Losing a tuft of hair every day? What hair loss reveals about your health

What a head of hair – or the opposite? If you suffer from premature hair loss or thinning hair, you definitely suffer – and women more so than men. After all, having beautiful and healthy hair means a lot in our society. It’s seen as a sign of vitality and strength. In ancient times, people even thought it’s where our soul lives.

An empirical study (link in German) has even found that people’s hair or hairstyle determines whether they like each other or not when they first meet. Remember the UK series Fleabag and the legendary sentence «Hair is everything!», which lead actress Phoebe hurls at her hairdresser Anthony after he gives her sister a bad haircut? Losing hair, that much is certain, shakes your self-esteem and reduces your quality of life.

But before delving deeper into the matter, let’s answer the most important question: how much hair loss per day is normal?

How much hair loss per day is normal?

Hair changes with age. That’s part of the natural ageing process. It gets thinner and less dense. The growth phases of the hair follicles shortens and hair growth decreases. In other words, losing hair is normal. But losing how much is normal?

According to research, people lose between 50 and 100 hairs a day. This is part of the natural hair cycle, which is divided into three phases: growth phase (anagen), transition phase (catagen) and resting phase (telogen). In the telogen phase, the hair finally detaches from the hair follicle and falls out to make room for new hair. If you lose more than 100 hairs per day (for children: 50 to 80) over the course of several weeks, it can be considered hair loss. Then what?

Hair loss: three common types, different causes

If you notice such high and regular hair loss over a long period of time, it’s best to consult a dermatologist. A so-called trichoscan digitally analyses the scalp, hair roots, hair density and hair condition. It’s also advisable to have a blood count done by your GP, as hair loss can be caused by a nutrient deficiency, such as iron deficiency. The three most common types of hair loss are androgenetic hair loss, diffuse hair loss and circular hair loss.

1. Androgenetic hair loss: thinning out

At 95 per cent, the most common is so-called androgenetic hair loss, i.e. hereditary hair loss (alopecia androgenetica). Due to a hereditary predisposition, the hair roots react hypersensitively to male sex hormones, so-called androgens, which women also have in small amounts. Specifically, dihydrotestosterone, a metabolic product of testosterone, gets in the way of the supply of nutrients to the hair roots. As a result, the hair follicles become smaller and only produce fewer and thinner hairs. This most often affects the hair on the middle parting.

In women, the symptoms usually only occur after menopause. That’s when the hair thins out – especially at the middle parting, but possibly also at the sides and back of the head. In rare cases, this process already begins at a younger age. According to research, hereditary hair loss affects 12 per cent of women around the age of 30, while between 30 and 40 per cent of women over 60 years of age are affected. However, women usually don’t go bald or have completely hairless areas.

Men, on the other hand, tend to experience hair loss in a different way: receding hairlines at the temples or thin hair at the top of the head can develop into a male pattern of hair loss over time, with the hair on the forehead and back of the head falling out and only a fringe of hair remaining. The first signs of hair thinning often appear in adolescence and continue with age. The earlier it starts, the more pronounced it becomes.

2. Diffuse hair loss: thinner and thinner hair

Also known as alopecia diffusa, diffuse hair loss can affect men and women of all ages. However, women are said to suffer from it more frequently. This type of hair loss occurs all over the head, with the hair becoming evenly thinner and the scalp often shining through. As the hair roots are damaged by various causes, the hair that grows back shows significantly slower and weaker growth. In rare and acute cases, this can lead to permanent bald patches and visible scarring.

There are many causes of diffuse hair loss and these need be diagnosed by a doctor. Possible causes include: stress, hormonal changes in women after pregnancy (tufts of hair are often lost during breastfeeding), thyroid disorders, nutrient deficiencies such as iron deficiency, chemotherapy, medication such as painkillers, antibiotics or blood thinners. Physical and chemical irritants such as dyes, perms, blow-drying too hot and braided hairstyles can also damage the hair.

3. Circular hair loss: bald, round patches

Circular hair loss (alopecia areata) affects one to two per cent of the population – women and men alike. It’s classified as a multifactorial disease which means genetic and environmental factors play a role. It’s still unclear, however, how the interaction works. «Current research gives strong indications of an autoimmune genesis,» writes the Institute of Human Genetics at the University Hospital Bonn.

Symptoms include the sudden appearance of bald, round patches on the scalp. In rare cases, hair loss can also occur on the eyebrows, eyelashes, in the beard area or on other hairy parts of the body.

With circular hair loss, the immune reaction is directed against the deep part of the hair root, which is destroyed. As a result, the hair falls out and can’t grow again. However, no scarring occurs and the subepidermal stem cells aren’t destroyed. «This means that the scalp’s potential to form hair isn’t lost, even if the disease is advanced or long-lasting. This means successful treatment is possible even after the disease has been present for a long time,» as described by this article (in German) in the specialist journal «Hautnah» . Circular hair loss is usually treated with cortisone. Since 2022, however, initial treatment success has been recorded with baricitinib, a so-called JAK inhibitor otherwise used for rheumatic diseases.

How is androgenetic alopecia treated?

Dermatologists usually prescribe medical treatments such as minoxidil or finasteride, with minoxidil being the mainstay treatment option today, as shown by many long-term studies and observations. This product is intended for long-term treatment and is applied to the affected areas over a period of several months. However, it leads to a considerable rebound effect as soon as it’s discontinued. In other words, patients have to use it for the rest of their life.

Finasteride, on the other hand, is only prescribed for men and after a precise analysis of the situation, as there are currently debates about side effects, which can range from considerable restrictions in sex life to severe depression.

Minoxidil is also sold in Switzerland under the names Alopexy, Neocapil and Regaine. This hair growth product can be purchased without a prescription but isn’t covered by health insurance.

According to current studies (article in German), microneedling, in which the scalp and hair roots are injured and stimulated to repair themselves through targeted tiny pinpricks, can further improve the results of minoxidil.

How to prevent hair loss

Healthy diet: A balanced diet with sufficient protein, iron, omega-3 fatty acids and vitamins is crucial for healthy hair. It can help to consult professionals to make sure you’re getting the right nutrients. For example, an iron deficiency is often the reason for hair changes in young or pregnant women. The remedy? A blood test and, if necessary, iron replacement therapy. Food supplements such as vitamin C, biotin, zinc or folic acid are also an option. In addition, there’s evidence (article in German) that vitamin D has a positive effect on hair.

**Stress management: **As mentioned above, stress can lead to diffuse hair loss. Relaxation techniques such as yoga, meditation and regular exercise can help reduce hair loss. However, stress-related hair loss can also be blocked by minoxidil.

Hair care: Washing your hair daily is generally not a problem. However, it’s important to use mild shampoos and conditioners to avoid over-stressing your hair. Avoid dyeing, styling and using excessive heat, for example when drying or straightening your hair. In addition, make sure not to tie your hair together too tightly and to avoid combing or brushing it forcefully.

Hair loss can be a distressing problem. The good news? If it’s diagnosed and treated in time, most people can restore or at least improve their hair health. Therefore, it’s worth looking after your hair and seeking professional help if you experience long-lasting hair loss. Many factors can lead to hair loss, which is why you should consult a specialist.