When Hair Thinning Is a Cause for Concern

by Meg Hemphill

I remember choking back tears at the hair salon a few years back, as the young intern combed fistful-size clumps of wet hair away from my scalp and remarked in her flat, unconcerned 18-year-old voice: “This is a lot of hair.” That was an understatement. I was four months postpartum and had an overactive thyroid — two potent contributors to hair loss. An astute hairdresser might have noted that it was an unusually large amount, something I might want to see a doctor about.

When is hair thinning a cause for alarm?

For starters, most healthy adults lose around 100 strands per day as part of the hair’s growth cycle. But most of us aren’t going to collect our strands (if we even could) and do a daily tally. So what does above-average shedding look like? “If one notices hair on the pillow or clumps of hair in the brush or comb, then that may be a sign of thinning or hair loss,” says Azza Halim, MD, a board-certified anesthesiologist and physician. Putting a hair-catcher in your shower can also help you evaluate how much you’re shedding. Hair loss can be gradual, including a slowly receding hairline, a widening part or a ponytail that gets thinner and thinner. Or it might be more sudden, with patches of hair falling out.

What about where it falls out of the scalp? Yes, that can determine what you might be dealing with. For example, if it’s even along the hairline or at the temples, that might be pattern baldness; if it’s round patches, that could be the autoimmune disease alopecia areata; whereas a circular loss of hair could signify ringworm; scaly patches may mean scalp psoriasis.

And then you need to take into account other symptoms you may be experiencing: Burning, stinging or intense itching? Swelling and sores? Weight loss? Increased heart rate? Once you note all the other things that don’t seem right with you, head to a health professional (a primary care physician or a dermatologist are good places to start). Tell him or her about the hair loss concerns as well as any other symptoms you’re experiencing, which will help guide them to what might be causing the hair loss. Don’t DIY. “Hair loss must be diagnosed to determine the cause, then treat it accordingly, as some types are reversible and others are not,” says Dr. Halim.

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