Many people—and women especially—take great pride in their hair. It makes sense, as your crowning glory is just as front and center, just as visible to the rest of the world, as your face.
Losing some hair every day is completely natural. It’s a sign your body’s growing new, healthy ones to replace the old. In fact, losing up to 100 hairs per day is normal. You can also kind of get an idea of what’s normal for you by just paying attention to what you typically see in your brush or shower drain. “If all of a sudden you’re noticing a lot more, or your ponytail is thinner or you’re seeing more scalp,” then you may be losing more hair than you should, Francesca Fusco, M.D., dermatologist at Wexler Dermatology in NYC and assistant clinical professor of dermatology at Mount Sinai, tells SELF.
There are many different types of hair loss. Some, like genetic andogenetic alopecia (female pattern hair loss) are irreversible and out of your control—you get the hand you’re dealt. But others, like the very common telogen effluvium, which is temporarily increased shedding caused by a wide variety of health and hormonal changes, can be fixed. With telogen effluvium hair loss, you need to think back to four or so months before to determine the culprit, Bethanee Schlosser, M.D., assistant professor of dermatology and director of the Women’s Skin Health Program for Northwestern Medicine, tells SELF. “Shedding peaks about four months after the incident” that caused it, she explains. Other types of hair loss may happen progressively over some time and depending on whether they damage the hair follicle, can be either permanent or fleeting.
If you’ve noticed your hair is falling out more than usual, looks thinner, or seems to be growing more slowly, here are some of the most likely things that could be causing it.
During pregnancy, most women notice their hair going into rapid growth mode. “That’s when everything is in a grow, grow, grow phase, because there’s surges of hormones [estrogen] that make hair grow,” Fusco says. Since the hair growth stage lasts longer, normal shedding doesn’t occur. Once estrogen levels go back to normal after delivery, hair resumes its normal growth cycles and starts to shed all that thick, luscious hair that accumulated over the last 10 months. Some women experience very mild shedding, but others experience intense shedding for a few months.
2. Changes in birth control
Going off the Pill or changing to a different type of hormonal contraception can also cause hormone-induced shedding. “Whether you’re just starting it, discontinuing it, or changing brands, your body can react by causing the hair to go into an increased shedding mode,” says Fusco.
3. Protein deficiency
Eating protein is essential for our bodies to make new hair cells. If you’re not eating enough, your body won’t have enough new hairs to replace the old ones when they shed.
4. Certain medications
“Medications can cause chronic shedding,” Schlosser says. The most notorious for doing so are blood pressure medications, but some antidepressants and HIV medications may do it as well. Always talk with your prescribing doctor if you notice you’re losing hair a few months after starting new meds.
5. Dandruff or scalp psoriasis
When the skin on the scalp is inflamed and itchy, and you frequently scratch the hell out of it, your hair may start to shed more than usual. Dandruff is the most easily treated cause of hair loss, Fusco says, because you can treat it with a zinc pyrithione shampoo (she recommends Clear Complete Scalp Care Anti-Dandruff System). “Consistency is the trick,” so it’s important to find a shampoo and conditioner you like, she says. Similarly, seeing a dermatologist to treat your psoriasis and restore your scalp’s health will get your hair growing back normally.
6. Going through intense emotional or physical stress
When you’re experiencing something stressful or traumatic—not your average day-to-day stress, but something big and life-altering like a divorce, a death in the family, a significant job change, or a big move—you may experience a temporary halt in hair growth as your body puts its resources toward getting you through said big event. “Hairs don’t all grow at the same rate,” Schlosser explains. “Some are growing some are resting and some are actively being shed. When you have these conditions, your body halts hair growth, and then things get restarted and all these hairs that have been halted start to get pushed out at the same time.” The same thing can happen with physical stress and trauma, like having a big operation, being hospitalized, or even losing a significant amount of weight very quickly.
7. Autoimmune diseases
“An autoimmune condition makes the body recognize its own hair follicles as foreign and it attacks them and makes the hair fall out,” Fusco explains. This could be alopecia areata—an autoimmune hair loss condition— or something like lupus, rheumatoid arthritis, thyroid disease, and certain types of anemia (like sickle-cell anemia, not the more common iron-deficiency anemia). Schlosser notes that lupus can cause some scarring of the hair follicle, resulting in permanent hair loss.
8. Wearing too-tight hairstyles too often
This can cause traction alopecia, Schlosser says. “Classically, this happens when people wear tight braids chronically, but i’ve seen it with tight ponytails, too,” she explains. It can cause progressive thinning of the hairline, and if you do it for long enough, the hair loss may actually become permanent. It’s considered a scarring process, which can damage the hair follicle beyond repair. Schlosser advises never wearing one hairstyle for too long, and trying not to pull too tightly if you can help it.
9. Heat-styling your hair on the reg
Fusco says that women will come to her explaining they have hair loss, when really they have something called trichorrhexis nodosa. This is a condition where damaged, weak points in the hair shaft cause hair to break off easily. The cause? Thermal damage to the hair from things like using hot tools and over-bleaching. “Hair loss is not necessarily from the root but it’s from somewhere along the shaft,” she explains.
10. Over-processing your hair
Getting frequent perms, chemical straightening or relaxing procedures—basically anything that uses harsh chemicals on your scalp and hair—can damage the hair follicle and cause permanent hair loss. “After repeated insults, the hair follicles just won’t grow back,” Schlosser says. This can cause hair to appear thinner, and may be especially noticeable on the scalp.
Remember, many hair loss conditions are treatable.
Most cases of increased shedding will gradually resolve on their own without treatment, Schlosser says. But if your hair doesn’t return to its normal fullness after six to nine months, see a doctor for an evaluation to find out if something else is going on. “If you ever have any symptoms like itching, pain, burning, flaking, redness, or notice you can’t see as many hair follicles anymore, you should seek help sooner.” See your primary care provider or go directly to a dermatologist who specializes in treating hair loss. They can determine what type it is and what the right treatment approach is for you.