Is My Hair Loss Normal?

Have you noticed more hair than usual coming out when you brush, comb, or style? Are you finding it on your clothing or in the shower?

Losing hair can be distressing, and at first glance you may wonder if the amount of hair you are shedding is normal, or if something is wrong. Hair loss that is more than usual, but not abnormal is known as hair shedding. According to the American Academy of Dermatologists (AAD), it’s normal to shed between 50 and 100 hairs a day. For people with long hair, the shedded hairs may be more noticeable.

If you are losing more hair than this on a daily basis, there may be cause for concern. Some famous people who have experienced hair loss include supermodel Tyra Banks, actress Keira Knightly, and actor Christopher Reeve. In all of these cases, the hair loss was temporary (although it lasted for several years for some of them). For others, like actress Jada Pinkett Smith and American Ninja Warrior athlete Kevin Bull, their hair loss is due to an autoimmune disorder.

The best course of action when experiencing abnormal hair loss is to see a dermatologist in order to pinpoint the cause and start any necessary treatments as early as possible.

Stress-related Hair Loss

Even if you are shedding more than 50 to 100 hairs a day, there may not be cause for concern. Excessive hair shedding is a common biological response to a very stressful life event, such as illness, surgery, high fever (including fevers due to Covid-19), the death of a close relative, job loss, or divorce. Women who have recently given birth or recently stopped taking birth control pills may also experience excessive hair shedding. Significant weight loss can also trigger it.

This type of hair shedding, known as telogen effluvium, may seem worrisome in the moment, but it is temporary, although if you remain in the high-stress situation, hair loss can persist. Hair shedding after childbirth tends to peak at four months postpartum and resolve six to nine months postpartum.

Androgenic Alopecia (AGA)

AGA, also called male-pattern or female-pattern baldness, is hair loss that occurs as a result of hormonal changes and genetics. Testosterone (in both men and women) causes the hair to shrink and fall out. In men, hair is lost in a characteristic “M” pattern, with the hairline receding over both temples and hair thinning at the crown. This may progress to complete baldness. For women, hair becomes thinner over the entire head, but rarely leads to total baldness.

Alopecia Areata

Alopecia areata is hair loss caused by an autoimmune disorder that mistakenly attacks hair follicles. Researchers do not fully understand why this happens, but they believe it is due to a combination of genetic and environmental factors.

Alopecia areata commonly begins as isolated, patchy hair loss in coin-sized areas on the scalp. The bald spots can also appear on other areas of the body where hair grows (beard, eyebrows, legs, arms, hands, feet). Alopecia areata may remain patchy or can develop into alopecia totalis (hair loss over the entire scalp) or alopecia universalis (hair loss over the entire body). The condition affects both men and women equally, and is seen across all races. It can be persistent or unpredictable. Many adults and children dealing with alopecia areata benefit from a support community.

Frontal Fibrosing Alopecia (FFA)

Some older women experience a thinning of hair at the hairline caused by a rare autoimmune condition called lichen planopilaris. Known as frontal fibrosing alopecia, or FFA, this type of hair loss may begin in the eyebrows before it is noticeable at the hairline. Men with FFA may notice thinning of the beard as well. FFA can cause permanent scarring, so it is important to get treatment right away to prevent permanent baldness.

Other causes of hair loss

Other causes of hair loss may include ringworm (a fungal infection often seen in children where hair falls out in patches that may appear red and scaly), trichotillomania (the compulsion to pull out one’s hair), traction alopecia (hair loss due to tight hairstyles like ponytails and braids), or other medical conditions.

If you are concerned about hair loss for yourself or your child, a consultation with a dermatologist can diagnose the cause and offer answers. Hair loss is treatable! The sooner treatment can begin, the sooner the physical and psychological effects of hair loss can be dealt with.