What to check when hair starts falling out

Hair Loss & Scalp

There is a normal range for how much hair falls out in a day. The issue is often not the amount but the direction of change.

Losing hair every day is natural

Hair repeats a cycle of growing (anagen), stopping (catagen) and resting before falling out (telogen). Because not all the hair on the scalp is in the same phase at once, a certain amount falls out naturally every day. Shedding of roughly 50 to 100 strands a day is commonly described as within the normal range.

So a single day's observation that a lot came out today is hard to judge by. The more important signal is change over several months.

The course differs by type

• Androgenetic hair loss is the most common type, in which hair becomes finer and the growth phase shortens, reducing density. In men the pattern of the front hairline and crown is common, and in women a widening around the parting. It progresses slowly and is hard to notice.
• Alopecia areata causes hair to fall out in round or oval patches with clear borders. An autoimmune reaction is known to be involved, and it appears suddenly.
• Telogen effluvium is a form in which a large amount falls out at once a few months after experiences such as childbirth, surgery, rapid weight loss or major stress. A triggering factor and a time lag are characteristic.

Signals worth checking

• Has the width of your parting widened compared with older photographs?
• Has the hair in the same area become noticeably finer?
• Has a patch of hair loss with a clear border appeared?
• Is there oily scaling, redness or itching on the scalp as well?

The last item may be related to seborrheic dermatitis. Irritation caused by scratching can make the condition worse.

Managing the scalp environment is not the same as treating hair loss

An approach that refines the sebum and inflammation of the scalp can help put the environment in order, but it should not be understood as treatment that replaces the cause of hair loss itself. Because the approach needed differs by type, the order is to have the condition assessed at a consultation and then set a direction.

It has to be viewed over time

Given the nature of the hair cycle, it takes several months for change to become visible. It is hard to judge from the result over a short period, and the degree and speed of recovery vary from person to person.

This column is general medical information provided to aid understanding. It does not guarantee the results of any specific treatment and does not replace a medical consultation. Treatment results and the course of recovery vary from person to person. Please confirm what is appropriate for your own condition through a consultation.