In a discussion around hair loss it is important to point out that there are three stages within the hair growth cycle. The first is anagen which is the phase in which the hair is actively growing, this phase lasts from 2-6 years. Catagen phase comes next as a transitional phase where the hair detaches from its blood supply, this lasts 1 -2 weeks. Telogen is the last phase in which the hair is released and the follicle rests for up to 3 months. During this time up 50 to 100 hairs can be lost in a day.
The most common type of hair loss is telogen effluvium results from a metabolic or other type of stressor. These stressors can vary from post partum hormone changes, fever as result of infection, to exogenous changes like stopping hormones like the pill. This type of hair loss occurs across the whole scalp. The stressor forces hair into telogen phase, and as result a few months after the stressor a large amount of hair loss occurs, as follicles return to anagen phase.
Patterned hair loss depends largely on genetics, androgenic alopecia typically relates to higher production of dihydrotestosterone, and higher levels of 5 alpha-reductase, these are 2 forms of androgen hormones. This type of patterned hair loss is more common in males, but can occur in women with PCOS due to the higher testosterone levels.
Alopecia areata is an autoimmune type of hair loss typically presenting with loss of complete patches of hair. This type of hair loss often presents alongside other autoimmune conditions like Hashimoto thyroiditis, diabetes mellitus, lupus, and celiac disease.
We often note more hair loss on wash days which is normal due to the friction of washing the average loss 200 to 300 hairs. On a non shampoo day average normal daily scalp hair loss in an adult is 40 to 100 hairs.
Lab testing can be helpful in determining cause of hair loss – this can include complete blood count, ferritin, thyroid panel, or even testosterone.
Nutritional and vitamin support can be helpful at preventing hair loss or balancing the immune system in autoimmune types, a consultation can help determine your individual needs.