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Why does so much hair fall out when I brush it?

Quick Answer

It’s normal to lose some hair each day as part of the hair growth cycle. However, losing large amounts of hair when brushing can indicate excessive shedding, which has various potential causes. The most common reasons for increased hair shedding include:

  • Hormonal changes or imbalance
  • Stress
  • Poor nutrition
  • Medications
  • Underlying medical conditions
  • Hair treatments or aggressive styling
  • Hereditary hair loss

If you notice your brush or shower drain getting clogged with lots of fallen hair, it’s important to identify the cause and address it to reduce excessive shedding. Consulting your doctor or dermatologist can help determine if it’s normal shedding or indicates an underlying issue.

The Normal Hair Growth Cycle

Hair grows in cycles consisting of three main phases:

  • Anagen – Active growth phase that lasts 2-7 years
  • Catagen – Transitional phase that lasts 2-3 weeks
  • Telogen – Resting phase that lasts 2-3 months

At any given time, around 85-90% of hair is in the anagen phase while only 10-15% is in the telogen resting stage. During telogen, old hairs naturally shed as new hairs push them out. Losing 50-100 hairs per day is considered normal.

Excessive shedding occurs when a higher percentage of hairs enter telogen at the same time. Hair loss experts estimate it’s normal to shed up to 250-300 hairs per day without an underlying issue. Losing more than this daily may indicate a problem.

What Causes Excessive Hair Shedding?

There are various potential causes of increased hair shedding or loss, including:

Hormonal Changes

Hormonal fluctuations or imbalances can disrupt the hair growth cycle and cause more hairs than normal to enter telogen shedding. This is common after pregnancy, discontinuing birth control pills, and during menopause. Thyroid disorders also impact hormone levels and hair growth.

Stress

Physical or emotional stress pushes more hairs into the shedding phase. Stress triggers may include major life events, trauma, grief, surgery, illness or crash dieting. Hair growth typically resumes 6-9 months after the stressful event ends.

Nutritional Deficiencies

A lack of protein, iron, zinc, essential fatty acids and other nutrients hampers hair growth and leads to loss. This may occur from following fad or restrictive diets.

Medications

Certain prescription drugs and supplements are linked to temporary hair shedding as a side effect. These include acne medications, beta blockers, antidepressants, NSAIDs and high-dose vitamin A supplements.

Medical Conditions

Diseases that cause inflammation or hormones changes, like lupus and polycystic ovary syndrome (PCOS), can trigger hair loss. Scalp infections, ringworm and other skin conditions also inflame follicles and impede growth.

Hair Treatments

Chemical relaxers, dyes, bleaches, straightening procedures and tools like curling irons damage the hair shaft over time, leading to breakage and loss. Aggressive heat styling and tight hairstyles that pull on the follicles also promote shedding.

Hereditary Hair Loss

Conditions like female or male pattern baldness are genetic and lead to progressive, patterned hair loss. Nutritional factors and hormonal changes often aggravate genetic hair loss.

Cause Description
Hormonal changes Pregnancy, menopause, stopping birth control, thyroid disorders
Stress Physical or emotional stressors like trauma, grief, illness
Poor nutrition Restrictive diets, eating disorders, deficiencies
Medications Hair loss as a side effect of certain drugs
Medical conditions Lupus, infections, PCOS, other diseases
Hair treatments Dyes, bleach, relaxers, heat styling damage
Hereditary Androgenetic alopecia, other genetic disorders

When to See a Doctor

Occasional increased shedding is usually normal. But see your doctor or dermatologist if you notice:

  • Sudden loss of large amounts of hair
  • Rapid hair loss over weeks/months
  • Bald patches on the scalp
  • Hair falling out in clumps
  • Hair getting thinner all over
  • Hair loss accompanied by a rash or skin irritation

A dermatologist can assess if the shedding is within normal limits and recommend blood tests or a scalp biopsy to diagnose any underlying medical conditions. Seeing a doctor promptly can help minimize permanent hair loss.

How to Reduce Hair Shedding

You can help curb excessive shedding and hair loss by:

  • Identifying and addressing triggers like stress or nutritional deficits
  • Eating a balanced, nutritious diet
  • Taking hair-boosting supplements like biotin and Viviscal
  • Gently massaging the scalp to improve circulation
  • Avoiding aggressive styling and heat tools
  • Using thickening shampoos and serums
  • Getting regular trims to prevent split ends

If an underlying health condition is causing hair loss, treating that can help normalize shedding. Medications like minoxidil and finasteride may also reduce shedding for certain types of hair loss.

When to Consider Hair Transplant Surgery

For progressive genetic hair loss like male or female pattern baldness, medications and natural remedies have limited effectiveness. As hereditary hair loss advances over the long-term, the only permanent solution is hair transplant surgery.

Hair transplantation involves harvesting follicles from thicker areas of the scalp, then artistically reimplanting them into thinning or balding zones. Modern techniques like follicular unit extraction (FUE) allow transplanting hair follicles one-by-one for a natural look.

Candidates for hair transplant surgery include:

  • Men or women with pattern baldness
  • Individuals with stable hair loss that’s unresponsive to other treatments
  • Healthy individuals without uncontrolled diseases
  • People with adequate donor hair on the scalp

Thanks to advanced techniques, hair transplants produce completely natural looking results. Many patients report gaining back a full head of hair and restoring confidence.

The Hair Transplant Procedure

The steps of a hair transplant using follicular unit extraction include:

  1. Administering local anesthesia – The scalp is numbed so the procedure is painless.
  2. Harvesting follicular units – Using a fine punch tool, grafts are extracted from the donor area one-by-one.
  3. Creating recipient sites – Tiny recipient sites are made where the grafts will be placed.
  4. Carefully reimplanting follicles – Grafts are meticulously reimplanted in the recipient area.
  5. Allowing healing – Within a week, transplanted hair sheds and regrows permanently within 4-6 months.

When performed by an experienced hair restoration surgeon, complications like infection and scarring are minimal. Patients can resume normal activity within 1-2 days.

Is a Hair Transplant Permanent?

Hair transplanted from the back and sides of the scalp to balding areas is permanent since those follicles are genetically resistant to hair loss. As long as the transplanted hair is not exposed to injury or disease, it will continue growing healthy, natural hair for a lifetime.

However, a transplant does not prevent future loss of native hair. Individuals predisposed to pattern baldness may need multiple procedures over time to address ongoing loss around the transplants. But the transplanted hair itself remains permanent.

Coping with Excessive Hair Shedding

Losing handfuls of hair on a daily basis can be distressing and affect self-esteem. Here are some tips to help cope with the anxiety and appearance changes of excessive shedding:

  • Remember that for most people, the shedding is temporary. Focus on targeting the trigger and staying healthy to allow regrowth.
  • Consider shorter hairstyles that create the illusion of thickness and volume.
  • Boost volume with color shampoos, texturizing sprays or dry shampoo.
  • Use headbands, hats, scarves or updos to disguise thin areas.
  • If genetic baldness is the cause, look into hair transplants for a permanent solution.
  • Join online forums to connect with others experiencing hair shedding and loss.

WhileWaiting for hair to grow back can require patience and adjustment, taking proactive steps allows you to minimize shedding and regain confidence.

Conclusion

Moderate hair shedding of 50-100 strands per day is normal. However, losing large clumps of hair when brushing or washing can signal excessive shedding stemming from a medical condition, stress, medications, hormonal changes or nutritional deficiencies.

Seeing increased hair in your brush and shower drain doesn’t automatically indicate a dire problem. But it’s important to identify factors contributing to increased shedding and address them to help normalize hair growth cycles and retention.

If you notice sudden, rapid loss or bald spots, consult a doctor to assess for underlying issues and rule out conditions like alopecia areata. With proper diagnosis and treatment of causes like vitamin deficiencies, infections and hormone disorders, hair shedding can often be reduced and regrowth restored.

In cases of irreversible genetic hair loss, options like hair transplantation can semi-permanently restore your hairline and a head of natural, thick hair. But the key is consulting experts early on to determine the best solutions for your unique situation. With the right guidance, excessive shedding doesn’t have to be permanent.