It is only natural to feel concerned when you notice clumps of hair in your brush or a handful of strands clogging the shower drain. However, it is normal for both men and women to experience a certain degree of hair shedding.
According to the American Academy of Dermatology Association, each person loses an average of 50 to 100 strands a day. The precise count may vary based on factors such as hair length, thickness and overall condition.
But what if you start losing hair beyond the normal range? What does it mean when visible bald spots and patchiness appear? If you are shedding hair a lot more than usual, this might be a sign of temporary or permanent hair loss. Specifically, when we refer to hair loss here, we are talking about patterned hair loss, also known as androgenetic alopecia.
Noticeable patterned hair loss is different from hair shedding, and they both require specific treatment. Learn how to tell the difference below.
What is Hair Loss?
Hair loss is a generic term to mean any form of losing hair. However, there are various types of hair loss, each with its own characteristics and causes:
Telogen Effluvium:
- Telogen effluvium is a temporary type of hair loss that disrupts the normal hair growth cycle.
- It occurs when a large number of hair follicles prematurely enter the resting phase (telogen) without transitioning to the next growth phase.
- This results in increased hair shedding without new hair growth, leading to noticeable hair thinning.
- Hair regrowth is often possible within three to six months once the underlying cause is addressed.
Alopecia Areata:
- Alopecia areata is an autoimmune disorder where the immune system mistakenly attacks healthy hair follicles, leading to patchy hair loss.
- It can appear abruptly and unpredictably, often in small, smooth patches on the scalp.
- Different forms of alopecia areata include totalis (complete scalp hair loss), universalis (complete body hair loss), incognita (diffuse hair thinning), and ophiasis (hair loss in a band on the posterior scalp).
- Hair regrowth in alopecia areata can vary, and complete recovery is not always guaranteed.
Androgenetic Alopecia:
- Androgenetic alopecia, also known as male or female pattern hair loss, is the most common form of hair loss.
- It is hereditary and can be managed with medication or surgical interventions.
- In men, hair loss usually begins above the temples and progresses across the scalp, possibly leading to complete baldness on the crown and hairline.
- In women, hair thinning typically occurs across the scalp while the hairline remains intact.
- Despite the terms, men can experience female pattern hair loss and women can experience male pattern hair loss.
Androgenetic alopecia is defined by hair miniaturisation where hair follicles gradually shrink. As the follicles weaken, they produce weaker, thinner hairs that shed easily. This manifests as a receding hairline, overall hair thinning or even complete baldness in specific areas.
Traction Alopecia:
- Traction alopecia is caused by hairstyles that exert excessive force on the hair follicles, leading to hair loss.
- It is reversible if diagnosed early, but prolonged stress on the follicles can cause irreversible damage.
- Symptoms include small bumps on the scalp, missing and broken hairs, especially along the hairline.
Cicatricial Alopecia:
- Cicatricial alopecia, also known as scarring alopecia, is a rare form of hair loss where inflammation destroys hair follicles and replaces them with scar tissue.
- It can start with small patches of hair loss and may progress rapidly with severe symptoms like itching, burning, and pain.
- Hair regrowth is unlikely in cicatricial alopecia due to the permanent damage to the follicles.
Different Appearance of Potential Hair Loss
- A receding hairline: Gradual thinning at the hairline is often seen in male-pattern baldness. (Androgenetic alopecia, Male/female pattern hair loss)
- Circular or patchy bald spots: Some individuals experience hair loss in circular or patchy bald spots on the scalp, beard or eyebrows. (Alopecia areata, tinea capitis)
- Sudden loosening of hair: Physical or emotional shock can cause hair to loosen. It may lead to handfuls of hair falling out when combing, washing or even with gentle tugging. (Telogen effluvium)
- Full-body hair loss: Certain medical conditions and treatments, like chemotherapy for cancer, can cause hair loss all over the body. (Chemotherapy induced anagen effluvium, Alopecia areata universalis)
Note: Any potential symptoms described do not imply a diagnosis. If you are experiencing hair loss, we highly recommend you consult a medical professional for a thorough evaluation.
Patterned Hair Loss
Patterned hair loss, also known as androgenetic alopecia is one of the common causes of hair loss that we see in Terra Medical. It can present as male or female pattern hair loss. Let’s take a closer look at the common causes of patterned hair loss:
Causes of patterned Hair Loss
- Hereditary: A meta-analysis published in 2017 identified 63 genes associated with male pattern baldness, with only six of these genes inherited from the maternal side. This shows that males are more likely to develop male pattern baldness if their father, grandfather or uncles had it. For females, it is estimated that one in two women will experience female pattern hair loss by age 80.
- Hormonal changes: Genetic factors can increase the likelihood of testosterone being converted into dihydrotestosterone (DHT) in some males. It can lead to smaller hair follicles, resulting in thinner hair that eventually falls out. In females, hormonal changes during specific life stages, such as menopause, can also predispose to patterned hair loss.
- Environmental Factors: While not as significant as genetics and hormones, environmental factors such as stress, diet, and certain medical conditions can contribute to hair loss. Poor nutrition, for example, can impact hair health and growth.
- Medical Conditions and Medications: Certain health issues like thyroid disorders, anaemia, and autoimmune diseases can lead to hair loss. Additionally, some medications, such as those used for treating cancer, arthritis, depression, and heart problems, can have hair loss as a side effect.
- Lifestyle Factors: Stressful lifestyles, inadequate sleep, smoking, and excessive consumption of alcohol can exacerbate hair loss.
What is Hair Shedding?
Hair shedding is a natural part of the hair growth cycle. The human scalp contains approximately 100,000 hair follicles, each going through the four-phase cycle of hair growth. However the issue comes about when the shedding exceeds the normal amounts we get daily, that becomes an issue and is what we term as telogen effluvium, or excessive hair shedding.
To better understand hair shedding we need to understand the hair cycle, which involves four phases:
Anagen
This is the longest phase of hair growth, lasting anywhere from three to seven years or more. During this stage, your hair follicles actively produce hairs that will grow until they are either trimmed or naturally shed at the end of their life cycle. Typically, 90 per cent of the hairs on your scalp are in this growth phase at any given time.
Moreover, the anagen phase differs depending on the type of hair. For instance, the anagen phase for eyebrow and pubic hairs is considerably shorter compared to that of scalp hairs.
Catagen
Once the anagen phase ends, the transitional phase begins and tends to last for around 10 days. Hair follicles start to shrink and hair growth slows down. The hair also detaches from the bottom of the hair follicle but will remain in place during the final stages of its growth.
Around 3% to 5% of your scalp hair is typically in the catagen phase at any given time.
Telogen
Following the catagen phase comes the resting phase, which typically lasts for three months. Around 10 to 15% of the hairs on your head are in this phase.
While hair growth stops completely during the telogen phase, hairs do not fall out. This is also the phase when new hairs begin to form in follicles that have recently released hairs during the previous catagen phase.
Exogen
The exogen phase is considered an extension of the telogen stage, typically lasting for about two to five months. During this phase, the hair that has stopped growing and detached from the follicle in the previous stage finally falls out.
This shedding can occur during everyday activities like washing, sleeping or brushing your hair. As these old hairs are shed, new hairs begin to grow within the follicles, continuing the hair growth cycle.
In a healthy hair growth cycle, hair shedding is balanced by new hair production. However, disruptions to this cycle can lead to excessive hair shedding (Telogen Effluvium). This manifests as either a prolonged shedding duration or an increased number of hairs being shed simultaneously.
Potential Causes of Excessive Hair Shedding
Losing some hair every day is normal, but there comes a point where it becomes excessive. This excessive hair shedding can be caused by various factors, including:
COVID-19, Dengue, and Prolonged Febrile Illness:
- Severe infections and fevers can induce TE by pushing hair follicles into the telogen phase prematurely. For instance, a study published in The Lancet observed a significant increase in TE cases following the COVID-19 pandemic, attributing it to the physiological and psychological stress associated with the disease .
- Another study in the Journal of the European Academy of Dermatology and Venereology found similar results with dengue fever, where patients exhibited noticeable hair shedding months after the febrile illness .
Surgery:
- The trauma and stress of surgery can trigger TE. The body’s response to the physical stress of surgery, anesthesia, and the emotional toll of recovery contribute to this condition.
- According to a study in Plastic and Reconstructive Surgery, patients often experience TE following major surgical procedures, linking it to the physical stress and metabolic demands of healing Plastic and Reconstructive Surgery.
Intense Stress and Worry:
- Acute or chronic psychological stress can disrupt the hair growth cycle, leading to increased shedding.
- Stressors like major life events, trauma, or ongoing emotional strain can trigger excessive shedding.
- It’s important to note that the effects of stress on hair shedding may not be immediate and can manifest a few months after the stressful event.
- A study in the Journal of Investigative Dermatology highlighted that increased cortisol and other stress hormones could cause more hair follicles to enter the telogen phase prematurely, correlating high-stress periods with increased TE cases .
Hormonal Imbalance:
- Fluctuations in hormone levels, including estrogen, progesterone, and androgens, can affect hair growth.
- Hormonal changes during menopause, pregnancy or childbirth can lead to excessive shedding.
- These hormonal shifts can disrupt the normal hair growth cycle and result in increased hair loss.
Rapid Weight Loss and Nutritional Deficiencies:
- Hair follicles require essential nutrients like iron, vitamin D, biotin, and zinc for healthy growth.
- Deficiencies in these nutrients can weaken hair follicles and lead to increased shedding.
- Poor diet, restrictive eating habits, and certain medical conditions can cause these deficiencies.
- A study in Clinical and Experimental Dermatology found that patients with rapid weight loss and poor nutritional intake had a higher incidence of TE, as the body deprioritizes hair growth during nutrient shortages.
Autoimmune Diseases:
- Autoimmune diseases or a weakened immune system can impact hair follicles and lead to hair loss.
- Conditions where the immune system mistakenly targets hair follicles, such as alopecia areata, can cause significant shedding.
- Frequent illnesses or chronic health issues can also affect overall hair health and contribute to excessive shedding.
- Drug-Induced:
Certain medications can cause TE by disrupting the hair growth cycle. Research published in Dermatologic Therapy identified drugs such as anticoagulants, beta-blockers, retinoids, and some antidepressants as common culprits. These drugs can induce TE by altering normal hair follicle cycling Dermatologic Therapy.
Hair Shedding vs Hair Loss: What’s The Difference?
Determining whether you’re undergoing hair shedding or patterned hair loss is almost impossible to do on your own. The line between normal shedding and patterned hair loss can be very fine. You might be losing more hair than usual, but is it enough to be considered patterned hair loss? A doctor can analyse the extent and pattern of loss for a more accurate picture.
Undiagnosed patterned hair loss can also lead to a stage where medication is ineffective, potentially requiring a hair transplant.
If you’re uncertain if your condition requires medical attention, here is a general guideline to help you tell the difference between hair shedding and patterned hair loss:
| Hair Shedding (Telogen effluvium) | Patterned Hair Loss (Hair Miniaturisation) | |
| Duration | Typically resolves on its own within six to eight months. However, it can sometimes become chronic. Other factors like medications, scalp conditions and excessive sun exposure can potentially prolong the shedding phase. | Persistent (can worsen over time) until treated. |
| Affected area | In most cases, hair shedding affects the entire body, you may also notice other areas thinning out such as eyebrows, eyelashes or body hair. | Hair loss often follows specific patterns on the scalp. In men, the hairline, temples and crown are typically the first areas to show thinning. For women, hair loss tends to concentrate on the crown and widen the middle parting. |
| Scalp appearance | No noticeable scalp baldness appears as a generalised decrease in density. (unless underlying hair issues) | Visible scalp baldness, receding hairline, patchy hair loss |
| Hair regrowth | Hair typically regrows on its own | Hair do grow back, however may appear much thinning |
| Examples | Hair fall, shedding after brushing, shedding in the shower, shedding after pregnancy or childbirth | Hereditary hair loss (androgenic alopecia) |
While the table provides a helpful comparison, bear in mind that patterned hair loss and shedding can vary depending on the individual. Consulting experienced medical professionals allows for a personalised assessment and can ensure you receive the most effective treatment plan. Never self-diagnose.
Treatment Options For Excessive Hair Shedding and Hair Loss
Excessive hair shedding and patterned hair loss can feel distressing, but different treatment options are available to address these issues:
Hair Growth Supplements
Hair growth supplements are nutraceuticals formulated with essential nutrients that may help prevent hair loss, nourish hair and promote growth. These supplements often include vitamins like Biotin (B7), Vitamin A, C, D and E, as well as minerals like Zinc. Deficiencies in these nutrients can be linked to hair loss.
Some examples of hair growth supplements include:
- Nutrafol is a hair growth supplement that contains vitamins, minerals and botanical ingredients. Clinical studies on Nutrafol suggest promising results.
For instance, a six-month clinical study of women showed a large majority of participants reporting positive change: 90% saw overall improvement in their hair, 86% noticed increased hair growth and 84% experienced reduced hair shedding.
- Nourkrin is another hair growth supplement that includes a combination of marine extracts and other ingredients. Another study explored Nourkrin and showed that it may also aid in enhancing hair growth.
A six-month treatment using Nourkrin with Marilex, as reported in The Journal of International Medical Research, led to a 35.7% rise in hair density, without any side effects.
Results may vary. Consulting a medical professional can help determine if either Nutrafol, Nourkrin or another hair growth supplement is suitable for your specific needs and explore the range of available options.
Low-Level Laser Therapy (LLLT)
Low-level laser light therapy (LLLT) is a type of treatment that uses low-intensity red laser light to promote hair growth.
By targeting the scalp with low-intensity red laser light, LLLT increases blood flow, speeds up healing, reduces inflammation and can boost hair follicle activity. Because of these benefits, LLLT is often combined with other hair loss treatments to address inflammation—a contributing factor in hair loss—and stimulate hair follicle activity.
Hair Transplant
A more permanent solution, hair transplant is a surgical procedure that involves transplanting healthy hair follicles from a donor area to the balding or thinning areas. It comes in two types:
- Follicular Unit Transplantation (FUT): This method involves removing a strip of scalp containing healthy hair follicles. The strip is then dissected under a microscope to separate individual follicular units for implantation in the balding areas. While scarring is minimised, it can be visible.
- Follicular Unit Extraction (FUE): This technique involves excising follicular units using a harvesting punch machine. It eliminates the need for strip removal, potentially resulting in microscopic scarring, invisible to the naked eye. However, FUE requires more skill and experience from the surgeon to avoid follicle damage.
Regenera AMT
Regenera AMT is a non-surgical approach to naturally stimulate hair growth, using the body’s own regenerative abilities. It provides a safe alternative to harsh medications or surgical procedures.
Typically, the procedure starts with a comprehensive evaluation of the patient’s hair and scalp. Next, a specialised solution containing regenerative cells obtained from small grafts is meticulously prepared. This solution is then carefully administered to the patient’s scalp, fostering natural hair growth, improving hair thickness and enhancing scalp health.
The best course of action is always to consult with an experienced medical professional. They can properly assess the cause of your hair loss, recommend a personalised treatment plan and guide you towards the most suitable treatment option.
Final Thoughts
While hair shedding and patterned hair loss are often used interchangeably, there is a key difference between them. Hair shedding is a part of the hair growth cycle, where old hairs naturally fall out to make way for new ones. It’s important to remember that hair shedding is normal, unless it becomes excessive or chronic.
On the other hand, patterned hair loss indicates a disruption in the hair growth cycle, leading to a decrease in overall hair density.
Recognising the signs and symptoms of hair shedding vs patterned hair loss is the first step toward seeking appropriate treatment. Whether you’re experiencing increased shedding or patchy bald spots, you should consult a medical professional for accurate diagnosis and personalised treatment options.
You are not alone. At Terra Medical, we provide a wide range of patterned hair loss treatments to address your specific needs. This includes FUE hair transplant, Regenera AMT, hair growth supplements and low-level laser light therapy, among others.
If you’re experiencing hair shedding or patterned hair loss, schedule a consultation today with our medical professionals. Together, we can create a personalised treatment plan to help you achieve a healthier, fuller head of hair.
FAQ
What is the difference between hair shedding and hair loss?
Hair shedding is a natural process where hair falls out as part of the hair growth cycle. It is normal to shed around 50 to 100 hairs per day. Hair loss, on the other hand, happens when something disrupts the cycle and prevents new hair growth.
How can I tell if I’m shedding too much hair?
While some shedding is normal, here are some signs that you might be losing more hair than usual:
- Finding clumps of hair in the shower drain or on your brush more often
- Noticeable bald spots or a widening part line
- Hair appears thinner overall
- Excessive hair coming out when you comb or style your hair
When should I seek help for hair shedding or hair loss?
You should see a doctor if you experience:
- Sudden or severe hair shedding
- Hair loss that persists for more than six months
- Other accompanying symptoms like itching, pain or changes in scalp health
A medical professional can determine the underlying cause of your hair shedding or loss and recommend appropriate treatment options
Can medications for other conditions cause hair loss?
Yes, certain medications can cause hair loss as a side effect. These may include:
- Chemotherapy drugs
- Antidepressants
- Blood thinners
- Hormonal medications
Does washing hair too often cause excessive hair shedding?
Frequent shampooing itself typically does not cause hair loss. However, if you are using shampoo brands with harsh chemicals or washing your hair too vigorously, it can irritate the scalp and potentially lead to temporary shedding. Make sure you use a mild shampoo and avoid excessive scrubbing or heat styling.
DISCLAIMER: The information provided in this article is for informational and educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Terra Medical recommends consulting a medical professional to determine the best treatment option for your specific needs.
