My hair is falling out. Should I be worried?
A drain clogged with hair isn’t just gross, it can also be concerning. Is your hair loss is something you should be worried about — or is it just a normal part of life?
Here’s the good news: Experts say that for most people, losing hair isn’t something to be too concerned with. But it's good to get answers, as those clumps that are suddenly coming out in the shower may be trying to tell you something that’s going on inside your body.
What’s a normal amount of hair to lose daily?
It’s normal to lose hair daily, and we actually lose more than you probably think. “We lose 100 to 150 strands a day on average,” says trichologist Gretchen Friese. “Some people lose a little less, and some people lose a little more. It depends where you are with your hair-growth stage.” There are different stages of hair growth: anagen, the growing phase; catagen, the transitional phase where hair starts to release from the follicles; telogen, the resting phase; and exogen, the shedding phase.
Depending on what stage of hair growth you are in, you may shed more or less hair. There’s no perfect science as to when you will enter these hair-growth phases, but some evidence suggests people are more likely to enter the shedding phase in the fall when the weather gets colder and people get less vitamin D from the sun. You also may lose more hair, or at least notice it more, on hair-washing days or other days when you’re paying a little extra attention to your scalp.
So how do you know if what you’re experiencing is unusual, without counting every strand of hair on the bathroom sink? While Dr. Susan Massick, a dermatologist at the Ohio State University, says losing hair every day is normal, you may be losing an unusual amount of hair if you notice “handfuls of hair,” or if you feel that there is easy shedding when running your hands through your hair. Bald patches in your scalp can also be a sign that you’re losing more hair than you can replenish.
What can cause hair loss?
Hair loss — when it's outside of the normal range — is usually a symptom of other things going on inside your body. There are many different things that may lead to hair loss, such as:
Changes in hormones, such as being postpartum
Stress
Anemia
Nutritional deficiencies, such as a lack of protein
Vitamin deficiencies, specifically vitamins A and D
Thyroid disease
Medications such as antidepressants or beta blockers
Chemotherapy
An intense life event — such as a death in the family or even a bout of illness like COVID-19 — may also be behind hair loss. Temporary hair loss caused by severe stress on the body — be it physical or emotional — is known as telogen effluvium.
Many people have experienced telogen effluvium after testing positive for COVID-19. In 2021, Drake shared on social media that his hair fell out as a side effect of COVID, while actress Alyssa Milano revealed in 2020 that her hair was coming out in chunks after her bout with the virus. The good news is that hair typically returns to its normal growth cycle once your body reaches equilibrium.
How autoimmune conditions affect hair loss
While your hair may bounce back after a quick illness or particularly stressful time, it’s also possible for hair loss to be connected to something going haywire with your immune system. Lupus, an autoimmune condition that can attack many areas of the body, may lead to hair loss by causing inflammation on the scalp and other hair follicles, causing hair, including eyebrows, eyelashes and facial hair, to thin and fall out.
Perhaps the most well-known condition to cause hair loss is alopecia, which, Massick explains, “causes your own immune system to attack the hair follicles [so that] the hairs just fall out, usually in patches, leaving behind smooth skin.” Jada Pinkett Smith and Ricki Lake are among the celebrities who have spoken candidly about living with alopecia.
Then there’s also a skin condition you should be aware of: If you’ve noticed itchy, irritated skin on your scalp, it’s possible you have the autoimmune condition scalp psoriasis. While there’s no cure for the condition, there are treatments that make it more manageable.
When hair loss is genetic
Sometimes genetics is at the root of hair loss. Male- or female-pattern baldness, also called androgenetic alopecia, is the most common reason for hair loss. It’s caused by an inherited sensitivity to the hormone dihydrotestosterone, or DHT. This hair loss can manifest at any point after puberty, and exactly where it occurs often looks different in men and women. Men typically have a receding hairline, while women find their center part widening over time.
Something to note: For a long time, people believed that the genes for baldness were inherited from your mother’s father (particularly if you were a man), but that’s not the case. Hair-loss genes can be inherited from both sides — so one grandparent having a bald dome may not necessarily mean you'll follow suit.
The Food and Drug Administration has two medications approved for this type of hair loss: Rogaine and Propecia. In addition, doctors may prescribe Avodart and spironolactone off-label.
How do I know if my hair loss is something to be concerned about?
In general, a little bit of hair loss is no big deal — but if you’re noticing a major shift in how much hair you’re losing, you should go to your primary care doctor for testing. They can rule out some of the big causes of hair loss, like deficiencies and thyroid conditions. This is especially important if you are experiencing any symptoms outside of shedding hair that might reveal something more serious going on.
It might also be time to consult with a dermatologist, says Friese. “A dermatologist will focus more on your hair loss, because our scalp is skin,” she explains. While oftentimes hair loss can be treated by first addressing the underlying issue, a dermatologist can also determine if you need additional treatment, such as corticosteroids.
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