Hair Shedding! We all experience it. However, there is no fear like seeing numerous stands of hair on the floor, on your clothes, in your comb, or on your hands. First thing first, just breathe and remember everyone loses 100 strands a day. In today’s article, Dr. Nikki D. Hill and I share the top 5 causes of hair shedding.
Increased Hair Shedding
When patients report increased hair shedding, I always ask about their background. First, I ask if they are seeing short hairs or long hairs, because this can help determine whether they are experiencing — breakage (short hair) or shedding (long hair).
Next I ask about grooming habits such as frequency of hair washing and hairstyle selection. Simple things such as grooming habits can lead to perceived increased shedding. If the hair is not combed or taken out of a protective style for weeks, those shed hairs will find their way onto your floor or in your comb. This is commonly mistaken as increased shedding. I counsel patients to wait a week after taking down a protective style to see if the shedding normalizes.
Additionally, some hairstyles can promote hair shedding, especially if they are pulled too tightly. Updos and protective styles are great for growing long hair but they should not be too tight and cause unnecessary tension on the scalp.
Medications, medical conditions and hormonal changes can lead to stress shed called telogen effluvium (TE). This happens when more than 100 follicles (a normal day shed count) shift simultaneously to a shed or telogen phase. The result is a noticeable increase in shedding.
TE typically occurs 1-3 months after the incident and can persist up to 1-3 months after the incident has resolved. Chronic TE is when you experience increased shedding for more than 6 months. Typically stress shedding will correct itself once the trigger has resolved and the hair follicles normalize back into normal growth cycles.
Blood work should be checked to make sure anemia, thyroid, amongst other internal conditions are not driving the process of the TE. Correcting these conditions can lead to a dramatic improvement in hair shedding. For medications started when the shed began, typically the shed will start to slow down once the body adjusts. For medications stopped, a similar pattern of waning may occur within a few weeks to months but should also cease once the body adjusts.
Hair products that do not agree with your scalp can cause increase hair shedding. Stop using the product immediately if this happens and see a Dermatologist if the condition persists.
Additionally, the hair can go through a shed phase when a chemical break is longer than usual, almost similar to stopping a medication and having resultant shedding. Length of time between chemical processes (relaxer stretching) and whether the patient is transitioning to a chemical-free state can influence shed or long hair breakage. The chemical transition shed will wane down with time, typically 2-3 months.
Lastly, examine the scalp to make sure there isn’t any inflammation that would cause hair to shed prematurely. A visit to the Dermatologist can help you determine if premature shedding is occurring. A biopsy should be performed to determine the cells in the inflammation, the pattern of the inflammation, and whether the follicles are becoming scarred. Once a diagnosis is given, treatment options are discussed and targeted towards the type of inflammatory scalp condition.
Nikki D. Hill, MD
Board-Certified Dermatologist and Hair Loss Specialist