When Should I Be Concerned About My Hair Loss?
Dr. Gunjan Gurav (she/her)

Dr. Gunjan Gurav (she/her)

Mar 21Hair and Skin Care

When Should I Be Concerned About My Hair Loss?

This article has been compiled by Vaibhavi Kodnani, a content writer at Proactive For Her.

How much hair fall is too much?

An average adult loses about 50-100 hairs every day. But suppose this number exceeds 100 hairs regularly for many weeks, then it is classified as excessive hair fall. At this point, you must consult a doctor who can diagnose the cause of the excess hair loss.

Understanding the life cycle of hair

Every hair on your scalp is at a different stage of the hair life cycle. There are mainly 4 stages of the life cycle of hair.

  • Anagen phase: A phase in which the hair strands are growing. About 90 per cent of your hair is in this phase at any given time.
  • Catagen phase: The transition phase wherein your hair stops growing. This phase lasts from 2-3 weeks, and about 1-2 percent of your hair is in the catagen phase.
  • Telogen phase: The hairs on your scalp are at rest in this stage and ready to detach from the scalp. 8-9 per cent of hair will be in this stage at any time.
  • Exogen phase: It is the last phase of your hair growth cycle. In this stage, the hair sheds from the scalp.

You experience excessive hair fall when your hair growth cycle shortens due to an underlying cause.

How to understand if you are losing too much hair?

If you notice any of the following symptoms, you are most likely losing too much hair:

  • A lot of hair on your pillow after waking up
  • Excess hair collecting in the brush or comb
  • A big bunch of hair fall while showering
  • Clumps of hair falling out
  • Average collection of hair in a week crossing 700 hairs
  • Itching, scaling of the scalp or boils on the scalp along with hair fall
  • The appearance of patches on the scalp
  • Hair fall preceded with pain or burning sensation in the scalp

Similarly, a few symptoms of hair thinning include:

  • Widened parting area
  • Receding front line
  • Low volume of hair

These symptoms suggest you must immediately see a doctor to diagnose and understand the cause behind your hair fall.

What are the causes of hair fall?

There are several reasons for hair fall. Understanding the root cause of the hair fall is crucial to receiving the necessary treatment. Whether the hair fall is reversible or not will depend upon the cause.

  1. Stress: Telogen effluvium is a condition wherein hair fall occurs post a stressful experience. It typically starts after 1-3 months after the stressful event. The stress causes too many hair follicles to get into the telogen or the resting phase. And within a few months, those hairs fall out. Symptoms usually include more than 100 hairs falling daily. Stressful experiences that can lead to telogen effluvium may include:
  • Illness or infection
  • Surgery
  • Childbirth
  • COVID
  • Divorce
  • Death of a loved one
  • Any other traumatic or stressful events

  1. Hormonal imbalance: Hormonal imbalances in the body can lead to female pattern hair loss or androgenetic alopecia in females. In this, the hair gradually starts thinning, and the parting widens. There can also be a frontal recession where the hair recedes on both sides. Hormonal imbalances happen in conditions like, PCOS, menopause, hypothyroidism.
  2. Nutritional deficiencies: Nutrition deficiencies can happen when your intake is poor or if the nutrients are not getting absorbed in your body. Switching to extreme diets and losing a significant amount of weight in a short span can lead to hair loss too.
  3. Autoimmune diseases: In certain autoimmune conditions, a bald patch of hair can appear overnight. This condition is known as alopecia areata, wherein the immune system attacks the hair follicles.
  4. Excessive treatments of hair: Overprocessing and overtreatment of hair can lead to the weakening of the hair shaft and cause hair fall.
  5. Exposure to pollution: Air pollution damages the hair quality and weakens it, making it prone to breakage.
  6. Excess exposure to the sun: Direct exposure to sunlight on the hair due to being outdoors for long periods can make the hair weak or brittle and cause split ends. This UV induced damage can cause hair fall.
  7. Mechanical damage: Mechanical damage refers to the mishandling of hair like tying it in tight ponytails, improper detangling techniques, and over-manipulation.
  8. Chemotherapy: Post chemotherapy, large clumps of hair fall out. Often, you will lose all your hair.
  9. Medication: Certain medications inhibit certain minerals from being absorbed in the body. Hair fall can also be a side effect of many drugs.
  10. Genetics: Genetics can also play a significant role in your hair fall. This type of hair fall is androgenetic alopecia or female pattern hair loss.
  11. Psychological disorders: Trichotillomania is a condition in which the person pulls out their hair, often to relieve stress.

How is hair fall diagnosed?

Your doctor will most likely diagnose your hair fall using the following few steps:

Diagnostic tests 

To understand the underlying causes of your hair fall, the doctor may suggest you take some tests to rule out nutritional and endocrine causes:

  • CBC test
  • Protein level
  • Ferritin test
  • Zinc levels

Some other tests include:

  • TSH test (if the thyroid is involved)
  • ANA test (antibody test for autoimmune disorders)
  • Ultrasound (may be recommended if it is hormonal hair loss)

Hair pull tests- The doctor may also examine your hair in the clinic. They will perform the hair pull test wherein they hold a tiny bunch of hair and pull it out. By checking the hair that falls, they can understand the status of your hair fall.

Hair examination under a microscope and dermatoscope- The doctor will also see your hair under a microscope to identify the kind of hair falling. The doctor may also use a handheld device known as a dermatoscope to assess the areas of hair loss that will give them an idea of the condition of the scalp, nature of the hair loss and the hair follicles.

Conclusion

If you notice any of the symptoms of hair fall discussed in this article, it is time to visit a doctor for diagnosis. The hair fall being permanent or temporary will depend on the cause of your hair fall. But most importantly, getting diagnosed in time is crucial for management and reversal of hair loss.



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