why is my hair shedding?
Hair shedding is a completely natural part of the human hair growth cycle. Most people lose between 50 to 100 hairs per day without realising it. While hair shedding is normal, excessive hair loss can sometimes be a sign of an underlying issue. To understand why people shed hair, it's important to explore the hair growth cycle and what the hair strand looks like when it sheds.
Hair shedding with a white bulb
Have you ever noticed that small white bulb at end of hair? This white bulb at end of hair is called a club hair. When you lose a club hair, it just means that you have lost a piece of hair that is in the telogen phase of the hair growth cycle. The white bulb at the end of your hair is essentially a bundle of protein, known as keratin. The role of the white bulb is to help the hair follicle root to the scalp, which then allows the hair to grow until it is shed.
Losing a few strands of hair with a white bulb everyday is the natural process of the hair cycle. Losing a handful of hair with a white bulb may indicate early signs of telogen effluvium, an underlying medical condition, stress or hormonal changes.
Hair shedding without a white bulb (this means the hair has not completed its natural growth cycle) may indicate other causes of hair loss such as a nutritional deficiency or another underlying medical condition. Hair breakage indicates weak, brittle hair which may also be a nutrient deficiency or heat styling.
Understanding the hair growth cycle
Anagen phase: The anagen phase is the growth phase and can last two to six years. About 85-90 percent of your hair is in this phase at any given time.
Catagen phase: During this transitional phase, the hair slowly stops growing. The follicle detaches from its nutrient supply — the dermal papilla — and starts moving towards the scalp surface. At the same time, keratin-filled cells clump around the root, forming a club hair, which is a hair with a white bulb at the end.
Telogen phase: The telogen phase (also known as the resting phase). Around five to 15 percent of all scalp hairs are in the telogen stage at any given time. During this phase, the small white bulb at the base of the hair helps hold the hair in place within the follicle until it is shed. For scalp hair, this phase lasts two to three months.
Exogen phase: The exogen phase is when the hair actually sheds from the follicle, often with the white bulb still attached.
Telogen Effluvium
If you’re shedding an increasing number of hairs with white bulbs at the end, and it feels like sudden hair loss, you may be experiencing telogen effluvium. This condition occurs when more hair than usual enters the telogen phase of the hair cycle, leading to increased shedding over time. Minoxidil, a common hair loss medication, also pushes more hair into the telogen phase when you first start the treatment. However, minoxidil alters the anagen phase allowing more of your hair to grow.
Telogen effluvium occurs following an emotionally stressful event or giving birth. You’ll notice the excess hair shedding beginning two to three months after the triggering event, and it typically lasts up to about six months. In contrast, androgenic alopecia or menopausal hair loss can last indefinitely if left untreated.
Symptoms of telogen effluvium
Sudden onset of increased hair shedding: normal hair shedding is typically 50-100 hairs per day, individuals with telogen effluvium may experience two to three times that amount or more.
Increase number of club hairs: If you have telogen effluvium, many of the shed hairs will have a small white bulb at the root (club hairs).
Diffuse hair thinning: Telogen effluvium causes hair to thin evenly across the scalp. You might notice a reduction in hair volume.
Treatment for telogen effluvium
Thankfully, telogen effluvium is usually temporary and tends to resolve on its own within six months. However, if the underlying cause is unclear or the shedding persists, it’s a good idea to consult a healthcare provider.
Consider the underlying cause: Excessive large amounts of hair falling out with a white bulb can signal telogen effluvium and will resolve once the stress is removed.
Nutrition: Protein and iron deficiency can also cause more hair to shed with and without bulb.
Get treatment: If telogen effluvium takes more than six months resolve, seek professional help.
Is topical minoxidil appropriate for telogen effluvium?
Minoxidil would only be considered appropriate if telogen effluvium was mixed with androgenic alopecia. Minoxidil pushes most of the hairs into the telogen phase when you begin minoxidil treatment. This initial shedding phase can last up to six months.
Telogen effluvium takes up to six months to resolve so it doesn't justify the use of topical minoxidil for the treatment of telogen effluvium. Topical minoxidil is an effective hair loss treatment, but in some cases, topical minoxidil does not work for everyone.
If you had mixed telogen effluvium with androgenic alopecia however, then topical minoxidil would be an appropriate treatment to consider. Speak to our pharmacist for a free hair loss assessment.
