It is always better to know the "what" before the "why".
So: What is Hair Loss?
Alopecia is the medical term.
Let me start with a disclosure: according to the American Academy of Dermatology, a daily shedding of 50-100 hairs is normal.
So if this is you, you can stop panicking right here.
For the rest of us, who lose hair abundantly-roughly more than 125 strands of hair per day-feel free to panic.
Just kidding, don't do that! That stress will only make it worse!
Instead, we can find ways to do something about it.
But to do that, we must know why we are losing hair.
We cannot treat something unless we treat the cause.
So let's find out what's causing your luscious strands to be stranded!
According to the AAD, Hair shedding is when you shed hair excessively than usual. It is common in people who have undergone stressful events.
Whereas, hair-loss is when your hair growth reduces or stops. This can be due to immunological factors, hereditary factors, certain disorders, etc.
Yours could be either one of them or both.
Before digging into that, let's understand a little about the hair growth cycle.
The Stages of Hair Growth
The human hair growth cycle is divided into 4 stages:
The duration of this phase differs from individual to individual. There is physical and visible hair growth in this phase. The longer the phase lasts, the longer the hair grows.
It is the longest among the 4 phases of hair growth, lasting about 3-5 years.
Most hair on the head is in the anagen phase.
Catagen phase - The transitional phase.
This phase starts following the anagen phase and lasts for about 10 days-2 weeks.
The growth slows down as the blood supply is cut off due to detachment from the follicle. The least hair on the head is in this phase at a given time.
Telogen phase - The resting phase.
The hair remains in place without actually growing or using nutrients from the body. The blood supply is cut off completely, but the hair neither falls nor grows.
The hairs stick around in this phase for about 3 months.
Exogen phase - The shedding phase.
The hair falls out as the base breaks free from the root of the hair.
The regular hair fall that we see in everybody happens in the exogen phase.
Why is your hair thinning?
The pattern of hair thinning can be different in different people according to the underlying cause. Let's look into each of these causes in detail.
Age
Like all other processes in the body, naturally, hair thins out and the growth also slows with advancing age.
Genetic: Androgenetic Alopecia
It may start at any age after puberty, but mostly as the person gets older. Androgenetic alopecia presents as male or female pattern baldness.
The male pattern of hair loss is likely to start around 50-70 years of age as thinning of hair from the temples and the crown of the head. Receding hairlines and bald spots may be seen. This happens due to hormonal changes in the man's body or sometimes due to nutritional deficits or infections. In most cases, the hormone Dihydrotestosterone is known to be the culprit. The increased level of this hormone is also linked with Benign Prostatic Hypertrophy.
The female pattern of hair loss typically causes thinning of hair all over the scalp. The overall thickness of hair is reduced. No receding hairlines are seen in this pattern.
Rarely, females may also present with male pattern baldness if the male hormones (androgens) are produced in excess in the female body.
Telogen effluvium
This is a temporary condition with excessive hair shedding from normal resting follicles brought about by stressful situations. This resolves with time, usually within 6 months, unless there is some underlying condition causing alopecia.
Stress causes the hair follicles to enter the telogen phase of the hair growth cycle and, the hair does not receive any nutrients due to a lack of blood supply. This leads to massive hair shedding.
Some everyday stressors that have the potential to cause Telogen effluvium are:
Pregnancy or Parturition
Due to hormonal changes like decreased estrogen levels and extreme physical stress, women may experience hair fall during pregnancy and shortly after childbirth.
Stress
Unfortunate events, ill friend or family member, or that deadline coming up at work- anything that causes you stress is also causing your hair to shed!
Life's hard at times and may lead to mental trauma and tension. Stress pushes a large number of hair follicles into the resting phase, thus arresting hair growth.
High-grade fever
Any cause like systemic infections or diseases leading to high fever is another stressful condition for the body that can cause telogen effluvium.
Surgery
Surgery in itself and the process of healing is extreme physical stress to the body. These procedures include anesthetic agents, which add fuel to the fire.
Recovery from a major illness
When the body is recovering, it functions at its maximum to bring things back to normal. Imagine how stressful that might be! Hair-fall can be expected during this time.
Emaciation or massive weight loss
Sudden and rapid changes in the BMI lead to physical stress, which ultimately follows the same principle of stress and hair fall. Weight loss is healthy, but it must be gradual. Sudden weight loss is also associated with a variety of diseases. So you must always consult a doctor if you experience such changes.
Anagen effluvium
In this condition, the fallen hair is in the anagen phase of the hair growth cycle.
Plenty of rapid and abnormal hair fall is spotted, not only from the head but also from other parts of the body like the eyebrows, eyelashes, and body hair.
This is commonly caused by diseases, drugs, or toxic metabolites that cause stress or injury to the hair follicle.
The growth process is usually resumed once the cause is removed.
The most common contributors of Anagen effluvium are:
Chemotherapy
Cancer chemotherapeutics are known to cause massive hair fall as a side effect. Among them, doxorubicin, nitrosoureas, cyclophosphamide, methotrexate, and fluorouracil are the commonest.
Medications
Anthelmintics like albendazole, anti-inflammatory drugs like colchicine, immunosuppressants like cyclosporin, and antiparkinson medications like levodopa may cause hair fall.
Chemicals
Chemicals like bismuth, thallium, boron, arsenic show similar effects on hair.
Autoimmune disease
Diseases like SLE (Systemic Lupus Erythematosus) or Lupus, Pemphigus Vulgaris, Rheumatoid arthritis, Graves' Disease, Hashimoto's Disease rank among the top contributors of hair fall.
Autoimmune diseases are those that produce antibodies that are directed against the body's own cells. For instance, Hashimoto's Thyroiditis is an autoimmune disease of the thyroid gland that causes hypothyroidism. Hair loss is one of the presenting features of the disease, and it happens because the antibodies attack the hair follicles.
Infection
STDs such as Syphilis is capable of causing hair fall from various sites of the body, says the AAD.
Certain infections like boils, abscesses, and psoriasis may cause bald patches due to localized hair fall at the infection area. Fungal infections, like ringworm on the scalp, may cause hair-fall around the area of infection.
Radiation therapy
Radiation causes hair fall from the exposed site.
Radiation therapy is aimed at destroying cancer cells. But with this form of treatment, there is always collateral damage to the nearby normal cells. During cranial irradiation, i.e., radiation to the scalp, the hair follicles get damaged. For example, in cases of melanoma or other tumors in the brain.
The damage and hair fall depends on the dose of radiation. The re-growth may be incomplete or may not occur.
COVID-19
According to WebMD, research shows that people suffering from COVID-19 have reported hair loss as a common complaint. The correlation between the disease and hair loss, probably due to the stressful illness, is observed and researched.
Alopecia areata
The hair follicles get attacked by auto antibodies formed due to this disease. The disease, being autoimmune, shows genetic predisposition. Thus, it may (or may not) be inherited from parents or close relatives. The disease primarily gets manifested during childhood or teenage. However, it may be encountered at any age. It may affect hair follicles all over the body.
It can be of three main types:
Alopecia areata: patchy baldness anywhere on the body
Alopecia totalis: complete baldness over the scalp
Alopecia universalis: the overall body hair is entirely lost
So: What is Hair Loss?
Alopecia is the medical term.
Let me start with a disclosure: according to the American Academy of Dermatology, a daily shedding of 50-100 hairs is normal.
So if this is you, you can stop panicking right here.
For the rest of us, who lose hair abundantly-roughly more than 125 strands of hair per day-feel free to panic.
Just kidding, don't do that! That stress will only make it worse!
Instead, we can find ways to do something about it.
But to do that, we must know why we are losing hair.
We cannot treat something unless we treat the cause.
So let's find out what's causing your luscious strands to be stranded!
According to the AAD, Hair shedding is when you shed hair excessively than usual. It is common in people who have undergone stressful events.
Whereas, hair-loss is when your hair growth reduces or stops. This can be due to immunological factors, hereditary factors, certain disorders, etc.
Yours could be either one of them or both.
Before digging into that, let's understand a little about the hair growth cycle.
The Stages of Hair Growth
The human hair growth cycle is divided into 4 stages:
- Anagen
- Catagen
- Telogen
- Exogen
The duration of this phase differs from individual to individual. There is physical and visible hair growth in this phase. The longer the phase lasts, the longer the hair grows.
It is the longest among the 4 phases of hair growth, lasting about 3-5 years.
Most hair on the head is in the anagen phase.
Catagen phase - The transitional phase.
This phase starts following the anagen phase and lasts for about 10 days-2 weeks.
The growth slows down as the blood supply is cut off due to detachment from the follicle. The least hair on the head is in this phase at a given time.
Telogen phase - The resting phase.
The hair remains in place without actually growing or using nutrients from the body. The blood supply is cut off completely, but the hair neither falls nor grows.
The hairs stick around in this phase for about 3 months.
Exogen phase - The shedding phase.
The hair falls out as the base breaks free from the root of the hair.
The regular hair fall that we see in everybody happens in the exogen phase.
Why is your hair thinning?
The pattern of hair thinning can be different in different people according to the underlying cause. Let's look into each of these causes in detail.
Age
Like all other processes in the body, naturally, hair thins out and the growth also slows with advancing age.
Genetic: Androgenetic Alopecia
It may start at any age after puberty, but mostly as the person gets older. Androgenetic alopecia presents as male or female pattern baldness.
The male pattern of hair loss is likely to start around 50-70 years of age as thinning of hair from the temples and the crown of the head. Receding hairlines and bald spots may be seen. This happens due to hormonal changes in the man's body or sometimes due to nutritional deficits or infections. In most cases, the hormone Dihydrotestosterone is known to be the culprit. The increased level of this hormone is also linked with Benign Prostatic Hypertrophy.
The female pattern of hair loss typically causes thinning of hair all over the scalp. The overall thickness of hair is reduced. No receding hairlines are seen in this pattern.
Rarely, females may also present with male pattern baldness if the male hormones (androgens) are produced in excess in the female body.
Telogen effluvium
This is a temporary condition with excessive hair shedding from normal resting follicles brought about by stressful situations. This resolves with time, usually within 6 months, unless there is some underlying condition causing alopecia.
Stress causes the hair follicles to enter the telogen phase of the hair growth cycle and, the hair does not receive any nutrients due to a lack of blood supply. This leads to massive hair shedding.
Some everyday stressors that have the potential to cause Telogen effluvium are:
Pregnancy or Parturition
Due to hormonal changes like decreased estrogen levels and extreme physical stress, women may experience hair fall during pregnancy and shortly after childbirth.
Stress
Unfortunate events, ill friend or family member, or that deadline coming up at work- anything that causes you stress is also causing your hair to shed!
Life's hard at times and may lead to mental trauma and tension. Stress pushes a large number of hair follicles into the resting phase, thus arresting hair growth.
High-grade fever
Any cause like systemic infections or diseases leading to high fever is another stressful condition for the body that can cause telogen effluvium.
Surgery
Surgery in itself and the process of healing is extreme physical stress to the body. These procedures include anesthetic agents, which add fuel to the fire.
Recovery from a major illness
When the body is recovering, it functions at its maximum to bring things back to normal. Imagine how stressful that might be! Hair-fall can be expected during this time.
Emaciation or massive weight loss
Sudden and rapid changes in the BMI lead to physical stress, which ultimately follows the same principle of stress and hair fall. Weight loss is healthy, but it must be gradual. Sudden weight loss is also associated with a variety of diseases. So you must always consult a doctor if you experience such changes.
Anagen effluvium
In this condition, the fallen hair is in the anagen phase of the hair growth cycle.
Plenty of rapid and abnormal hair fall is spotted, not only from the head but also from other parts of the body like the eyebrows, eyelashes, and body hair.
This is commonly caused by diseases, drugs, or toxic metabolites that cause stress or injury to the hair follicle.
The growth process is usually resumed once the cause is removed.
The most common contributors of Anagen effluvium are:
Chemotherapy
Cancer chemotherapeutics are known to cause massive hair fall as a side effect. Among them, doxorubicin, nitrosoureas, cyclophosphamide, methotrexate, and fluorouracil are the commonest.
Medications
Anthelmintics like albendazole, anti-inflammatory drugs like colchicine, immunosuppressants like cyclosporin, and antiparkinson medications like levodopa may cause hair fall.
Chemicals
Chemicals like bismuth, thallium, boron, arsenic show similar effects on hair.
Autoimmune disease
Diseases like SLE (Systemic Lupus Erythematosus) or Lupus, Pemphigus Vulgaris, Rheumatoid arthritis, Graves' Disease, Hashimoto's Disease rank among the top contributors of hair fall.
Autoimmune diseases are those that produce antibodies that are directed against the body's own cells. For instance, Hashimoto's Thyroiditis is an autoimmune disease of the thyroid gland that causes hypothyroidism. Hair loss is one of the presenting features of the disease, and it happens because the antibodies attack the hair follicles.
Infection
STDs such as Syphilis is capable of causing hair fall from various sites of the body, says the AAD.
Certain infections like boils, abscesses, and psoriasis may cause bald patches due to localized hair fall at the infection area. Fungal infections, like ringworm on the scalp, may cause hair-fall around the area of infection.
Radiation therapy
Radiation causes hair fall from the exposed site.
Radiation therapy is aimed at destroying cancer cells. But with this form of treatment, there is always collateral damage to the nearby normal cells. During cranial irradiation, i.e., radiation to the scalp, the hair follicles get damaged. For example, in cases of melanoma or other tumors in the brain.
The damage and hair fall depends on the dose of radiation. The re-growth may be incomplete or may not occur.
COVID-19
According to WebMD, research shows that people suffering from COVID-19 have reported hair loss as a common complaint. The correlation between the disease and hair loss, probably due to the stressful illness, is observed and researched.
Alopecia areata
The hair follicles get attacked by auto antibodies formed due to this disease. The disease, being autoimmune, shows genetic predisposition. Thus, it may (or may not) be inherited from parents or close relatives. The disease primarily gets manifested during childhood or teenage. However, it may be encountered at any age. It may affect hair follicles all over the body.
It can be of three main types:
Alopecia areata: patchy baldness anywhere on the body
Alopecia totalis: complete baldness over the scalp
Alopecia universalis: the overall body hair is entirely lost