Hair shedding, also called "hair fall" or "effluvium" in medical circles, can be troublesome. More hair in your brush, in your shower drain, in your sink, on your pillow, etc. is NOT something that most people look forward to noticing... especially if you're seeing less hair on your head! Decreasing coverage in men or shrinking ponytail volume in women are top complaints of those experiencing hair loss. But, what are the causes of shedding? Is shedding temporary? Normal, natural? How much shedding is "too much?"
Some hair loss patients that we see at Bauman Medical Group often complain of seeing hair literally falling out of their scalp. Many patients will actually bring in hair that they have collected over time and others will physically show us that hair is literally falling out of their head when they comb through it. If you are a 'hair collector' we can discuss whether that's a good idea or not! Patients often also complain of hair shedding when they start a new hair regrowth regimen.
Some patient complain that excessive shedding occurs at regular intervals or specific times of the year. To know whether a shedding phase is significant or not sometimes requires a little bit of investigation on the part of Hair Restoration Physician. Sometimes the amount of noticeable hair shedding is a function of the color, quality, curl and length of the hair. Other factors may include the frequency of shampooing, styling or other haircare habits.
The normal and natural Hair Growth Cycles that each follicle goes through gives us some insight. Every normal follicle on your body will spend a certain amount of time producing hair (Growth or Anagen Phase) and some time 'resting' (Catagen/Telogen Phases), eventually switching back into a growth phase. Unlike other parts of your body--think: fingernails--which will grow cotinually and uninterrupted, hair production in the follicles has a specific "on" and "off" routine. The length of time that healthy follicles would normally spend in a growth phase is determined genetically--some people can grow long hair to their hips and others to only their shoulders.
Somewhere between the time when the hair follicle switches off and then begins to produce hair once again, the resting hairshaft is shed. In the animal kingdom, there may be a synchronized shed of hair (like in the Springtime, for example) to ready the animal for the summer months by shedding the protective 'winter coat.' In humans, hair cycling is considered to be mostly randomized and actually not that well understood. However, we do know that hair follicles can 'cycle off' due to a variety of reasons, including but not limited to hereditary hair loss, certain medications, crash diets, stress, illness, high fever, etc.
Of the approximately 100,000 hair follicles on a normal scalp, it is estimated that on any given day 10% (approximately 10,000) are in a resting phase and not producing hair. Each day, some of the resting follicles are 'switching on' and others are 'switching off' theoretically each producing a shed of a single hair. According to medical textbooks, 100-200 hairs shed per day is considered "within normal limits." In patients without a hair loss problem, the numbers of hairs shed are theoretically replaced by the new growth. But the problem is that for some patients with some types of hair loss, the shed hairs may not replaced by good quality hairs or by any hair at all!
There are many factors that could determine whether 100-200 hairs shed is a problem or not for different patients. Progressive hereditary hair loss (male pattern or female pattern baldness) is characterized by a shortening of growth cycles as well as a miniaturization of the hair follicles in the affected area. This means that in these patients, hair follicles in the hairline and crown/vertex area in men and the frontal, temporal or top area in women, will continue to will produce thinner, shorter and wispier hair over time. These patients may or may not complain of shedding.
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"Hair Complaints..." to be continued!
If you are seeing excessive hair shedding as well as a decrease in coverage of your scalp or a recession of the hairline or decrease in hair volume, this could be a sign of a medically-treatable hair loss condition. For more information, contact Dr. Alan Bauman at doctorb@baumanmedical.com or visit http://www.baumanmedical.com
