When to worry about your hair loss, according to trichologists

You may notice more hairs in your brush or more strands falling out while you shower. Clogged drains aside, this can cause concern for many. Hair loss – losing about 100 strands a day – is completely normal and occurs as part of the natural hair growth cycle, according to Dominic Burg, a hair and scalp specialist called a trichologist who is the lead researcher at Evolis Professional.

If you have trouble deciding what is “normal” and what might be a problem, keep reading.

Normal hair loss vs. severe hair loss

Hair loss can cause panic attacks, but it is different from hair loss.

“Hair loss is generally characterized by a significant change, disruption or dysfunction in the hair growth cycle,” explained Burg, whose company sells hair care products. “This can happen for a variety of reasons, including genetics, age, diet, hormonal changes, lifestyle and life events, as well as inflammatory pathologies.”

Hair loss, on the other hand, is based on each hair follicle following its own hair cycle. Because they are not synchronized with each other, you will not shed them all at once, but rather at a rate of about 80 hairs to 120 hairs a day, Burg explained.

If you tend to wait a few days between hair washes, you may notice what may appear to be excess hair loss, but it is actually not a sign that you are losing hair.

“If you have not washed your hair for a few days, you will have some hair that has been freed from the pores of the hair follicle or shed from the scalp, but which is still present on the head – either tangled with other hairs or just very loosely connected to the scalp, “said Burg.” The longer you wait between washes, the more hair will build up this way, so when you finally wash, it may look like you shed a lot at once. But you actually just release part of a few days’ outcome. “

Where things get worrying, though, is if you notice that you are losing more than the normal amount of daily hair loss. Fortunately, you do not have to count the hairs individually to find out this.

Severe hair loss can take many forms, depending on the causes behind it. Alopecia areata, an inflammatory and autoimmune form of hair loss, is a serious condition that occurs when there is a loss of a large number of hairs at once, and presents itself as round bald spots on the head, Burg said. If you notice that you are losing hair in other areas, such as your eyelashes or eyebrows, this may be a sign of alopecia universalis.

Did you know that your hair is most likely thickest in the month of July?

PeopleImages via Getty Images

Did you know that your hair is most likely thickest in the month of July?

Some other types of hair loss may not be so severe, but may still warrant a visit to your doctor. For example, hormonal hair loss, which Trichologist Gretchen Friese said usually appearing on the temples, on the crown of the head, or on the upper front of the head, is usually a temporary form of hair loss.

Another form is diffuse hair loss, which is when the scalp begins to show through the hair all over the head, said Friese, who is certified by BosleyMD, which sells hair regrowth products.

This can be stress-induced, is not usually associated with itching or burning, and the shed is usually self-limiting (meaning it only lasts a month or two), Burg explained.

Stress-induced hair loss and COVID-19

Stress-induced hair loss increased in 2020 in the midst of the COVID-19 pandemic. While surveys has shown that the COVID infection itself caused hair loss for approx 20% of people who have contracted the virus (probably due to trauma to the body caused by high fever and long-term illness, Friese said), the generalized stress of the pandemic also causes people to lose their hair.

“Staying home, financial problems, homeschooling, being away from loved ones, fear of getting sick and social restrictions are some of the reasons people are feeling more stress right now – and stress can be a major cause of hair loss.” said Friese.

Still, there are ways to deal with the anxiety that a pandemic can cause. To Sharleen St. Surin-Lord, a board-certified dermatologist specializing in hair, it is important to incorporate mind, body, lifestyle and intestinal health in the treatment of skin and hair conditions.

“I advise my patients in high-pressure positions or situations – and those who suffer from anxiety – to meditate once or twice a day, listen to the ocean waves and practice deep breathing techniques,” said St. Surin-Lord. “I also recommend going for walks to get some fresh air, and if necessary send a referral to a psychiatrist.”

Seasonal hair loss

No, you do not imagine it. The hair loss you notice in early fall and winter may actually be related to the season. According to Friese, some are surveys has shown that we have the highest number of hairs in the telogen phase, or resting phase, in July.

“Hair in the telogen phase will generally fall off about 100 days after they have entered that stage, meaning people can see more hair loss towards the end of summer and into autumn,” Friese said.

“The idea behind ‘seasonal hair loss’ is that during the summer months we hang on to more hair to provide increased protection from the sun. We then cut these hairs to make room for thicker hair to grow in the winter, ”Friese explained.

Burg also did this, adding that during the winter our bodies can be ready to produce new hair close to the scalp to help with the insulation, which can result in hair loss as the body pushes the older hair out to make us ready a cold winter.

When to visit your doctor

In essence, whenever there is a loss of large amounts of hair that is unexplained (e.g., if you are not postpartum or undergoing chemotherapy), you should visit your doctor.

Red bumps or pus bumps on the scalp, tenderness, tenderness or intense itching also require an immediate visit to the dermatologist, said St. Surin-Lord. These are signs of inflammatory hair loss and can lead to scarring, which can result in permanent hair loss.

“Early intervention is essential to save one’s hair in these situations,” she said.

Regardless of the type of hair loss, there are treatment options available, Berg noted. They range from cosmetic products to give volume and mask any temporary hair loss to medications that help with inflammatory hair loss as well as treatments to increase hair growth.


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