Hair loss

Hair loss means losing more hair than expected, developing thinner areas, or having patches without hair. The medical term is alopecia. It is a symptom rather than a single disease.

Hair loss can affect only the scalp or also involve the eyebrows, eyelashes, beard, or body hair. It may happen gradually over years or begin within days or weeks. Some types are temporary, while others continue without treatment.

Seeing hair on your pillow, clothing, or shower drain does not always mean something is wrong. Hair naturally moves through cycles of growth, rest, and shedding. A noticeable change from what is normal for you is more useful than counting individual hairs.

Hair loss may appear as:

• Gradual thinning on the top, temples, or front of the scalp
• More hair coming out during washing or brushing
• One or more smooth, round bare patches
• A widening part or a smaller ponytail
• A receding hairline
• Broken hairs of different lengths
• Loss of eyebrows, eyelashes, beard, or body hair

The scalp may look normal. In other cases, there may be itching, burning, tenderness, redness, flaking, crusting, or small bumps.

A smooth scalp with visible follicle openings suggests that the hair roots may still be present. A shiny area without these openings can be a sign of scarring hair loss, where inflammation has damaged the follicles. This needs prompt medical assessment because lost hair may not regrow.

Family-pattern hair loss develops gradually and is influenced by genes and hormones. It can cause a receding hairline, thinning over the crown, or a widening part. It is also called androgenetic alopecia.

Temporary increased shedding, called telogen effluvium, can begin a few months after a major illness, high fever, surgery, childbirth, rapid weight loss, severe emotional strain, or another physical stress. Hair usually sheds across the whole scalp rather than in one patch.

Hair styling and damage can break hairs or pull on their roots. Tight braids, extensions, ponytails, chemical straightening, bleaching, and repeated heat may contribute. Long-term pulling can eventually cause permanent follicle damage.

Alopecia areata causes smooth, clearly defined patches. It happens when the immune system mistakenly targets hair follicles. It may affect scalp or body hair and sometimes causes small dents in the nails.

Scalp ringworm is a fungal infection, despite its name. It can cause scaly patches, broken hairs, itching, or tender swelling. It is more common in children and can spread through close contact or shared items.

Less common causes include thyroid conditions, iron or other nutritional deficiencies, certain medicines, hormonal changes, and inflammatory skin conditions. Scarring forms of alopecia are less common but important to identify early.

Do not stop a prescribed medicine because of hair loss without speaking with the clinician who prescribed it.

Book a routine appointment if your hair loss is sudden, patchy, steadily worsening, or causing concern. You should also arrange an assessment if it affects your eyebrows or eyelashes, follows a medicine change, or comes with scalp itching, scaling, pain, or burning.

Seek same-day medical advice for a painful or soft swollen area of scalp, pus, rapidly spreading redness, or fever. These features can occur with a significant infection or intense inflammation.

Get urgent help after a hair product or treatment if you develop a serious chemical burn. Call emergency services for trouble breathing, faintness, or swelling of the face, mouth, or throat. These symptoms relate to a severe reaction rather than hair loss itself.

A healthcare professional will ask when the loss began, whether it is shedding or breaking, and whether it is patchy or widespread. They may ask about recent illness, childbirth, weight change, stress, diet, medicines, family history, and hair-care practices.

They will examine the scalp and hair pattern. A gentle pull test may show whether hairs are shedding easily. A handheld magnifying tool called a dermatoscope can give a closer view of hairs, follicles, and scalp skin.

Blood tests are not needed for every person. They may be used when your history or examination suggests iron deficiency, a thyroid condition, or another medical cause. Scalp scrapings can test for fungal infection. Occasionally, a small skin sample called a biopsy is needed, especially if scarring hair loss is possible.

Treatment depends on the cause. Temporary shedding often improves after the trigger has passed or an underlying condition has been managed. Pattern hair loss may be treated with minoxidil or, for some people, prescription medicines. These treatments do not suit everyone and usually need continued use to maintain their effect.

Alopecia areata may be treated with corticosteroids or other medicines that affect inflammation. Scalp ringworm usually requires prescription antifungal medicine taken by mouth because creams alone may not reach infected hair follicles. Scarring hair loss often needs specialist treatment to limit further damage.

Gentle hair care can reduce breakage and pulling:

• Choose loose hairstyles and avoid styles that cause pain
• Reduce frequent bleaching, straightening, and high-heat styling
• Detangle gently, especially when hair is wet
• Eat a balanced diet with enough protein and iron-containing foods
• Protect exposed scalp from strong sunlight

Avoid taking high-dose hair supplements unless a deficiency has been found. More is not always better, and some supplements can cause harm or interfere with blood test results. Biotin, commonly sold for hair growth, can affect several laboratory tests.

Temporary shedding usually does not stop immediately when its trigger resolves. New growth also takes time to become visible because hair grows slowly.

Hair may regrow fully after some causes, including many cases of telogen effluvium and scalp ringworm treated early. Alopecia areata can regrow and later return. Pattern hair loss usually progresses gradually, although treatment may slow it or improve density.

Hair loss caused by permanent scarring may not regrow in affected areas. Early assessment focuses on protecting the remaining follicles.

Can stress cause hair loss?

Major physical or emotional stress can shift more hairs into the resting phase. Shedding often begins several months later, so the connection may not be obvious.

Does washing make hair loss worse?

Washing releases hairs that were already ready to shed. Gentle washing does not usually cause hair loss, although rough handling can increase breakage.

Will cutting or shaving hair make it grow back thicker?

No. Cutting changes the hair above the skin but does not change the follicle, growth rate, or number of hairs.

Should I take vitamins for hair loss?

Vitamins may help when a specific deficiency is present. They are unlikely to correct hair loss from another cause. A healthcare professional can decide whether testing is appropriate before you start supplements.