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The Many Possible Reasons You're Losing Your Hair

When your hairbrush looks like you just sheared a sheep.

by Jordan Rosenfeld
Aug 31 2017, 12:00pm

Ullstein Bild / Getty

The Scenario:
Lately, you've started to notice something horrifying every time you take a shower: Your drain is now clogged with clumps of hair so dense they resemble your neighbor's Shih Tzu. You also find stands of hair on your pillow in the morning and the mats in your hairbrush feel like the aftermath of a sheep shearing. Why the hell are you losing so much hair?

The Facts:
Before you panic it's important to consider that you're probably not a very good judge of the quantity of your hair loss. Regardless of whether you're a woman or a man (we'll stay neutral for the sake of this piece since hair loss patterns vary in location and volume according to your sex), all of us lose approximately 50 to 100 strands per day, and an increasing 2 percent every year on average, says Lindsay Bordone, assistant professor of dermatology at Columbia University Medical Center. "For someone who has very thick hair, losing a hundred strands a day might not be that much, whereas for people with very thin hair, that could be a lot."

If your mop is shedding more hair than usual, going on more than a few weeks, you may very well be experiencing "telogen effluvium" (TE). This condition results after something stressful occurs to body or mind, ranging from childbirth, to high fevers, to surgery or a traumatic accident, Bordone tells me. It can take up to three months to present itself, however, so while your hair loss may seem sudden, it probably has a source you can trace back. TE is not a disease, and so long as you are not under continual stress, it will resolve itself within a year.

Another common cause of TE, says Bordone, is weight loss. "It's very common after people have started a juice cleanse, or become vegan, or a change from their previous diet," she says. In essence, your body goes into starvation mode so it shifts energy away from things that aren't absolutely needed, like hair growth.

The Worst Case Scenario:
If there's nothing traumatic or dramatic in your recent past to explain your hair loss, you may be dealing with one or more serious forms of hair loss such as alopecia areata (AA), an autoimmune condition that manifests when your immune system attacks your own skin. If affected areas contain hair follicles, the follicles will go dormant, and you will lose hair. Alopecia areata presents in a very specific way, however.


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"The classic presentation is a coin shaped area of baldness or thinning, [typically] on the scalp," says Robin Evans, a dermatologist with Southern Connecticut Dermatology and a clinical instructor at the Albert Einstein College of Medicine. These coin-shaped spots can be as small as a centimeter in size, or much bigger and they can present in just just a few, or you can have numerous ones. These can also affect beards, eyebrows, and eyelashes as well as other areas of skin with hair follicles. The good news here is that the condition is treatable with medication that helps to wake up dormant hair follicles and regrow hair.

A more serious form of AA is alopecia universalis (AU) where you lose all the hair on your body, including eyebrows, arm hair, genital hair, and anywhere else you should be graced with follicles. This hair loss can be gradual or come on rather suddenly (though it's unlikely you'll lose all hair overnight), though researchers still don't know a lot about it. They believe there is a genetic component to it, and it is often accompanied by other autoimmune diseases. While most cases of AU have only hair loss as a symptom, some cases of AU may come with burning or itching and can also be associated with other conditions like atopic dermatitis and thyroid disorders.

What is Probably Happening:
While all of these possible methods of hair loss might have you scrolling through WebMD in a hypochondriac terror, at the end of the day the answer is probably far more simple: "The most common cause of hair loss is due to breakage from the stuff that we do to hair to make it look the way we want," Evans says. So all that blow drying, man-bunning, French braiding, any styling technique that pulls on the hair, perms, heat styling, and other hair play can crack off your glossy strands and leave you with a pillow full of fluff.

However, Evans points out, There are so many other conditions of hair loss that "one shouldn't assume one has the most common cause." Other causes can include medication side effects, stressors, underlying medical conditions, thyroid disease, Lupus, and other autoimmune disorders, iron deficiency, and menopause.

She recommends you let a professional dermatologist assess that for you if you suspect your hair loss is not normal. In her own full-service dermatology practice she says that patients coming in for hair loss receive "one of the most comprehensive and lengthy consultations" of all other conditions because it's important to rule out any number of the numerous conditions that could be causing it. In a nutshell: Don't panic over that pile of hair, but don't ignore it, either.

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