Why Hair Falls Out and Gets Thinner

Hair has a natural cycle of growth and decline (called shedding). So, if you occasionally find a bit more hair on the bathroom floor, don’t panic. Natural hair loss is individual and variable.

“The estimated rate of shedding can be from 100 to 200 strands per day,” says Carolyn Goh, MD, assistant clinical professor of dermatology, UCLA Medical Center. “It can also vary seasonally. Some people lose more hair in the winter, while others lose more in the summer.”

Shedding is usually a sign of upcoming regrowth. But if hair loss is sudden or excessive, talk with your doctor, especially if you have started any new medications.

All in the Family

Genetics mainly determine how much hair you have and its rate of change and loss. Some people still have a full head of hair at 80 years of age, while others may start losing it in their 30s. Generally, hair eventually becomes less pigmented and strands can become thinner. Miniaturization, a common process, occurs when hair follicles become smaller and thus the strands are thinner. Hair follicles may also stop producing new hair.

Common Causes and Treatments

Any partial or complete hair loss is called alopecia. It’s more frequent in men, but occurs in women, too. A medical condition called alopecia areata, thought to be an autoimmune disorder, results in losing patches of hair. It tends to run in families, but it can also be triggered by stressful life events, such as major traumas and illnesses. Alopecia areata hair loss can occur on the scalp and all over the body from eyebrows to eye lashes, arms, legs, and the pubic area. If the hair loss is not widespread, it usually grows back in a few months. However, if the hair follicles are scarred, which is rare, hair cannot grow back.

Male pattern baldness, or androgenetic alopecia, affects two out of three men. FDA-approved minoxidil (Rogaine), available over-the-counter (OTC), works for many men. But, once you stop using the product, hair growth also stops. It can, however, work more broadly than advertised.

“The packaging says it’s only effective on the back of the head and top of the scalp because that’s where they studied it,” explains Dr. Goh. “When you do a research study it’s easier to study on a localized area, so that’s where they can say it works. It may not work as well on the hairline in the front, but can work there for some people.”

It’s not expensive and minoxidil may also work for other non-scarring types of hair loss.

If you’re female and your ponytail seems thinner, your part wider, and the hair near your temples is receding, you may have female pattern hair loss (FPHL). OTC products containing either 2 percent or 5 percent minoxidil have been FDA-approved to treat FPHL. As in men, regrowth is not permanent, and it works for many, but not all, women.

For topical treatments to be most effective, the hair and scalp need to be healthy. If the skin is flaky or too oily, the product may not absorb as well.

Other less common triggers of hair loss include some medications (e.g., chemotherapy, blood thinners, heart medications, antidepressants), and health conditions, such as thyroid problems and lupus. Treatments are available and depend upon specific conditions. They include prescription pills, topical medications, ultraviolet light therapy, and steroid injections under the skin’s surface.

Take Good Care of Your Hair

Hair-thickening shampoos retain hair moisture, which can make your hair appear fuller. They may also help reduce breakage. When styling hair, avoid high-heat drying, hot hair curlers and curling irons. Know that hot oil treatments can damage hair follicles. Comb or brush hair gently. Avoid tightly pulling hair into a bun, braids, or into hair clips, as physical stress can cause hair to fall out.

Nourish your hair from the inside by eating healthfully and eating enough. Very low-calorie diets and inadequate protein can cause hair loss, as can malnutrition. Before taking a supplement, find out which, if any, nutrients you lack. Too much or too little can affect scalp and hair health. For example, too much vitamin A and E and excess selenium have been linked to hair loss. And though bold promises have been made about biotin and folic acid, most studies suggest these supplements have no influence on hair growth or thickness.

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