Young patients recently shifted to metro cities are presenting with prickling in the scalp, itching, dandruff, oily scalp and pain in the hair roots. Various studies have identified this as ‘Sensitive Scalp Syndrome’ resulting from exposure to increasing levels of air pollution including particulate matter, dust, smoke, nickel, lead and arsenic, sulfur dioxide nitrogen dioxide, ammonia and ... [Show full abstract] polycyclic aromatic hydrocarbons (PAH) which settle on the scalp and hair. Indoor air conditioned environments cause volatile organic compounds (VOC) released from various sources to settle on the scalp. The pollutants migrate into the dermis, transepidermally and through the hair follicle conduit, leading to oxidative stress and hair loss. We have used antioxidants, regular hair wash, Ethylenediaminetetraacetic acid (EDTA) shampoo, and application of coconut oil to provide protection the hair and counter the effects of pollution. In this review, we have evaluated the causes, clinical presentation, mechanism of hair loss due to pollution and discussed the the management of hair loss due to air pollution (HDP). Hair loss due to pollution can coexist with or mimic androgenic alopecia. It requires careful history and trichoscopic evaluation to identify and advice a planned hair care program. Patients uniformly show an encouraging response within 6 - 8 weeks of following the hair care regimen.