Hair Shedding: Causes and Treatments: An Encyclopedia Guide

Quick answer: Hair Shedding: Causes and Treatments addresses the natural process of hair release from the scalp and potential factors that can increase it. While shedding is a normal part of the hair growth cycle, excessive shedding, often referred to as telogen effluvium, can be triggered by stress, hormonal shifts, nutritional deficiencies, and certain medications. Treatments often focus on identifying and addressing the underlying cause to normalise the cycle. It is crucial to differentiate shedding from hair loss, where the follicle itself is affected, as their management differs significantly.

Key takeaways

• Normal vs. Excessive Shedding: Losing 50 to 100 hairs daily is typical; anything significantly more could be excessive shedding.
• Telogen Effluvium: This common condition is characterised by a temporary increase in hair shedding, often triggered by stress or physiological changes.
• Underlying Causes: Factors like stress, hormonal imbalances, nutritional deficiencies, and certain medical conditions can provoke increased shedding.
• Diagnosis is Key: Identifying the root cause is crucial for effective management, often requiring a professional diagnosis.
• Management Focus: Treatments typically involve addressing the underlying trigger and supporting healthy hair growth through nutrition and care.

Hair Shedding: Causes and Treatments: what the evidence shows

Hair shedding is a natural and continuous process, part of the hair growth cycle, where old hairs are released to make way for new ones. Understanding Hair Shedding: Causes and Treatments means recognising the distinction between normal shedding and excessive shedding. The average person sheds between 50 to 100 hairs per day. This is a normal part of the hair's life cycle, which has three main phases: anagen (growth), catagen (transition), and telogen (resting). Shedding occurs during the telogen phase, after which the hair follicle re-enters the anagen phase to grow a new hair.

When shedding becomes noticeably excessive, it is often referred to as telogen effluvium. This condition is characterised by a sudden, widespread increase in the number of hairs entering the telogen (resting) phase prematurely, leading to more hairs being shed daily. Unlike alopecia, where hair follicles stop producing hair, telogen effluvium typically results in temporary shedding, and the follicles remain active and capable of regrowing hair once the underlying cause is resolved. Research indicates that telogen effluvium can occur about 2 to 4 months after a significant physiological or psychological stressor, as the hair cycle is disrupted, pushing a large number of hairs into the resting and then shedding phase simultaneously.

Common causes of excessive hair shedding

Excessive hair shedding, particularly telogen effluvium, can be triggered by a range of factors. Identifying these causes is the first step in addressing the condition.

• Stress: Significant physical or emotional stress, such as major surgery, severe illness, childbirth, or a traumatic event, can disrupt the hair cycle. The body prioritises essential functions, diverting resources away from hair growth, leading to premature entry into the telogen phase.
• Hormonal Changes: Fluctuations in hormones are a common trigger. Childbirth (postpartum shedding), discontinuation of hormonal birth control, thyroid imbalances (both hypo- and hyperthyroidism), and menopause can all lead to increased shedding. Androgenetic alopecia is a distinct condition, but hormonal shifts can also influence general shedding patterns.
• Nutritional Deficiencies: A lack of essential vitamins and minerals can impair healthy hair growth. Iron deficiency (anaemia), zinc deficiency, biotin deficiency, and severe protein restriction are known to contribute to excessive shedding. A balanced diet is crucial for supporting the hair growth cycle.
• Medications: Certain drugs can have hair shedding as a side effect. These include blood thinners, retinoids, some antidepressants, blood pressure medications, and chemotherapy drugs. It's important to consult with a healthcare professional if you suspect medication is causing shedding.
• Sudden Weight Loss or Restrictive Diets: Rapid and significant weight loss, especially when accompanied by inadequate nutrient intake, can shock the system and induce telogen effluvium.
• Illness and Infection: Acute illnesses, high fevers, and chronic conditions can trigger shedding. Scalp infections, while less common, can also lead to localised shedding.

What the evidence does not show about hair shedding

While many factors are linked to hair shedding, it's important to clarify what current evidence does not strongly support. For instance, there is currently insufficient evidence to conclude that everyday factors like routine shampooing, brushing, or wearing hats directly cause excessive hair shedding in individuals with otherwise healthy hair follicles. While these actions may dislodge hairs that are already in the telogen phase and ready to shed, they do not typically disrupt the hair growth cycle itself to cause premature shedding. Similarly, despite anecdotal claims, hard water has not been scientifically proven to directly cause telogen effluvium, though its mineral content can affect hair texture and manageability.

The mechanism of telogen effluvium

The underlying mechanism of telogen effluvium involves a disruption of the hair growth cycle. Normally, about 85% to 90% of hairs are in the anagen (growth) phase, 1% in catagen (transition), and 10% to 15% in telogen (resting). In telogen effluvium, a higher percentage of anagen hairs prematurely enter the catagen phase, and then quickly progress to the telogen phase. This results in a larger than normal proportion of hairs (sometimes up to 50%) being in the telogen phase at any given time. After the typical telogen period (around 2 to 4 months), these hairs are shed all at once, leading to the noticeable increase in shedding. The good news is that the hair follicles remain healthy, and once the trigger is removed, the cycle usually normalises, and hair regrows.

Signs to look for

Recognising the signs of excessive hair shedding can prompt timely intervention:

• Increased Hair in Shower Drain: A significantly larger amount of hair collecting in the drain after washing.
• More Hair on Brush or Comb: Noticeably more hair strands left on your styling tools than usual.
• Hair on Pillows or Clothing: Finding an unusual amount of hair on your pillow, clothes, or furniture.
• General Thinning: While the overall hair density might decrease, it is typically an even, diffuse thinning across the scalp, rather than bald patches.
• Rapid Onset: Telogen effluvium often presents as a relatively sudden increase in shedding, typically occurring a few months after a specific trigger.

What you can do to manage hair shedding

Managing hair shedding effectively often involves a multi-faceted approach, starting with identifying and addressing the underlying cause. Once the trigger is removed or managed, the hair cycle can normalise, and shedding typically decreases over time.

• Stress Management: Techniques such as mindfulness, meditation, yoga, regular exercise, and adequate sleep can help reduce stress levels and their impact on hair health.
• Balanced Nutrition: Ensure your diet is rich in essential nutrients, including iron, zinc, biotin, vitamin D, and protein. If dietary intake is insufficient, supplements may be considered under medical guidance. Prioritise whole foods, fruits, vegetables, lean proteins, and healthy fats.
• Gentle Hair Care: Avoid harsh brushing, tight hairstyles, and excessive heat styling, which can exacerbate breakage. Use a wide-tooth comb on wet hair and be gentle when washing and drying.
• Review Medications: If you suspect a medication is contributing to shedding, discuss alternatives with your doctor. Never stop prescribed medication without medical advice.
• Scalp Health: Maintain a healthy scalp environment. Regular, gentle cleansing and massage can promote circulation. Ensure you are using products appropriate for your scalp type.

When the cause may be something else

It is important to differentiate excessive hair shedding (telogen effluvium) from other conditions that cause hair loss. While shedding involves hairs falling out with the follicle remaining active, hair loss often indicates a problem with the follicle itself, leading to reduced or no hair production.

• Androgenetic Alopecia (Pattern Hair Loss): This is a genetic condition causing gradual thinning, typically with a receding hairline or crown thinning in men, and diffuse thinning or a widening part in women. Unlike shedding, it is progressive and often permanent.
• Alopecia Areata: An autoimmune condition where the body attacks hair follicles, leading to distinct, smooth, round patches of hair loss.
• Traction Alopecia: Hair loss caused by prolonged tension on hair follicles from tight hairstyles.
• Hair Breakage: This is not hair shedding or hair loss but refers to the hair fibre snapping along the shaft due to damage (e.g., chemical processing, heat styling, harsh brushing). You'll notice short, broken hairs rather than full strands with a bulb attached.

When to get professional advice

Consulting a healthcare professional, such as a GP or a dermatologist, is advisable if you experience persistent or severe hair shedding. They can help identify the exact cause and recommend appropriate Hair Shedding: Causes and Treatments. This is particularly important if:

• Your shedding is severe or lasts for more than 6 months.
• You notice bald patches or significant overall thinning.
• You have other symptoms like fatigue, weight changes, or changes in skin/nails.
• You are unsure of the cause.
• Home remedies or lifestyle changes aren't making a difference.

Early diagnosis can lead to more effective management strategies.

Comparison of Hair Shedding vs. Hair Breakage

Feature	Hair Shedding (Telogen Effluvium)	Hair Breakage
Mechanism	Hair detaches from the follicle, usually with a white bulb.	Hair fibre snaps along the shaft due to damage.
Appearance	Full-length hairs with a bulb at the root.	Shorter, fractured pieces of hair, no root bulb.
Cause	Internal factors: stress, hormones, nutrition, medication.	External factors: heat styling, chemical treatments, harsh brushing, UV.
Impact	Temporary reduction in hair density across the scalp.	Frizzy texture, split ends, uneven length, appearance of thinning.
Treatment Focus	Address underlying health/lifestyle cause, support follicle health.	Improve hair fibre strength, moisturise, gentle handling, avoid damage.

Frequently asked questions about Hair Shedding: Causes and Treatments

How many hairs is it normal to shed per day?

It is generally considered normal to shed between 50 to 100 hairs daily. This amount can vary slightly from person to person and may increase on wash days. If you consistently notice significantly more hair than this, or if you see a noticeable reduction in your hair's overall density, it might indicate excessive shedding requiring further investigation into its causes and potential treatments.

Can diet impact hair shedding?

Yes, diet plays a crucial role. Deficiencies in key nutrients like iron, zinc, biotin, vitamin D, and protein can disrupt the hair growth cycle and lead to increased shedding. Ensuring a balanced diet rich in these elements supports healthy hair follicles. Severe calorie restriction or rapid weight loss can also trigger telogen effluvium, highlighting the importance of sustainable and nutrient-rich eating habits.

Is it possible to stop hair shedding completely?

No, it's not possible or desirable to stop hair shedding completely, as it is a natural and necessary part of the hair growth cycle. Hairs must shed to make way for new growth. The goal when addressing excessive Hair Shedding: Causes and Treatments is to normalise the shedding rate back to within the typical range of 50 to 100 hairs per day by identifying and managing the underlying triggers.

How long does excessive hair shedding typically last?

Excessive hair shedding, particularly telogen effluvium, is usually a temporary condition. It often begins about 2 to 4 months after a triggering event and can last for several months, typically resolving within 6 to 9 months once the underlying cause is addressed. However, if the trigger persists (e.g., chronic stress or ongoing nutritional deficiency), the shedding can continue or become chronic.

Can hair products cause shedding?

Hair products are generally not a direct cause of telogen effluvium (excessive shedding). While some harsh products or chemicals might irritate the scalp or cause breakage, they typically do not alter the hair growth cycle to induce widespread shedding from the follicle. If you experience irritation or an allergic reaction, it is best to discontinue use and consult a dermatologist.

Conclusion

Understanding Hair Shedding: Causes and Treatments is essential for differentiating normal hair turnover from excessive hair loss. While shedding is a natural process, a significant increase often points to an underlying physiological or psychological stressor, such as hormonal changes, nutritional deficiencies, or high stress levels. Effective management centres on identifying and addressing these root causes, allowing the hair growth cycle to normalise. Consulting with a healthcare professional can provide clarity and guide appropriate strategies, ensuring healthy hair regrowth.

Sources and references

• American Academy of Dermatology Association, "Hair loss: Diagnosis and treatment", ongoing resource.
• British Association of Dermatologists, "Hair Loss", ongoing resource.
• Mayo Clinic, "Hair loss", ongoing resource.
• National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), "Alopecia Areata: Questions and Answers", ongoing resource.
• PubMed Central, "Telogen Effluvium: A Review", 2021.

Watermans Expertise: Supporting Healthy Hair

At Watermans, we understand the concerns surrounding Hair Shedding: Causes and Treatments. Our formulations are designed to create an optimal scalp environment, which is fundamental for healthy hair growth and can support the normalisation of the hair cycle. While our products do not treat medical conditions like telogen effluvium, they are crafted with ingredients aimed at strengthening existing hair fibres, reducing breakage, and promoting the look of fuller, thicker, and healthier hair. Regular use of Watermans shampoos and conditioners can contribute to overall hair vitality and a healthy-looking scalp, which is important during periods of shedding and regrowth.

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Find these ingredients in Watermans products

• Biotin: you will find this ingredient in our Hair Growth Shampoo.