Understanding the causes of hair loss and when to seek treatment

hair loss treatment causes trichologist
hair loss treatment causes trichologist

When you start to notice some extra hair in your brush or circling the shower drain, it’s natural to become worried about hair loss and start weighing treatment options. However, shedding—even a lot of it – is often normal and happens to everyone.

“Light shedding is normal and part of the hair’s life cycle,” affirms Amy McMichael, MD, a board-certified dermatologist and the spokesperson for the Reflections of Alopecia Areata campaign. “You may see this type of hair shedding when you shower or brush your hair.”

Dr McMichael, who specialises in hair and scalp diseases, notes that serious hair loss, on the other hand, happens when more hairs fall out than grow in. Outside of genetics, says Dhaval Bhanusali, MD, a board-certified dermatologist and founder of Skin Medicinals and Hairstim Labs, this can be caused by stress, illness, tight ponytails and other hairstyles that cause traction, nutritional deficiencies, autoimmune conditions, thyroid issues, and other medical conditions.

But how can you tell the difference between normal shedding and serious hair loss? While all experts agree that it is best to ask your dermatologist, there are a few things that you can keep in mind to help you gauge where you fall on the hair loss spectrum. Identifying your normal hair shedding rate is the first step—and there are a few places you should look to do so.

General hair shedding

hair loss
Man facing hair fall issues, Image Credit: Getty Images

Dr McMichael says that the average number of strands that you should expect to lose each day depends on how thick and long your hair is. But if you’re looking for a range, she says it is generally normal to lose anywhere between 50 to 100 hairs per day.

Board-certified trichologist David Kingsley, FWTS, of the World Trichology Society adds that there is a discrepancy in this hard-and-firm amount, due to the difference in length of each person’s hair growth phase. For this reason, he recommends not getting too hung up on the numbers: Hair loss amounts in this so-called-average range can still be considered excessive hair shedding if it’s abnormal to you.

“For instance, if you count your hair over a few weeks and notice that about an average of 90 hairs fall out, you might decide that this is okay, because it fits nicely in the ‘normal’ range,” he explains. “However, if you were only losing 45 hairs per day [at one point], 90 is twice your normal average. This could mean that you have excessive hair loss.” The takeaway? Compare your own hair fall with your history—not with someone else’s, says Kingsley.

Hair loss while brushing

There are a few instances when we notice hair shedding most, the first being when we brush our hair. Kingsley says the more often you brush (and shampoo) your hair, the less strands you should see fall out each time. So, if you lose 45 strands per day on average, but also brush every day, you should see a smaller, consistent number in the bristles; you’ll see the bulk of normal shedding in the shower.

If you brush your hair less often, like a few times a week, you can expect to see an uptick of hair shedding, since strands will accumulate from not being brushed everyday. Ultimately, how much you see in your brush is dependent on your daily habits.

Hair loss while showering

hair loss treatment causes hair issues wash hair hairball
(Image credit: Lindsay Cash/Unsplash)

The next place we notice hair shedding is in the shower, post-shampoo. What’s considered a normal amount depends on how much hair you have to begin with. Dr McMichael says that those with shorter and thinner hair tend to shed less than those with thick, long hair.

The range of how much hair you lose when washing it varies. Kingsley says that the less you shampoo, the more hair you’re going to see shed when you do—and that 75 to 80% of the hair you lose during the day comes away when you shower. Dr McMichael emphasises that noticing a pattern of hair loss that deviates from your baseline is a better indicator of a problem, rather than sticking to a numerical amount.

In your hands

Again, this is dependent on the person. Dr McMichael says it is common for a person to lose five to eight strands when they run their hands through their hair—but you still have to take certain factors into account, such as hair type and texture, products, and stress levels. “Every person is unique,” she says.

Kingsley adds that the normal amount of hair you lose daily shouldn’t change rapidly—and that it’s important to differentiate between running your hands through your hair and pulling on your strands. The latter doesn’t accurately indicate whether your hair loss is normal or something to worry about, and Kingsley cautions about using this as a barometer due to its addictive nature. “I find that if a person pulls on his or her hair and does not see any hair the first time, he or she will repeat the action four or five times until hair comes out,” he says. “It is almost as if people want continuous proof that their hair is falling out.”

When to see a doctor

hair loss treatment causes hair issues wash hair hair fall
(Image credit: Tim Mossholder/Unsplash)

According to Dr McMichael, some obvious signs that your hair loss or shedding is abnormal and requires treatment include bald spots and patchiness; losing large clumps of hair and experiencing scalp symptoms, such as irritation and itchiness, should also be cause for concern. Remember that hair loss is not limited to the hair on your head: These symptoms might also apply to your eyebrows, lashes, and face—or anywhere on your body that normally has hair.

Kingsley adds that excess hair shedding lasting longer than 2 to 4 weeks requires medical attention. And if you notice that your ponytail has grown thinner or that you can wrap a band around it more times than you could previously (assuming that the band is not stretched out), seek treatment—this could be another sign of abnormal hair loss.

Whatever you do, all experts advise checking in with your doctor before taking any action. “Every form of hair loss is different and treatment depends on the type of hair loss the individual is dealing with,” says Dr McMichael. “Healthcare professionals provide treatment guidance based on different factors, such as the amount of hair loss and the location of hair loss. Patients should always speak with their doctor to make treatment decisions.”  

This story first appeared on www.marthastewart.com.

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