In the second part of the 'Health For You' podcast, Dr. Divya Sharma, leading dermatologist and founder of Dr. Divya’s Skin and Hair Clinic, Bengaluru, discusses key aspects of hair care
Published Apr 27, 2025 | 7:00 AM ⚊ Updated Apr 27, 2025 | 12:57 PM
Hair loss. (iStock)
Synopsis: Dr. Divya Sharma explains the rise in hair loss cases, the influence of diet, sleep, and lifestyle, and the risks of using hair colours, especially for thyroid patients. Dr. Divya also addresses traditional remedies like onion oil and clarifies the difference between hair fall and hair loss, particularly conditions like telogen effluvium
In the second part of the interview for ‘Health For You’ podcast, Dr Divya Sharma, renowned dermatologist and hair care expert and founder of Dr Divya’s Skin and Hair Clinic in Bengaluru speaks about hair care. She speaks on why there has been a rapid increase in people losing hair, how much of a role does daily food, sleep and lifestyle habits influence hair loss and growth.
She also discusses the use of hair colours, explaining why thyroid patients should avoid certain types. Dr. Divya further addresses traditional remedies like applying onion oil and lime to the scalp, evaluating their effectiveness. Excerpts from the interview:
Q. Is there a difference between hair fall and hair loss?
A. Hair is not a permanent organ—it has life cycles. It keeps growing, staying for a while, falling, and regrowing.
For example, after illnesses like COVID, dengue, or chikungunya, or after delivery, sudden weight loss, or nutritional deficiencies, many people experience hair coming out in bunches. This is called telogen effluvium, or hair shedding. In such cases, while the hair grows long, the volume of the ponytail decreases. Patients often say, “It’s growing long, but it’s not as thick—I can’t make a bun like before.”
In contrast, hair loss means the regrowth is less. You’ll notice widening of the central parting or bald patches on the crown. This indicates the new hair isn’t growing as long or as thick as before, and it can lead to permanent hair loss.
Q. Does hair loss have different patterns, especially in women?
A. Yes. Most patients who have shedding for a long time—especially women—often complain that one side of their hair looks thinner. They sometimes mistake it for early baldness, but it usually isn’t.
In men, baldness typically starts at the temples and crown. In women, the female pattern of hair loss presents as a widening of the central parting, what we call a “Christmas tree pattern.” In men, it can involve the vertex, the frontal part, or both. Very rarely, even men can have a pattern that looks like female hair loss, where the center hairline remains good but the central parting starts to widen.
Male pattern baldness usually presents with thinning at the crown and the sides. In women, hair loss most commonly shows as thinning along the central parting, which gradually becomes wider and more noticeable.
Q. People often blame water when they experience hair fall in cities like Bengaluru or Chennai. Is that true?
A. Honestly, I sometimes feel bad when people say that, because Bengaluru, is a wonderful city to live in—ask those of us who stay here. I don’t think water alone is responsible for hair fall. Washing hair with hard water, which contains more calcium and magnesium, can increase frizziness and dryness. You may require more shampoo and soap to cleanse properly, but this issue isn’t unique to Bengaluru—it’s common across most major cities where resources are constrained.
Hard water can cause more split ends, dryness, and frizz, but whether it impacts hair growth through the food chain—for example, if crops are affected by mineral content—we don’t have strong studies to prove that. Also, lifestyle changes in big cities play a bigger role. We eat out more, sleep irregularly, and lead more stressful lives. It’s often easier to blame the water, but multiple lifestyle factors contribute much more to hair fall.
Q. How much role does stress play in hair fall?
A. Stress definitely has a role. Because people do overeat when they’re stressed out, they sleep less—that causes weight gain. There are a lot of studies which say that if your cortisol is on the rise, it will also reduce the hair cycle. It all boils down to metabolism and nutrition. So for the India who slept early, for India who slept well—these issues barely existed.
Q. What’s your take on over-the-counter shampoos, oils, and serums for hair growth?
A. I think oils and shampoos have no real role to play in promoting hair growth. Sometimes shampoos reduce static electricity, so you may see less hair fall, but they don’t actually prevent it. Many people worry when they use oil or conditioner and notice more hair falling. The truth is, it’s very difficult to pull hair out from the root with a shampoo or oil — what you see falling was already detached, and the washing or oiling just makes it more visible.
As for over-the-counter serums, we cannot be sure if what they claim on the label is actually present in the product. If someone is experiencing hair shedding, it is always better to consult a dermatologist rather than rely solely on OTC products. Hair grows very slowly, and this demands patience and consistency. As I often tell my junior colleagues and patients, hair treatments are not like a course of antibiotics for a cough or cold where you stop once you feel better. Until the internal causes are addressed, consistency in treatment is key.
Q. What about hair colors and early greying? How safe are they? And how does henna compare?
A. Early greying has become much more common today. As I mentioned earlier, we are eating more but are seeing a lot of nutritional deficiencies. Whether it is due to changes in soil quality or food habits, deficiencies in vitamins, micronutrients, and iron are now very common. This, along with decreased sleep and increased stress levels, affects the stem cells responsible for hair pigment production, leading to earlier graying.
When it comes to coloring, you cannot simply tell a patient to avoid coloring if they have grayed early. It becomes a lifestyle choice. Importantly, hair color by itself does not damage your hair. There is a lot of negativity around hair coloring causing hair fall or stunting hair growth, but that is not true. If a hair oil is not impacting your hair growth, neither will a hair color.
However, sensitive skin patients may sometimes experience allergic reactions, and people with conditions like thyroid disease or autoimmunity may develop issues like lichen planus pigmentosus (LPP) after hair coloring. The ingredient paraphenylenediamine (PPD) in many hair colors can trigger such reactions. While PPD-free colors are safer, they are not 100 percent hypoallergenic either—they are simply a better alternative.
If you have a history of thyroid disorders, eczema, or sensitive skin, it’s important to ask your dermatologist to recommend a PPD-free hair color. Long-term use of dyes can sometimes cause pigmentation on the forehead, but this doesn’t happen in every patient.
Q. And henna? Does it cause dryness or frizziness like some say?
A. See, henna cannot turn your hair black. If your henna is making your hair look black, there is definitely the addition of a dye to it. Honestly, when you see hair coloring, you don’t see the color washing out with shampoo. What they call as a root touch-up means the new hair growing in is white—that is the new hair. Most commercial hair colors are permanent dyes.
If you are sensitive to metals, such as artificial jewellery, you should avoid conventional hair colors. In that case, it’s better to go for PPD-free colors, which help prevent allergic reactions. But on the whole, if it is pure, homegrown henna, nothing matches it. It’s possibly the only chemical-free option available. However, you must be comfortable with the orange-brown hue that natural henna gives
Q. Is use of conditioners bad for hair?
A. Always oil your hair and not your scalp. Also, you MUST use a conditioner.In Indian households, conditioners tend to get neglected—the shampoo bottle finishes fast, but the conditioner lasts for months! But it’s important: whether you color your hair, have frizzy hair, or not, you should make a habit of applying conditioner on the hair shaft for a few minutes before rinsing off, or use a leave-on conditioner.
Remember, when advertisements show a conditioner traveling from the root through the length of the hair, that’s not technically correct. Hair strands are already “mature”—they don’t regenerate from within. So moisturizing them externally is essential.
Q. How should one oil their hair? Should it be left overnight?
A. We just discussed how hair doesn’t have any natural ammunition to protect itself from the dryness caused by air conditioning and heat. Nothing from the scalp nourishes the hair shaft directly. So it’s the hair body that actually has a thirst for moisture.
It’s important to oil your hair about an hour or two before a head bath. However, I do not recommend sleeping with oiled hair overnight—not even on the hair length. And definitely not on the scalp. Scalp oiling overnight is a big no-no.
The reason is simple: the same pillow you sleep on comes in contact with your face. This can lead to clogged pores, comedones, or even oil-induced acne. Always make it a point to oil your hair briefly before washing, but avoid keeping the oil overnight.
Q. Which oil is the best?
A. You would you be surprised to know that coconut oil is the only oil which can penetrate the cuticle of the hair! No matter how expensive oils come on the shelf, a good old coconut oil is still beating the competition. Of course, there are expensive oils like Moroccan oil, argan oil—and they also are good—but nothing still beats a good old coconut oil for your hair.
Q. What should be the routine post-wash?
A. After every wash, you must apply a conditioner or use a leave-on conditioner.
Nowadays, most shampoos are sulfate-free. That means they are gentler but also less effective as cleansers compared to older formulas. Because of this, they should be used more regularly.
In India, patients often hesitate to wash their scalp frequently, believing that washing with chemicals will harm their hair. But that’s a myth. To maintain scalp health, you should ideally cleanse your scalp at least three to four times a week. And if you’re a male, you can even wash it every day. If you go to the gym, you should wash it more often.
Q. What foods are good for hair health?
A. We always emphasise a low-carb, high-fiber diet for overall health, and it’s the same for your hair. Hair requires a lot of micronutrients. Dry fruits and seeds are excellent sources, and foods rich in iron are particularly good for promoting hair growth.
If you are a non-vegetarian, your diet naturally provides richer sources of iron and protein for hair health. However, we never give blanket food advice. It’s best to curate a diet plan with a dietician, especially focusing on iron-rich, micronutrient-rich, and low-carb foods.
That said, eating only protein for hair is not the right approach either. Some patients believe that taking protein powders alone will solve hair fall issues, but that’s not true. Hair health, like overall body health, needs a balance—you require proteins, healthy fats, and even some carbohydrates.
Also, it’s very important to avoid foods that compromise metabolic health. Processed foods, deep-fried items, and eating out regularly—like a burger every week—will definitely weaken your hair over time. Cutting down on junk food is crucial for maintaining strong, healthy hair.
Q. Do popular home remedies like onion juice, lime, and curd really work for hair and scalp health?
There’s a condition known as alopecia areata—it’s an autoimmune condition. Earlier, onion oil was a grandmother’s remedy because it would irritate the scalp, and in alopecia patches, such irritation could sometimes stimulate hair regrowth. We saw some success with that in our college days.
However, beyond such specific cases, onion juice or oil won’t penetrate deep enough into the scalp to promote hair growth. Today, it’s more of a marketing gimmick than a scientifically backed solution. When it comes to lime and curd—there is some logic. Dandruff is partly due to an alteration of the scalp’s pH, and since the skin naturally has an acidic pH, applying lime or curd can temporarily improve the scalp condition. These remedies have been around for generations, and while not completely baseless, their effects are usually short-term.
I always feel we are yet to fully discover how scientifically valid some traditional practices are. That said, practices like using castor oil with the hope of growing hair in male or female pattern baldness are not effective. In cases of progressive hair loss, home remedies won’t help, and medical treatments or procedures become necessary.
For dandruff, lime and curd might offer temporary relief. But for general hair fall, male pattern baldness, or female hair loss, onion juice or similar home remedies won’t help. It’s important to consult a dermatologist for proper evaluation and treatment.
Q. When should someone consider getting a blood test done for hair or skin health?
A. Every 6 months to 1 year, at least an annual checkup is mandatory for everyone. It’s not for skin and hair. Skin and hair is actually going to tell us what’s happening inside. So at least annually—only once—you must get it done. All ages, irrespective.
Q. Do daily habits like tight ponytails, braiding while sleeping, or over styling worsen hair fall?
A. They don’t worsen hair fall, but they can damage the cuticle. So you’ll have more split ends and you’ll have more issues like frizz. You want to use a dryer, you want to use a straightener—do it. But don’t do it too often. Keep it at a distance from your hair. It may not impact hair loss or hair fall, but it does damage the hair body.
Q. Are there advanced treatments fr early balding? Is it safe?
A. Yes, a lot of advanced treatments are now available, and most of them fall under the category of regenerative medicine. Treatments like platelet-rich plasma (PRP) therapy and growth factor concentrate are derived from the patient’s own blood. Blood contains platelets with more than 100 growth factors, which can stimulate hair growth when used appropriately.
The world is moving increasingly toward regenerative approaches—using the body’s own growth factors to promote hair regrowth. These procedures, when done by a qualified dermatologist, are very safe because they are derived from your own blood.
Other treatments include mesotherapy and newer advances like exosomes. Exosomes are signaling molecules that the body uses for communication between cells. Globally, exosome-based therapies are advancing rapidly, though India is still catching up in this area.
We are also moving toward more specific approaches like stromal vascular fraction therapy. Here, a small piece of the patient’s skin is taken to create a microenvironment rich in factors that promote hair growth, which is then injected back into the scalp using micro-needling devices.
It’s important to understand that no single treatment works as a complete solution for hair regrowth. These treatments are usually done in combination, and while none offer an instant or guaranteed fix, many of them are very safe and effective when done under proper medical guidance.
(Edited by Ananya Rao)
