The real reason your hair is falling out

Everyone sheds their hair. You’re not the only one who finds clumps of lost strands in your shower drain, stuck in your vacuum cleaner and all over your carpet – the fact is, hair shedding is totally normal.

The hairs on your scalp have a life cycle of between two and eight years, beginning with the anagen (growing) phase. The second step is the catagen phase, when the resting and shedding phases of the hair cycle are generally combined. On average, a woman loses around 70 to 160 strands per day.

But what happens if you start to notice that you’re losing more hair than usual? What if you're experiencing breakage or bald patches and your hair isn’t growing back? Should you be worried? 

Female hair loss is actually a super common issue (way more than people realise). According to the Australian Journal of General Practice, approximately 49 per cent of women will be affected by hair loss throughout their lives, with female pattern hair loss (FPHL) being the most common cause of female alopecia (an autoimmune disorder that causes hair to fall out in small patches). 

The thing is, there are so many different types of triggers for hair loss that it can be hard to pinpoint exactly why your strands are falling out in the first place. To cut through all the noise, we spoke to Anthony Pearce, a specialist integrative medicine trichologist, and trichologist Carolyn Evans-Frost at Absolique Hair Health, to help break down the cause of hair loss in women.

The signs of hair loss  

First things first, how do you know if the amount of hair you’re shedding is normal or not? Pearce says, “The amount of hair shed daily or over a week varies in all of us and is determined by a number of factors. Therefore, the practical definition of excessive hair loss is ‘more than the individual would normally lose’.”

Evans-Frost adds, “When experiencing hair loss, women may notice double the amount of hair falling and usually note more on the wash day as that is when the hair is manipulated more.” She notes, however, that the actual hair washing does not cause the hair loss. “The other symptom women may notice is hair thinning as a result of the hair loss. Women are busy and sometimes don’t notice the physical hair loss but do gradually notice more scalp showing as a result of the hair loss and subsequent hair thinning.” 

The different types of hair loss 

According to Pearce, there are two common types of hair loss you should be aware of: generalised thinning and reduced volume (androgenic thinning) and telogen effluvium, or excessive shedding. “Generalised thinning tends to appear slowly over time; it’s reported that 20 per cent of volume is lost before it becomes apparent to the individual. Nutrient-metabolic disturbance or the adverse effects of certain medication or hormone therapy are the common causes.”

“Telogen effluvium (TE) is the diagnostic term to describe the rapid and excessive shedding of follicle scalp hair following illness or febrile fevers,” says Pearce. “TE is now held to be a non-specific reaction to a wide variety of physiological and/or emotional stressors that synchronise up to 50 per cent of all scalp hair follicles into a premature termination of anagen phase – which then moves in to telogen shedding phase.” 

The common causes of hair loss in women

While most women will be diagnosed with ‘genetic’ hair loss, Pearce says that few women actually exhibit true genetically inherited androgenic scalp hair thinning. “Those seeking answers are invariably given the diagnosis of ‘genetic’ hair loss – even where there is no family history.”

According to our experts, the reasons behind hair loss in women is varied. “Baldness in women is very gradual and normally a result of the hair loss or hair thinning. Main causes are low iron and ferritin in conjunction with hormonal problems which may be associated with low vitamin D, use of birth control to curb hormonal problems, and menopause. All can be addressed in various ways to avoid any balding,” explains Evans-Frost.

While there are evidently a number of things that can cause hair loss, these are some of the most common hair loss causes. 

#1 / Hormonal imbalance
If your hormones are out of whack, it can lead to a whole heap of health and beauty issues – from adult acne to weight gain and - you guessed it - hair loss. That’s because hormones play a major part in regulating the hair growth cycle. If you're experiencing hormonal changes, this can lead to a support collapse of hair follicle growth – meaning your hormones are no longer able to provide the ‘metabolic energy’ to sustain scalp hair follicle activity. “As a non-essential tissue in nutritional, metabolic or hormonal terms, scalp hair is often the first to reveal internal disturbance or deficiency by increased hair shed and/or degraded hair shaft quality,” says Pearce.

#2 / Nutrient deficiency
No shock here - this is one of the biggest hair loss culprits. “Vitamin D, zinc, iron and iodine (essentially in that order for hair growth) are considered the most important nutrients for optimal metabolic functioning. Women are more prone to be deficient in these nutrients than are males,” says Pearce

#3 / Shock or prolonged stress
Yep – stress can *literally* make your hair fall out. If you’re suffering from sudden emotional shock or prolonged and unrelenting mental distress, this may have an impact on the health of your hair. “Stress is a common reason given for hair loss problems, but it’s usually only the most severe events which will trigger a TE hair shed or onset of alopecia areata – or other autoimmune problem,” explains Pearce. “The death or grave illness of a loved one, marriage or other relationship breakdown, harassment, business, employment or career termination with resultant financial anxieties are just some examples of the types of emotional stressors likely to cause scalp hair loss.”

#4 / Dramatic weight loss
It turns out going down a few dress sizes can also impact your hair. If you experience rapid weight loss in a short period of time either by a crash-diet or illness, this can trigger hair loss. The fluctuation in your Body Mass Index (BMI) causes physical stress, which signals the hair follicles to move into an inactive stage. As well as this, the lack of calorie intake and nutrients deprives the hair of vital supplements for growth. This is all the proof we need to stay away from any fad diets or harsh detox diets! Instead, a balanced lifestyle is best for healthy hair growth.

#5 / Medication
Some medicine can cause hair loss. Strong combination drugs such as antibiotics, chemotherapy and blood dialysis can impact the health of your hair, says Pearce. He also notes that iron infusions – a popular method of addressing iron deficiency in females – can often activate TE in susceptible people: “Iron is very oxidative with a very reactive potential that can cause physiological ‘shock’ to the body from the high amounts rapidly administered.” According to Pearce, certain medication such as synthetic hormonal therapy (contraceptives or hormone replacement therapy) can also take a toll on your hair. “Any prescription medication has the potential to trigger a TE episode, but other common drugs are thyroid medication, anti-cholesterol drugs (Statins), anti-androgen medication, anti-convulsant/mood stabilising drugs, anti-depressant medication, and anabolic steroids,” he says.

#6 / Pregnancy 
Hair loss is one of the side effects of pregnancy and is completely normal during the postpartum period. While you’re pregnant, the rise in hormones keeps you from losing hair (your hairs go into the telogen resting phase). However, after delivery, the hormones return to normal levels, which allows the hair to fall out and return to the normal cycle. It's usually a temporary phase and your hair will eventually go back to how it was pre-pregnancy. “Post-partum TE usually commences eight to 10 weeks after childbirth, but when it commences and how severe the hair shed depends on individual circumstances with mother and baby,” explains Pearce.

#7 / Acute illness
Those who suffer from medical conditions or have a sudden illness might also experience hair loss. It’s not uncommon for someone to see a lot of hair falling out from around four to three months after being sick, “Particularly when accompanied by high febrile states (elevated body temperature), vomiting and diarrhoea – especially from contaminated food/water,” adds Pearce.

#8 / Major surgery
If you have undergone some kind of surgery or an extensive dental procedure, this can trigger TE, “Particularly when substantial blood loss or intra-operative complications have occurred,” says Pearce. 

#9 / Allergic reactions 
Allergic reactions to certain products can not only irritate your scalp, they may irritate your hair follicles, too. If the irritation persists, it can damage the hair follicles and result in hair loss. Pearce says this can be from any source, but most commonly from chemicals applied to the scalp. “Commonly, one to four months (average two to three months) after any of these [allergic reaction] experiences, the hair will begin to shed abruptly and be lost in excessive amounts for about two to three months before settling,” says Pearce. “Ordinarily TE is considered a temporary and self-correcting form of generalised scalp hair loss, but will only fully resolve when nutrient-metabolic support is optimised to support follicle phasing reset.”

What to do about hair loss and thinning hair

First of all, don’t stress. You’re not alone and hair loss is nothing to be embarrassed about. If you're looking for the best hair loss treatment, know that one product won’t be the answer. Rather than reaching straight for the minoxidil (an active ingredient usually prescribed for hair thinning) and waiting for new hair to appear, it’s best to see a professional. That way you can have your general health, diet and blood pressure assessed so that you can properly diagnose the problem.  

“If anyone notices change in their hair, the first step is a visit to the doctor to get some blood tests,” says Evans-Frost. “The doctor should rule out any obvious causes to do with health or medication. If the hair loss does not stop past 12 months, or if the hair loss or hair thinning is rapid and obvious and causing you concern, you would benefit from visiting a trichologist, whom is a hair specialist, to ease your concerns.”

Looking for more tips on how to get healthy hair? Find out why your scalp health is so important and the pre-shampoo treatments you need to introduce into your haircare routine.

Do you suffer from hair loss? We’d love to hear about the treatment options that have worked for you.

Main image credit: Getty