Why Is My Hair Falling Out So Much

Hair loss, clinically referred to as alopecia, represents a prevalent dermatological condition that affects individuals across various demographics and ethnicities. It is characterized by the abnormal shedding or thinning of hair, which can significantly impact the psychological well-being and social interactions of affected individuals. While it is normal for adults to shed between 50 to 100 hairs daily as part of the natural hair cycle, concerns arise when the rate of shedding surpasses the rate of regrowth.


As we proceed, you will discover not only why your hair might be falling out but also all possible solutions to address this condition.

The doctor, a young man with a beard, is attentively listening to the patient, an older man with baldness, as he explains his concerns about hair loss.

What Are the Symptoms of Losing Hair

The symptoms of hair loss can vary widely depending on the underlying cause but typically begin with noticeable changes in hair thickness and volume.


Common signs include a receding hairline, thinning patches especially on the top of the head, and more hair than usual collecting on pillows, in shower drains, or in hairbrushes.


Some individuals may also see broadening of their part or bald spots suddenly appearing.

Understanding the Complete Hair Growth Cycle

The hair growth cycle is a sophisticated biological process divided into four distinct phases: anagen, catagen, telogen, and exogen. Disruptions to this cycle are directly linked to various forms of hair loss.


Anagen Phase (Growth Phase)


This is the longest phase of the cycle, lasting between two to eight years. During this phase, cells in the root are dividing rapidly, adding to the shaft. Approximately 85% to 90% of all hairs are in this phase at any given time.


Catagen Phase (Transition Phase)


Following the anagen phase, the cycle enters the catagen phase. This short phase, lasting about two to three weeks, serves as a transitional period during which the follicle contracts and detaches from the dermal papilla (a structure that feeds the follicle). Growth stops, and the follicle undergoes structural changes.


Telogen Phase (Resting Phase)


Lasting approximately two to four months, the telogen phase is a resting period. While growth does not occur during this phase, it doesn't fall out either. The old hair remains in place as new hair begins to form in the follicle.


Exogen Phase (Shedding Phase)


This is the final phase of the growth cycle. The exogen phase is an extension of the telogen phase where the old hair is shed, and new hair continues to grow. Typically, shedding 50 to 100 hairs a day is considered normal as these hairs are in the exogen phase.

The image illustrates the hair growth cycle, detailing the different phases: Anagen (growth phase), Catagen (transition phase), Telogen (resting phase), and Early Anagen. It shows a cross-section of the skin with hair shafts at various stages of development, highlighting key components such as the dermal papilla, hair matrix, epithelial column, arrector pili muscle, and sebaceous gland.

What Are All the Possible Causes of Hair Loss

Hair loss is influenced by a complex interplay of genetic, hormonal, environmental, and health-related factors. Understanding the myriad causes and identifying the risk groups can help in managing and potentially mitigating this condition.

Genetic predisposition

Genetic predisposition is a primary factor in many types of hair loss, where sensitivity to dihydrotestosterone (DHT) leads to follicular miniaturization. 

Hormonal Influences

Hormonal changes also play a role, particularly in conditions like postpartum hair loss and menopause-related shedding.

Medical Conditions

  • Thyroid disorders: Both hypothyroidism and hyperthyroidism can cause thinning.
  • Polycystic ovary syndrome (PCOS): This condition often includes symptoms such as thinning and hirsutism due to hormonal imbalances.
  • Autoimmune diseases: Conditions like lupus and alopecia areata involve the immune system attacking follicles.
  • Infections: Fungal infections like tinea capitis (scalp ringworm) and bacterial infections can lead to patchy loss.
  • Iron and protein deficiencies: Essential for health, deficiencies in these nutrients can result in shedding.
  • Eating disorders: Anorexia and bulimia can lead to severe nutritional deficiencies, impacting growth.
  • Chemotherapy and radiation therapy: These cancer treatments are notorious for causing anagen effluvium, a rapid and extensive loss.


Psychological and Physical Stress

Stress, whether emotional or physical, can trigger several types of hair loss:

  • Telogen effluvium: Severe stress can push hair follicles into a resting state, resulting in diffuse hair shedding.
  • Trichotillomania: This hair-pulling disorder is often triggered by stress and can cause uneven bald patches.

When an individual experiences stress, the body increases the production of certain hormones, including cortisol, which is often referred to as the "stress hormone." Elevated cortisol levels can alter the normal regulatory functions of other hormones, including those involved in the hair growth cycle, such as androgens and estrogens.

The body's response to stress also involves the release of neuropeptides and neurotrophins, which can influence inflammation around hair follicle.

Focus on the present, simplify your daily routines, and set aside time for relaxation and mindfulness to protect both your mental and physical health.

Dermatological Conditions

  • Seborrheic dermatitis: This inflammatory skin condition can cause scaly patches and dandruff that may lead to hair thinning if not properly managed.
  • Psoriasis: Though primarily a skin disease, when it affects the scalp, it can lead to temporary hair thinning.

Smoking

Smoking negatively impacts health by impairing blood flow, reducing the delivery of essential nutrients to follicles. The toxins in cigarettes also increase oxidative stress.


The same applies to vaping.

Types of hair loss

Androgenetic Alopecia (AGA)

Often referred to as male-pattern baldness or female-pattern hair loss (FPHL), this form is the most common, affecting millions worldwide. It is characterized by a genetic predisposition and is influenced by hormonal levels, specifically dihydrotestosterone (DHT).

Men typically experience a receding hairline and thinning at the crown, while women generally notice thinning hair across the top of the head. Treatments like topical minoxidil and oral finasteride are effective for many, alongside emerging technologies such as red light therapy.

Alopecia Areata

This is an autoimmune disorder where the body's immune system mistakenly attacks healthy hair follicles, leading to sudden, patchy hair loss. While there is no cure, treatments such as corticosteroid injections and topical immunotherapy can promote hair regrowth. Laser caps, which emit low levels of laser light, may also support treatment by improving cellular activity and promoting circulation.
An image showing a before-and-after comparison of a man's scalp from day 1 to day 120, demonstrating significant hair growth after using a red light laser cap. The cap, featured in the center of the image, is described as one-size-fits-all and emits a 650 nm frequency light with 272 diodes to promote hair regrowth.

Traction Alopecia

Caused by constant pulling on the hair due to tight hairstyles like ponytails, braids, or dreadlocks, this condition can lead to permanent loss if not addressed early. The primary treatment is the cessation of the causative styling practices. Additionally, hair regrowth serums that strengthen the hair and improve the scalp environment can be beneficial.

Cicatricial (Scarring) Alopecia

This rare group of conditions involves inflammation that destroys hair follicle cells., leading to scarring and irreversible hair loss. Treatment focuses on controlling the inflammation with medications such as antibiotics, antifungals, or immunosuppressive drugs. Early diagnosis and treatment are crucial to prevent permanent follicular damage.

Telogen Effluvium

Characterized by widespread thinning of the hair, telogen effluvium occurs when a large number of hairs enter the resting phase (telogen). It is often triggered by severe stress, major surgery, or significant life changes. The condition is usually temporary, and the hair often regrows after the underlying cause is addressed. Nutritional supplements and stress management techniques, including red light therapy, can aid recovery by promoting a healthy growth environment.

Anagen Effluvium

This type of condition is primarily caused by treatments such as chemotherapy. The impact can be dramatic and sudden. While typically temporary, the use of cooling caps during chemotherapy has been shown to reduce the severity and accelerate regrowth.

Frontal Fibrosing Alopecia

This condition primarily affects postmenopausal women and involves a slowly progressive loss of hair and scarring that occurs predominantly across the front and sides of the head. Treatment may involve anti-inflammatory medications, but hair regrowth is often limited due to scarring.

How is a Diagnosis Made

  • Scalp examination
  • Blood tests
  • Hormonal profiling
  • Genetic testing
  • Biopsy
  • Dermatoscopy

Comprehensive Treatment Strategies for Hair Loss

When loss does occur, initial interventions often include the use of specialized shampoos and serums designed to nourish the scalp and fortify its structures, which may stabilize the condition. Doctors can provide a comprehensive evaluation and, if necessary, prescribe medications or recommend advanced treatments tailored to the specific type and cause of the condition.

Here is an exhaustive overview of the current therapeutic approaches available for managing this condition.

Serums

Serums often contain active ingredients that increase blood flow, and provide essential nutrients directly to the scalp’s structures.

Bio-Veloxin® Serum, notable product in this category contains Capilia Longa, a peptide formula derived from turmeric, known for its anti-inflammatory and antioxidant properties.
A bottle of Nordic Biolabs Hair Growth Serum, labeled as "Bio-veloxin", designed to stimulate hair growth with premium ingredients and custom blending techniques.

Pharmacological Treatments

Minoxidil (Rogaine®): Available as a topical solution or foam, it is one of the most commonly prescribed treatments.

Finasteride (Propecia®): This oral medication is effective in treating male pattern baldness by inhibiting the enzyme 5-alpha reductase, which converts testosterone to dihydrotestosterone (DHT), a hormone implicated in hair loss.

Spironolactone (Aldactone®): Often used for female pattern hair loss, this medication serves as an anti-androgen, blocking the effect of DHT.

Corticosteroids: Used primarily for a. areata, corticosteroids can be administered either topically, orally, or through intralesional injections to reduce inflammation.

Dutasteride: Similar to finasteride, this medication is another alpha-reductase enzyme inhibitor for patients who do not respond to finasteride.

Advanced Therapies

Platelet-Rich Plasma (PRP) Therapy: Involves injecting a concentration of a patient’s own platelets into the scalp.

Laser Therapy: Low-level laser therapy (LLLT) uses red light lasers or LED light to stimulate epidermal stem cells in the hair follicle, promoting regrowth and decreasing inflammation. Today, red light laser caps, which you can use at home, are very popular, and the effects are excellent.

Hair Transplant Surgery: Techniques such as follicular unit transplantation (FUT) and follicular unit extraction (FUE) involve the removal of hair follicles from areas of dense growth and transplanting them to balding areas.

Scalp Micropigmentation: A tattooing procedure that creates the illusion of stubble or a shaven look on the scalp, helping camouflage hair loss.

Experimental and Novel Treatments

Hair Cloning: Research in this area aims to use cloning technology to multiply follicles in the lab from a patient’s existing hair cells.

Microneedling: Often used in combination with topical treatments, this technique involves using fine needles to create micro-punctures in the scalp, which can stimulate hair growth through increased collagen production and enhanced absorption of topical applications.

Supplements

Supplements often contain a blend of vitamins and minerals.

 Key ingredients typically include:
  • Biotin (Vitamin B7) - Supports keratin production
  • Vitamin D
  • Zinc
  • Iron
  • Vitamin C
  • Omega-3 Fatty Acids
  • Selenium

When should you be worried about hair falling out

When assessing hair loss, it's important to differentiate between normal hair shedding and significant hair loss that may warrant medical attention. Generally, losing about 50 to 100 hairs a day is considered normal.

If you begin to see noticeable thinning of your hair, particularly at the crown or hairline, which is not the typical pattern of growth for you, it could indicate an underlying issue.

Sudden bald spots or patches where hair is unexpectedly falling out in clumps, or increased scalp visibility, can be signs of an acute condition such as alopecia areata or other dermatological conditions.

Changes in the scalp's appearance, such as scaling, redness, or dandruff that is not typical for you, can suggest conditions like psoriasis or fungal infections which may lead to hair loss.

Any pain, discomfort, or itching that accompanies hair loss could be symptomatic of inflammation or infection.
If you observe hair loss after initiating a new medication, it could be a side effect, and discussing alternatives with your doctor might be necessary.

In any case where hair loss is sudden, excessive, or accompanied by other symptoms, seeking the advice of a healthcare provider is advised. Early diagnosis and treatment can improve outcomes for many conditions.