Assessment

Hair loss diagnosis is not a single-test problem. Two patients can present with identical-looking shedding and have entirely different causes — one androgenetic, one nutritional, one medication-induced. The investigations that distinguish them are complementary, not interchangeable.

A targeted blood panel — including thyroid function (TSH), ferritin, full blood count, vitamin D, and where indicated, free testosterone, DHEA-S, and sex hormone binding globulin — identifies or excludes systemic causes. Without this, a clinician is treating a presentation, not a diagnosis.

A scalp assessment — ideally including scalp imaging or trichoscopy — evaluates follicle health directly. It identifies miniaturisation patterns characteristic of androgenetic alopecia, distinguishes between active and dormant follicles, quantifies density, and establishes a baseline against which treatment response can be measured. A visual inspection alone is not sufficient; follicle miniaturisation is only reliably detected under magnification.

Hair loss has over 50 known causes. Without a diagnosis, treatment is guesswork. Carisma Hair Clinic begins every assessment with scalp imaging and density mapping — not with a product recommendation. The outcome of that diagnostic assessment determines which, if any, treatment pathway is appropriate.

For men specifically, the diagnostic picture is explored in greater clinical depth in the full breakdown of hair loss causes in men. For those who have already identified that they are concerned about male pattern baldness in Malta, that post covers the genetic and hormonal mechanisms in detail. And if you have noticed specific early physical changes and want to understand whether they constitute a warning sign, the guide on early signs of balding in men addresses the practical signs to look for.

Evidence suggests that across all hair loss types, earlier clinical intervention is associated with better long-term outcomes — making timely assessment one of the most important steps any patient can take. As research from the American Academy of Dermatology confirms, many causes of hair loss are treatable when identified early.

Ready to Take Control of Your Hair Loss?

If you've been researching your options and want a clinical assessment rather than another generic recommendation, Carisma Hair Clinic offers a comprehensive diagnostic consultation — scalp imaging, density mapping, and a personalised protocol designed around your specific pattern of loss.

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Dr. Giovanni Scornavacca and the team at Carisma Hair Clinic are available at our St Julian's clinic.

Frequently Asked Questions About Why Is My Hair Falling Out Malta in Malta

Is it normal to lose hair every day?

Yes. Normal daily hair fall is 50 to 100 hairs. Hair follicles cycle continuously through growth (anagen), transition (catagen), and resting (telogen) phases, and shedding telogen hairs is a natural part of this process. The concern arises when daily shedding consistently exceeds 150 hairs, or when loss is concentrated rather than diffuse — meaning visible changes in density or coverage appear. The distinction between normal cycling and problematic loss is one reason a clinical assessment, rather than self-assessment alone, is useful. Results may vary for each individual depending on hair cycle characteristics and overall health.

How do I know if my hair loss is serious?

There is no universal threshold, but several patterns suggest that watchful waiting is not appropriate: visible scalp through parted hair that was not previously visible, a hairline that has moved from a reference photograph, patches of smooth or sudden hair loss, shedding that persists beyond three months at elevated levels, or hair loss accompanied by scalp symptoms such as itch, pain, or redness. Hair loss in women under 30 with any hormonal symptoms also warrants earlier investigation. If the question "is this serious?" is persistent enough to bring you to a search engine, it is persistent enough to take to a clinician.

Can stress cause hair to fall out?

Yes, but not immediately. Psychological or physiological stress does not cause immediate hair loss. Instead, significant stress can trigger telogen effluvium — a process in which an elevated proportion of follicles enter the resting phase simultaneously, resulting in diffuse shedding approximately two to three months after the stressor. This is typically reversible once the trigger resolves. Chronic, sustained stress — along with poor sleep, inadequate nutrition, and elevated cortisol levels — may also contribute to worsening of underlying androgenetic alopecia in genetically susceptible individuals.

How much does a hair loss consultation cost in Malta?

Carisma Hair Clinic offers a free initial consultation, which includes scalp imaging and a clinical assessment by Dr. Giovanni Scornavacca. Subsequent treatment costs depend on the diagnosis and the protocol recommended — options range from prescription medication plans through to PRP or exosome therapy. Because there is no single cost for "hair loss treatment," the consultation assessment is the appropriate starting point before any costs are discussed. You can book your free consultation here.

What blood tests should I get for hair loss in Malta?

A standard hair loss blood panel includes: thyroid-stimulating hormone (TSH) to exclude thyroid dysfunction; ferritin (stored iron) and full blood count to assess for iron deficiency and anaemia; vitamin D; and, depending on presentation, free testosterone, DHEA-S, sex hormone binding globulin, prolactin, and fasting glucose. Women with irregular periods, acne, or unexplained weight changes may also require evaluation for PCOS. The specific panel appropriate for your presentation is best determined by a clinician after a history and scalp assessment. For a comprehensive guide, see the post on blood tests your doctor should order.

Does hair grow back after it falls out?

It depends entirely on the cause. In telogen effluvium, provided the trigger resolves, hair may regrow over three to six months — follicles are dormant but intact. In nutritional deficiency, hair growth can resume once stores are adequately restored. In androgenetic alopecia, the answer is more nuanced: follicles that have undergone partial miniaturisation can often respond to medical treatment (finasteride, minoxidil, or combination therapy) with stabilisation and partial regrowth, but follicles that have been permanently dormant for many years are unlikely to recover. This is why the timing of treatment matters significantly — the earlier the intervention, the more follicles remain viable. Results may vary for each individual.

Is hair loss treatment safe?

The treatments used at Carisma Hair Clinic — including prescription finasteride, topical minoxidil, PRP therapy, and exosome treatment — have established safety profiles supported by clinical research. Clinical studies indicate that these therapies are well-tolerated in the majority of patients when prescribed and monitored by a qualified clinician. As with any medical treatment, individual responses can vary and potential side effects should be discussed during your consultation. Dr. Giovanni Scornavacca reviews each patient's full medical history before recommending any treatment pathway.

About the Author

Dr. Giovanni Scornavacca is a hair restoration specialist with over 20 years of clinical experience, with advanced training at universities in Rome and Bologna. He leads the Hair Reset Protocol at Carisma Hair Clinic — Malta's most complete non-surgical hair regrowth programme. Dr. Scornavacca specialises in diagnosing and treating androgenetic alopecia, telogen effluvium, and complex hair loss presentations using PRP, exosome therapy, and tailored prescription protocols.

Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Results may vary for each individual. Always consult a qualified healthcare professional before starting any hair loss treatment. Dr. Giovanni Scornavacca and Carisma Hair Clinic are available for clinical consultation at our St Julian's, Malta clinic.

Written and reviewed by Dr. Giovanni Scornavacca, Carisma Hair Clinic. Published: 26 June 2026.

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