Excessive Hair Loss: Causes, Symptoms & Treatment
Reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Shower thoughts are one of the internet’s great totems of culture, but yours can easily be overtaken by fear if you suddenly start seeing too much of your hair circling the drain.
We’ve all had mornings or evenings where the sight at the bottom of the shower or sink makes us worry: am I losing my hair?
But before your thoughts turn to toupees and you start making accusations to your comb, there may not be reason to panic. Because there’s actually a difference between normal hair loss and excessive hair loss. As you might suspect, it’s a numbers game.
Normal Hair Loss: What Can You Spare?
The good news for anyone worrying themselves over a few lost locks is that you’re actually supposed to lose hair on a daily basis — and a lot more than you might suspect.
In fact, the average hair loss for an adult is somewhere in the ballpark of as much as 100 hairs, according to the American Academy of Dermatology (AAD). The AAD explains that, with over 100,000 hairs on your head, losing between 50 and 100 is par for the course.
Most of those hairs are actually at the end of a natural life cycle. Believe it or not, every hair on your head is on its own independent journey and schedule, with some starting a new job while others are writing out their wills.
A hair follicle has a three phase life cycle, and those phases are broken up as follows: anagen, catagen, and telogen.
90 percent of your hair at any given time should be in the anagen phase, which is essentially the living and growth phase of the hair’s life cycle. This is where it’s growing out — producing.
Once the anagen phase is over, the catagen phase begins. You can think of this as retirement: golden years, relaxing, not producing much, but still alive and thriving. Sadly for the hair, it only lasts a few weeks. A couple percentage points of your hair will be in this phase at any given time.
At the end of the catagen phase comes the telogen phase, which is essentially the end-of-life segment of your hair’s journey. In this phase the follicle is all but dead. It’s really just preparing to fall out, where it will go briefly dormant before starting things anew. About nine percent of your hair is in this phase at any given time, unless something isn’t working the way it should.
Signs That Your Hair Loss is Excessive
If 100 hairs a day is normal, then excessive is anything over that. But hair loss is a little more complicated than that — it also has to do with how many follicles are restarting their cycles after the telogen phase, and whether the hair you have is staying in proportion, with regards to phases.
If any of these criteria are off, you’re likely experiencing excessive hair loss. Depending on what exactly is going on, your particular type of hair loss can be diagnosed. Here are some of the most common types of hair loss:
Androgenic alopecia (also known as male pattern baldness) is the one you’re statistically most likely to be suffering from. It can show up as early as your 20s, or much later, and it can develop so subtly that you may not even notice the effects at first.
Androgenic alopecia has some telltale characteristics. You’ll see receding or thinning at the edges of your hair line, and your crown will begin to thin or become outright exposed. There are several factors at play in causing you to have this kind of hair loss, but the big ones are genetics and hormones (and age).
With regards to treatment, there are oral and topical medications that can block hormones and stimulate growth — and even reverse a bit of the loss, potentially. But time is of the essence with this one: the sooner you address it the sooner you stop losing hair.
If male pattern baldness is part of your genetics, then telogen effluvium is a product of your environment. Telogen effluvium is typically brought on by trauma, stress, or other severe and negative occurrences. And it can manifest in many forms, brought on by surgery, illness, sudden weight loss, or even PTSD.
Telogen effluvium is basically a sudden imbalance in the ratios of your hair phases: it’s diagnosed when more than 10 percent of your hair enters the telogen phase, causing a disproportionate amount of your hair to be non-producing. It’ll look like thinning across your whole scalp.
The good news is that telogen effluvium will likely correct itself after the underlying cause is addressed; you’ll get your hair back when your surgery heals, or when your body calms down after trauma, or recovers fully from an illness.
Hims has helped thousands of men regrow their hair
Two words: man buns. Traction alopecia is hair loss due to physical trauma to your actual hair: pulling, burning, scarring or other damage. It is sometimes referred to as traumatic alopecia, for that reason.
Traction or traumatic alopecia can also be brought on by psychological conditions that cause you to literally pull out your own hair, like trichotillomania.
The solutions are simple if time consuming: therapy for the psychological stuff, and giving up bleaching and man buns so your hair doesn’t feel like it’s gone fifteen rounds every morning.
Alopecia areata is caused by your own immune system. It’s a type of hair loss where, essentially, your immune system attacks your follicles and forces your hair into hibernation — sometimes permanently.
Unfortunately, it’s often not curable. Autoimmune diseases are complicated to treat, and since your autoimmune condition underlying alopecia areata may be different than the next person’s, your best bet is to treat the underlying disease first, and seek guidance on hair loss solutions from a healthcare professional.
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No matter the treatment plan, the best place to start is somewhere. Early action is the best hair loss prevention.
If your hair loss seems excessive, it may be time to look into treatments. Rather than going around with tweezers and keeping a count every day, your best bet may be to get the process started and talk to a healthcare professional about your concerns.
It’s always best to seek medical advice and attention sooner than later, but with hair loss this is particularly true, because the sooner you catch the problem, the less hair you’re likely to lose permanently.
Treatment options for hair loss are many, but the most effective options are typically topical or oral medications that treat the symptoms. This might look like hormone maintenance or growth stimulation for you, or frequently both. You may be offered medications like finasteride (brand name Propecia®), which will help with hormone regulation, or minoxidil (brand name Rogaine®) which can stimulate follicle regrowth.
A healthcare provider will also help you assess environmental and lifestyle concerns, because your hair loss might have to do with poor diet, obesity, excess stress; really anything that’s not good for the rest of your body can also be bad for your hair.
Whatever is causing your problems, don’t delay addressing them. Worrying without help will only lose you sleep — and more hair.