If you’re noticing more hair shedding or thinner hair than usual, the first step to finding the right treatment or management technique is understanding why your hair might be falling out. Below we look at the most common factors which may be causing hair thinning and how to recognise them.
Male pattern baldness, or androgenetic alopecia as it is otherwise known, is a genetic condition which is the most common cause of hair loss in both men and women. Some men will notice hair loss earlier than others because of an inherited sensitivity to the male hormone dihydrotestosterone (DHT), which binds to hair follicles and causes them to shrink. The process is called ‘miniaturisation’, and it basically shortens the anagen (growth) phase of the hair so with each cycle, the hair grows shorter and thinner until it eventually will stop growing at all.
Male pattern baldness earned its name because it follows a predictable pattern which makes it fairly easy to recognise and distinguish from other types of hair loss. In men, thinning usually begins at the hairline/temples and crown. The hair follicles at the back and sides of the head are usually resistant to the effects of DHT, which is why they are used as ‘grafts’ in hair transplants.
Even though it’s genetic, it doesn’t mean it can’t be treated. Two medications, Finasteride and Minoxidil Spray, are approved by the MHRA as clinically proven treatments for this type of hair loss. They’re not the only options, but they are the most well-established.
A stressful event can cause a rapid type of hair loss called telogen effluvium. The trigger can be sudden weight loss, illness, surgery, childbirth, to name a few. It usually causes increased hair shedding from all over the scalp (called diffuse shedding), because the stressful event causes hair follicles to suddenly shift into the telogen (resting) phase rather than staying where they should be, which is in the anagen (growth) phase.
With the rising popularity of weight management drugs like Ozempic and Mounjaro, users have reported hair loss as a side effect. Evidence suggests that this is not a direct side effect of the medications themselves, but rapid weight loss can trigger telogen effluvium. There was also a rise in hair loss during the Covid-19 pandemic. A recent study found that a one-off, extreme stress event can trigger the nervous system, causing stem cells in the hair follicles to die and triggering an autoimmune response. This research helps explain why, anecdotally, many people report hair loss following a stressful life-event never fully recovering.
In the case of telogen effluvium, hair tends to grow back once the trigger which caused it is resolved.
Besides one-off stressful events, chronic stress has also been linked to increased risk of hair loss, such as everyday job stress. One study linked chronic stress to hair follicles remaining in the resting phase for longer, which could contribute to hair loss.
Lots of nutrients are absolutely essential for healthy hair growth and strength, so deficiencies can cause your hair to fall out. Some of the most important are iron, zinc, vitamin D, vitamin B, and protein.
If you think you might be missing some of these key minerals and vitamins, we recommend speaking to your doctor and arranging a blood test, which can identify what you might be lacking. Once a nutritional deficiency has been identified, your doctor might recommend dietary changes or supplements.
There are a few different kinds of alopecia, as it actually just means hair loss.
One type is alopecia areata, which is an autoimmune condition, not fully understood by doctors just yet. It usually causes round or oval patches of hair loss on the scalp but can also affect other parts of the body that grow hair, like the face or body. It’s not quite as predictable as other types of alopecia like androgenetic alopecia, as it can affect individuals differently, and may resolve or recur periodically. We know that it’s caused by the immune system attacking healthy hair follicles, but we don’t know why this reaction happens. It can happen to both men and women at any age, but in about half of all cases, it starts during childhood and typically accompanies another type of autoimmune condition, like thyroid disease.
Some health conditions like thyroid issues can cause hair loss. Certain medications may also cause hair loss, like drugs for blood pressure, arthritis or antidepressants (to name only a few). Another type of alopecia which is well-documented is hair loss caused by chemotherapy (drugs which treat cancer). Chemotherapy drugs are designed to attack rapidly dividing cells (like cancer cells), but hair follicle cells are also some of the most rapidly growing in the body, so the drugs can also attach these cells too. For most people who experience hair loss from chemotherapy, the hair tends to grow back once they stop the treatment. To help manage the condition, a lot of chemo patients wear a cool cap which reduces blood flow to the scalp, helping stop the chemotherapy drugs from affecting the hair follicles.
If you’re experiencing persistent thinning or patchy hair loss, seek medical advice early. Most types of hair loss, whatever the underlying cause, respond best to early intervention.
All of our blog articles are reviewed for medical accuracy by our Medical Director before publication.
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