This article was last updated on April 16, 2022
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It can sometimes feel like your hair is everywhere: in your shower drain, in your brush, on your sheets, on your clothes, on your partner’s clothes — but just because you’re seeing it shed doesn’t necessarily mean you’re experiencing hair loss. You’re supposed to lose about 100 strands every single day, no matter how you wash or style your hair, says Maryanne Senna, MD, a dermatologist and instructor at Harvard Medical School who specializes in hair loss. But when you notice your hair’s not growing back after it sheds, or if you’re losing clumps that seem outside the norm, it’s usually a sign of or reaction to something else (or in many cases, multiple things) happening in your body, she says.
“The majority of the hairs on your head are in the growth phase, and about 10% of your hair is in the resting phase,” Dr. Senna says. “That’s on purpose, because if hairs grew and shed at the same time, we would all go through temporary baldness.” Resting hairs “rest” for three to four months, then gradually shed over time, and this is the stuff you’ll see when you wash and brush.
In a lot of cases, dermatologists can trace your intense shedding back to “telogen effluvium,” a hair loss condition caused by a big change in your body, which can be anything from stress to starting a new medication. “After an ‘insult,’ your body sends a signal to put all the hairs in the growth phase prematurely in the resting phase,” Dr. Senna says. And then you lose it. Doctors know the patterns in which these inciting events lead to hair loss, but the exact reason why this happens is sort of a mystery, which is why it’s important to take a holistic approach to treatment, explains Arielle Nagler, MD, assistant professor of dermatology at NYU Langone Medical Center. In other words, it’ll be pretty tough for you to self-diagnose, so seeing a doctor and telling her everything that’s going on with you will be crucial.
It’s hard to miss these periods of shedding, and the trauma of seeing your hair fall or noticing your scalp widen can bring out a range of emotions, from helplessness to just plain confusion. “Find a dermatologist who, in their profile, specializes in hair loss,” Dr. Senna says. They see hair loss often enough that they know how to handle can pinpoint your symptoms in a very systematic way. And if you’re very concerned, it’s also ok to skip the derm and go straight to a trichologist — they’re less easy to find, but incredibly skilled and well-equipped to get to the root of the problem.
Here are the top reasons why you might be shedding.
Having a baby.
People who just had a baby usually experience periods of “aggressive shedding” about three to four months after giving birth, Dr. Senna says. Estrogen levels are usually higher during pregnancy (which is why your hair is thicker), and then they drop suddenly after you give birth, she says. It’s very common, and usually the person’s hair will grow back to its normal fullness by the time the baby turns one.
Changing birth control pills.
Starting, stopping or just changing types of birth control can cause your hair to fall out, because your body thinks there’s been an “incident,” and wants to move all your hair into the resting phase, Dr. Senna says. It also matters what’s in your birth control, Dr. Krejci-Manwaring says. Birth control pills with estrogen are typically good for your hair, but ones with progesterone only can contribute to hair loss.
Tight or damaging hairstyles.
“Any constant hairstyle that pulls the hair back so there’s pressure at the root — like ponytails or cornrows — can cause traction alopecia,” Dr. Senna says. This is more common with Black women, and more than half of African American women will cite hair loss or thinning hair as their number one concern, according to the American Academy of Dermatology. Wearing extensions or wigs that clip in or are glued to existing hair puts more stress on your strands. Other treatments like bleach, dye, relaxers, and perms can weaken your hair. Even tools like a flatiron or curler can reach extremely high temperatures that further fracture your hair.
Sudden weight loss or diet change.
When you lose a lot of weight rapidly, your body counts that as an inciting event, Dr. Senna says. Making a big diet change, like cutting out an entire food group, can also make your hair shed because your body isn’t getting the same nutrients that it did before. If you did make a big change, Dr. Senna says tracking your food for just three consistent days can be a helpful way to assess whether or not your new diet is balanced. “It’s usually easy to figure out where you can add a protein boost, like a scoop of beans or some more yogurt,” she says.
Emotional stress.
Day to day stress doesn’t usually cause hair loss, but when something significantly stressful happens (like the death of a loved one) it can definitely cause hair loss, says Paradi Mirmirani, MD, a dermatologist with Kaiser Permanente. “Stress that leads to loss of sleep or weight alteration could alter your cortisol to the point where it would also alter your normal hair cycle,” she says.
New medication.
Dr. Senna describes hair loss because of a new medication as a, “damned if you do, damned if you don’t” situation. Hair loss is a huge side effect for so many different types of prescription medications: anti-convulsants, blood pressure, selective serotonin reuptake inhibitors, and tons more — even OTC heartburn medications. These meds can cause chronic hair loss that’s really difficult to treat unless you find a medication that won’t cause hair loss — which is even harder in many cases.
So if the hair loss is really bugging you, you’ll need to work with your doctor to figure out whether you have other options — or if the benefits of the medication outweigh the hair loss.
Thyroid conditions.
Someone with a thyroid condition like hyperthyroidism or hypothyroidism can experience hair loss, Dr. Senna says. “There are hormone receptors at the hair follicles, so in women where there’s an androgen hormone environment, that can contribute to the hair loss,” she says. Unfortunately, some thyroid drugs can also contribute to hair loss.
Hereditary baldness.
Male and female pattern baldness is the most common type of hair loss and is genetic, Dr. Krejci-Manwaring says. “It’s a complete myth that it all comes from your mother’s side, so everyone can stop blaming their mother for their hair problems!” Hereditary baldness affects up to 80% of men and 50% of women, and is usually caused by many other factors.
Bottom line: Hair loss can be upsetting AF, but it’s not something you necessarily have to just deal with — get yourself to a doc and figure out what your options might be.
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