Hair Loss: 7 Typical Causes and How to Spot Them

What is hair?

We can spend hours styling our hair, but we don't typically give our individual hair follicles much thought. What even is hair?!

Every hair follicle is made from a protein called keratin. Follicles are rooted in the dermis by the hair bulb where new cells "collect" and build upon each other to form the strand. Blood vessels and sebum work together to nourish the hair and keep it silky and strong as it grows. Hair growth comes in cycles and can vary depending on your health and age, but the average person's hair grows by about 1/2 inch per month. The growth cycle of an individual follicle is divided into three stages:

1. Anagen phase: This is the hair's growth phase which can last anywhere from 2 to eight years. A single hair can hang out on your head for eight years! Don't worry, it's estimated that about 90-95% of the hairs on your head are still chugging along in the growing phase.
2. Catagen phase: This is when the growth starts to slow down and the follicle strands as it gets ready to say goodbye. The growth slows down and the follicle shrinks in this phase. This lasts between two and four months.
3. Telogen phase: This is the retirement age for the hair follicles. After three to four months of rest, without growing, the old hair falls out and new hairs begin to grow in their place. It's the circle of life.

Hair shedding is a part of the normal hair life cycle. In fact, the American Academy of Dermatology (AAD) said "It’s normal to shed between 50 and 100 hairs every day." Out of the ~100,000 hairs on your scalp, losing just 50 doesn't seem like such a big deal! However, if you seem to be losing more or notice sparse patches beginning to form on your head, it might be time to raise an eyebrow.

What are the common causes of hair loss?

Hair loss, hair shedding, and hair thinning are not the same things. Hair shedding refers to the natural fallout of old hairs replaced with new ones. Hair lossis when the hair falls out without having a "replacement" to come in after it. Just like hair shedding, hair loss is normal to an extent; it's estimated that about 35 million men and 21 million women in the U.S. have issues of hair thinning or hair loss at some point in their lives.

There are many different types of hair loss. Hair can fall out in patches or thin overall and can range in severity, even leading to baldness. Getting to the root cause of hair loss can be tricky, but more often than not, it can stem from one (or more) of the following causes:

Androgenetic alopecia

Sometimes referred to as androgenic alopecia, male pattern baldness, or female pattern hair loss, this is by far the most common cause of hair loss for both men and women. This is a form of hereditary hair loss that is usually characterized by a receding hairline and thinning of hair and bald spots at the crown of the head. Hormones and family history both play into an individual's risk of this type of hair loss. For men, family history seems to be the biggest determinant whereas, in women, menopause (which alters hormone levels) is the guiltiest culprit of hair loss. This can eventually lead to female-pattern baldness.

Telogen effluvium

This is hair loss that's brought about by stress. The tricky part in spotting it is recognizing that it usually occurs 2-3 months after a stressful event, such as a major illness, surgery, infection, major weight loss, or after childbirth. This is because it creates a large amount of the male hormone androgen.

Tinea capitis

This type of hair loss causes hair to fall out in patches and is due to a fungal infection of the scalp. This is common in children and causes the scalp to become dry, flaky, and scaly.

Alopecia areata

Alopecia areata is an autoimmune disease in which the immune system attacks the hair follicles and causes them to fall out and form bald patches. It can also affect other areas of the body and is commonly diagnosed along with other autoimmune conditions.

Side effects of medications

Hair loss is a surprisingly common side effect of a number of medications. Typically drugs that alter hormone levels have the greatest effects and can include beta-blockers, birth control pills, cancer treatment, hormone replacement therapy, steroids and acne medications.

Traction Alopecia

Traction alopecia is caused by prolonged tugging on the hair follicles as a result of certain hairstyles. Tight braids, such as cornrows, can cause the hair to fall out at the root.

Symptoms of medical conditions

As we mentioned above, certain conditions such as autoimmune diseases can cause the hair to fall out. Trichotillomania is a mental condition in which individuals pull out their hair. Autoimmune diseases, syphilis, polycystic ovary disease, thyroid diseases (both hyper and hypothyroidism), sex-hormone imbalances, a protein deficiency, or an iron deficiency (anemia) can cause temporary or permanent hair loss. With any type of hair loss, it's best to consult a doctor or dermatologist so they can get a full view of your symptoms and identify any other illnesses.  

Getting to the root of hair loss

Treating hair loss first starts with understanding the type of hair loss you're experiencing. If you're concerned about your hair growth or lack thereof, you can ask yourself these 4 questions to find the most likely cause.

1. Is your hair falling out in patches or thinning overall?Hair loss can take shape differently depending on the cause. Alopecia areata and telogen effluvium are typically characterized by the hair falling out in patches. Androgenetic alopecia often results in hair thinning around the face and at the crown of the head. Other types of hair loss are not concentrated in specific areas.
2. Have you experienced any major stressful events in the past ~6 months?Stress is a huge culprit in hair loss, but it doesn't happen right away. Hair loss as the result of a major surgery, stressful event, weight loss, or after childbirth is called telogen effluvium and typically does not result in total balding or permanent hair loss. It's important to remember that COVID-19 may negatively impact your physical and mental health due to prolonged isolation, so keep it in mind if you experience higher-than-usual amounts of hair loss.
3. Do you have any pre-existing autoimmune diseases?Autoimmune diseases often come in groups and commonly affect the skin and hair. If you are experiencing hair loss alongside other skin conditions or have previously been diagnosed with an autoimmune disease, it's likely the cause of your hair loss.
4. Have you started taking any new medications within the past ~6 months?Medications all come with their side effects, especially those that purposefully alter your hormones. If you started taking any new medications, it could be the cause of your hair loss. Take note of it along with any other changes you notice in your physical or mental state and talk to your doctor about how your new medication could be negatively affecting your body.

If you're concerned about your hair loss at any rate or stage, you should contact your doctor or dermatologist to find what medical treatments are right for you.

How to promote hair regrowth

Your doctor will be best able to diagnose your hair loss and recommend the most effective treatment options for you. Your doctor will likely perform a "pull test" in which they see how many strands of hair fall out from light tugging, but they can also run blood tests, thyroid tests, and hormone tests to verify what is causing the hair to fall out. From there, they may recommend using the popular hair-regrowth medications minoxidil (rogaine) or finasteride (propecia). Many people are also seeking out hair transplants to restore receded hairlines and regrow hair in bald spots, but if you aren't willing to take the leap or are looking for more affordable alternatives, you can try any of the following:

• Biotin:Biotin is a buzzworthy vitamin that has been around for years to help treat and prevent hair loss. A biotin deficiency can result in brittle nails, hair breakage, and hair loss, but luckily, it can be found both in pill form or in many foods such as fatty fish, nuts, and eggs. If you're looking for even more scientifically-proven support, biotin is most effective when paired with protein supplements to strengthen the skin and hair.

• Collagen:Collagen is the most abundant protein in the human body and is responsible for keeping the skin firm and vibrant and the hair and nails strong and healthy. The trouble is that collagen production begins to drop as we age. Collagen may support future hair growth by acting as a powerful antioxidant that fights off hair and skin-damaging free radicals, as well as providing the body with proline, an amino acid that is essential to keratin (the protein that makes up hair). Collagen can be hard to come by in many food sources, but many clean collagen supplements are available to work more protein into your diet.
• Vitamins:Biotin is a b-vitamin that is necessary for keeping the hair and skin healthy. Other vitamins that are important for hair growth are vitamins A, C, D, and E, and minerals zinc and iron. Luckily, you can find biotin and other vitamins in many different foods such as fish, meat, whole grains, nuts, and green vegetables. You can also take a multivitamin to make sure there are no holes in your diet. This method of "gentle nutrition" can set you up to prevent hair loss without making any major changes to your diet or lifestyle.
• Omega-3s:Omega-3 vitamins have also been shown through trials and scientific studies to improve hair growth, thickness, and shine. They may also reduce the inflammation sometimes associated with hair loss.

Hair loss is a bummer, but in many cases, it can be explained and reversed just by eating more diverse and wholesome meals and adding a supplement to your diet here and there. It never hurts to add some more leafy greens and whole grains to your diet, but if you're worried about your hair loss at any stage, contact your doctor to help get to the root of your hair loss and find ways to stop it in its tracks.

Summary Points:

Hair growth occurs in cycles and can vary depending on your health and age. The average person's hair is approx. 1/2 inch per month.

Androgenic alopecia, male pattern baldness, or female pattern hair loss, is by far the most common cause of hair loss for both men and women.

Traction alopecia is caused by prolonged tugging on the hair follicles as a result of certain hairstyles.

Collagen may support future hair growth by acting as a powerful antioxidant that fights off hair and skin-damaging free radicals, as well as providing the body with proline, an amino acid that is essential to keratin.

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Article References:

1. https://www.drugs.com/health-guide/hair-loss.html
2. https://www.medicalnewstoday.com/articles/327005#causes
3. https://en.wikipedia.org/wiki/Hair_loss
4. https://www.healthline.com/health/hair-follicle#hair-regrowth
5. https://www.healthline.com/health/how-much-hair-loss-is-normal
6. https://www.aad.org/public/diseases/hair-loss/insider/shedding
7. https://thebaldcompany.com/hair-loss-facts-statistics-myths/
8. https://aestheticsandhairclinic.com/your-primer-on-hair-loss-and-its-treatments
9. https://www.healthline.com/nutrition/best-vitamins-hair-growth#TOC_TITLE_HDR_3