Dr Kavish Chouhan explains the early warning signs of hair loss from shedding over 50 strands a day to widening partitions and discusses the rise in early balding among teens, driven by genetics, nutrition, hormones, and lifestyle pressures.
Published Nov 23, 2025 | 7:00 AM ⚊ Updated Nov 23, 2025 | 7:00 AM
Losing 50 strands of hair in 24 hours is normal.
Synopsis: Hair loss is a progressive phenomenon. The most important reason is genetic factors. Genetics determines the extent of hair loss. Other than that, there are nutritional factors, hormonal imbalance, and stress — all playing a role in different proportions.
Early hair loss is becoming increasingly common, with many people missing the subtle signs until the thinning becomes visible.
In this exclusive interview with South First, Dr Kavish Chouhan, Dermatologist, hair transplant surgeon, and Director & Co-Founder of DermaClinix, explains why early detection matters, what the first warning signs look like, and how simple medical interventions can prevent minor shedding from turning into permanent balding.
Drawing from his clinical experience, he breaks down the emotional, genetic, nutritional, and lifestyle factors driving early hair loss today.
Q: Hair loss causes emotional pain almost 10 times more than physical pain. Why is hair so important to a person?
A: Hair contributes a lot to your physical appearance and personality. Imagine a balding college student. His friends will make fun of him, and he’ll feel looked down upon. The same thing is now happening even with school-going kids and early adolescents, which is very disturbing for them.
We also see many patients whose families worry over getting a good marriage match, an unfortunate social reality. Ideally, confidence shouldn’t depend on looks, but the reality is different. I’ve had patients who were completely under-confident, struggling in their jobs or personal lives, and after a hair transplant, their confidence and overall persona improved drastically. Whether we like it or not, hair does play an important role.
Q: What are the early red flags that we miss when it comes to hair loss?
A: In general, what everyone needs to understand is that 50 strands of hair falling off in 24 hours is completely normal. Everyone loses some hair because that hair is recycled. When you start losing more than 50 hairs per day consistently, then you must consult a dermatologist.
You should do this in the early stages. It is then possible to improve this just by some basic nutritional factors or some medicinal treatment. With basic treatment, you would be able to control hair fall. The problem is that people go into a vicious cycle of using various kinds of oils and some ‘desi’ ayurvedic treatments. They don’t take proper treatment when it’s required, and many of them come too late to a dermatologist. So consult a qualified dermatologist if you are consistently facing hair loss of more than 50 hairs per day.
Q: Before suggesting a hair transplant, what are the treatment options you consider?
A: Hair transplant is a last resort. We don’t directly go to a hair transplant in most cases. We first try to improve it with medical treatment.
First, we make the correct diagnosis, what is the actual reason for hair fall, what factors are contributing, and what we can improve. Even in patients whom we consider for hair transplant, we first start them on medical treatment and regenerative therapies. We do some basic tests to see if they are deficient in common nutrients required for hair, and we treat that first.
Only the areas that have gone completely bald are planned for a hair transplant. This journey is always a ladder — most patients we treat medically, some we add regenerative therapies like PRP (Platelet-rich plasma), and only in a very few do we go for a hair transplant.
Q: Who is a candidate for a hair transplant?
A: Those with receding hairlines, and those who want to restore their hairline. For them, a hair transplant is going to be a big boost because medical treatments don’t work very effectively in the hairline. In that front area, a hair transplant is the only solution.
Also, for increasing density in areas that have gone completely bald, a hair transplant becomes the only option.
Q: In the case of women, what signs indicate they might need treatment or a transplant?
A: Women have two main patterns. First is female-pattern hair loss the partition starts widening, and the area around the partition starts thinning. In those cases, we mostly treat medically and with regenerative therapies.
The second category is androgenetic alopecia in females, similar to males. Their hairline starts to recede, and they lose hair from the sides. In such cases, we may need to improve the hairline.
It depends on the pattern and whether non-surgical treatment helps. If the density has significantly gone down, especially in the frontal area, transplant becomes the easy option. And now with long-hair FUE, we can do it without trimming, and without downtime — making it much easier for females.
Q: Why does hair loss happen, and why is the treatment such a long journey?
A: Hair loss is a progressive phenomenon. The most important reason is genetic factors. Genetics determines the extent of hair loss. Other than that, there are nutritional factors, hormonal imbalance, and stress — all playing a role in different proportions.
In men, genetics contributes almost 80 percent. In women, nearly 50 percent is nutritional, hormonal, and stress-related. We target the dominant factor. Nutritional and hormonal hair loss improves significantly. But genetic factors cannot be changed as of now. So we treat accordingly.
Q: Are there tests to determine the cause of hair loss?
A: Yes, for nutritional factors and hormonal imbalance, it’s easy to run basic tests. For genetic factors, we have a detailed genetic analysis. A simple swab test for a newborn can help predict the likelihood of going bald in their 20s or 30s. We can now predict that quite efficiently. We cannot change genes yet, but we can give more targeted treatment based on genetic issues.
Q: Is a hair transplant painful? Is it permanent?
A: Hair transplant is done under local anaesthesia. You are awake throughout. We numb only the area we are working on. The only time you feel pain is when we inject the anaesthesia — and even that is less painful than giving a blood sample.
During and after the surgery, there is absolutely no pain. It is very safe if done by a qualified dermatologist or plastic surgeon in a proper operating theatre.
Transplanted hair is permanent. But that does not make your other existing hairs permanent. Those may continue to fall in the future, and you may need more treatment or even another transplant, depending on progression.
Q: Are there people who cannot undergo a hair transplant?
Yes. Patients on blood thinners or cell-cycle inhibitors have reduced response and higher surgical difficulty. They should avoid a transplant unless that issue is sorted out. Some people have primary inflammatory scarring alopecias — autoimmune conditions where the immune system destroys hair roots. In such cases transplant will not work.
A qualified dermatologist must diagnose whether the hair loss can actually be treated by transplant or if it can return simply with medicines and injections. For example, alopecia areata — patchy hair loss — often resolves fully with medicines. So correct diagnosis is essential.”
Q: Who were your youngest and oldest transplant patients?
The youngest was a 10-year-old child with an extensive burn injury. Half of his scalp was burnt. We did three procedures under our charitable programme, ‘Operation Hope’, and fully restored his hairline. He is now in college and doing very well.
The oldest was 74 years old. Older patients have more comorbidities, but we can still do it if managed well. We design the hairline to match their age so it looks natural.
Q: What are three mistakes that cause hair fall?
A: First, parlour procedures like straightening, re-bonding, and keratin. All of these damage hair and increase hair fall.
Second, using narrow combs and being harsh while combing. Always condition your hair properly.
Third, poor nutrition. Low protein and low vitamins/minerals have a big impact.
Q: Does wearing a helmet lead to hair loss?
No, it does not. It’s a myth. Hair roots are not affected by wearing a helmet.
Q: Does frequent shampooing cause more hair fall?
No. Ideally, shampoo two or three times a week. Shampooing only sheds the hair that is already in the resting phase. It does not cause hair fall.
Q: Is onion extract useful?
Unfortunately, no. It may irritate the scalp and can be counterproductive.
Q: Do garlic, potato or coffee powder help in regrowth?
No. These irritate the scalp and, in higher concentrations, can cause burns and scarring, which permanently reduce chances of regrowth.
Q: Does applying oil prevent hair fall?
In one sentence, oiling does not help control hair fall. Oil molecules are too big to reach hair roots, which are 5–7 mm deep. Oil works only as a conditioner on hair length. When applied to the scalp, it clogs pores, attracts dust, and worsens dandruff. If applying at night, wash it off in the morning. Use it only on the hair length as a conditioner.
(Edited by Majnu Babu).
