Are you worried about frequent hair loss? Do you often see hairs on your pillow? Is your hair falling abnormally while you comb? If so, you might worry less as we explain the different types of hair fall and explaine how routine hair shedding is far different from hair loss.
How does normal hair grow?
Underlying your skin are structures known as hair follicles. These follicles are the synthetic machinery of the hair you see on your skin. Each follicle functions to produce and grow individual hair. According to the American Academy of Dermatology, hair grows about half-inch per month on average.1
Hair grows in several stages, which are as follows:
- Anagen stage: an active period of hair growth lasting 2 to 8 years.
- Catagen stage: a transition phase when hair stops growing, and which lasts 4 to 6 weeks.
- Telogen stage: this is the resting phase in which hair falls out and lasts 2 to 3 months.2
Hair Shedding is a Normal Physiological Process
Many people start worrying whenever they see a tuft of hair while running fingers through their hair, on a pillow case or in the shower drain. However, it is totally normal based upon the hair growth cycle to shed 100-150 hairs a day. Yes! It is true.
Cause of androgenic alopecia
Hair loss is different from everyday common hair shedding.
The condition is commonly known in medical science as androgenic alopecia.
Androgenic alopecia is a genetic condition that affects both men and women over the years. Men with such conditions are said to have male pattern baldness. In men, the hairline recedes, and this often leads to partial or complete scalp baldness. However, in women, hair becomes thin over the head without receding of the hairline.3
Several research studies indicate that this form of hair loss is related to hormones within the body known as androgens, specifically an androgen named dihydrotestosterone.
In the normal human body, an enzyme called 5-alpha reductase converts testosterone into dihydrotestosterone. Dihydrotestosterone is responsible for many important sexual functions during puberty. But as adults, it is of no value and can cause miniaturization of hair follicles.4
In persons with androgenic alopecia, 5-alpha reductase activity increases due to genetic predisposition, causing increased levels of dihydrotestosterone production. This increased dihydrotestosterone then results in characteristic baldness.5
Temporary Hair Shedding Owing to Various Stressors
When the body starts shedding more hairs every day in significant numbers (more than 125 hairs per day), it is termed telogen effluvium or excessive hair shedding. It is a temporary form of hair loss that resolves whenever the stressor is removed.6
Stressors of hair shedding
Excessive hair shedding is seen commonly among those who have experienced one or more of the following stressors:
- Weight loss (20 pounds or more)
- Childbirth by a woman
- Unnecessary stress
- High-grade fever
- Stoppage of birth control pills7
Differentiating Hair Shedding from Hair Loss
It is quite easy to know whether you’re having normal hair shedding or are actually losing hair. If you’re shedding more than 100-125 hairs per day, it is probably due to telogen effluvium, which is nothing but excess hair shedding due to stressors, as discussed above.
However, if you notice thinning of your hair and bald patches on the scalp, it can be considered hair loss.
When does permanent hair loss occur?
There are certain conditions in which you lose hair as well as the ability to regenerate the lost hair. Scarring alopecia is characterized by the permanent scarring of the skin after the loss of hair.
There are several reasons behind the scarring alopecia, and the following are the most common:
- Inflammation of the skin resulting in damage to the hair follicles
- Inflammation of the hair follicles (folliculitis)
- Autoimmune diseases targeting hair follicles
- Chemotherapeutic drug therapy, especially taxane drugs (docetaxel or paclitaxel).8
- Tightly woven hair when pulled apart abruptly, causing hair follicles to push out of the skin.
Hair Shedding Seen After Hair-loss Treatment
You might have often seen partially bald persons complaining of hair loss even after hair loss treatment. Well, if you find any such person, let him know the rationale behind this:
Whenever you apply or take a proven product for hair loss, the active substance reaches the hair follicles, stimulating them to start generating hair. A few weeks after the commencement of treatment for hair loss, the growth spurt of new hair starts to begin. This spurting hair pushes out some of the old, weak, and thin strands that were about to be lost. The spurting hair means that the hair follicles have triggered the anagen or growth phase. In addition to minoxidil and propecia, a company called Hair Restoration Laboratories has developed a Hair Restore line totally devoted to helping to block DHT from harming the hair follicles and stimulating the follicles to generate new, thicker, healthier, and stronger hair to take the place of thinning hair caused by androgenic alopecia. Among hair loss experts, a combination of minoxidil, propecia and topical solutions such as those offer by Hair Restoration Laboratories provided you the best chance to prevent hair loss caused by androgenic alopecia and promote your best head of hair possible.9
Take-Away Message
There is no need to worry if you’re losing 100 strands of hair per day as it is part of the normal hair cycle. However, it is advised to consult your dermatologist if you see bald patches on the scalp or are experiencing hair loss of more than 150 hairs per day. Even if this occurs, there are effective and safe treatments available to quickly stop the progression of androgenic alopecia.
References
- Hair and scalp care. https://www.aad.org/public/everyday-care/hair-scalp-care.
- Alonso, L. & Fuchs, E. The hair cycle. J. Cell Sci. 119, 391–393 (2006).
- Androgenetic alopecia: MedlinePlus Genetics. https://medlineplus.gov/genetics/condition/androgenetic-alopecia/.
- Kinter, K. J. & Anekar, A. A. Biochemistry, Dihydrotestosterone. StatPearls (StatPearls Publishing, 2020).
- Ustuner, E. T. Cause of androgenic alopecia: Crux of the matter. Plast. Reconstr. Surg. 1, (2013).
- Rebora, A. Telogen effluvium: A comprehensive review. Clinical, Cosmetic and Investigational Dermatology vol. 12 583–590 (2019).
- Telogen effluvium | DermNet NZ. https://dermnetnz.org/topics/telogen-effluvium/.
- Breast cancer and hair loss | Breast Cancer Care. https://breastcancernow.org/information-support/facing-breast-cancer/going-through-treatment-breast-cancer/side-effects/side-effects-chemotherapy/breast-cancer-hair-loss.
- Oh, J. W. et al. A guide to studying human Hair follicle cycling in vivo. J. Invest. Dermatol. 136, 34–44 (2016).