How much hair loss when brushing or washing is normal?

WE’VE all been there – collecting a ball of hair from the plughole or hairbrush wondering “is this normal?”

The first concerning thought is hair loss, which affects more around half of men and women in their older years.

There are dozens of causes of hair loss in both young and old people, coming on suddenly or gradhually.

It can be emotionally difficult to deal with.

But for the general person, clumps of hair when washing, styling, or brushing, is totally normal, experts say.

How much falls out is linked with how thick, knotty, dirty, curly/straight or coarse/fine the hair is.

Dr Fiona Worsnop, consultant dermatologist at Stratum Dermatology Clinics, Oxfordshire, said: “One of the commonest myths I encounter around hair loss is the perception that washing the hair less often, or brushing the hair less often, will cause less hair loss.  

“The truth is that the hairs which fall out during gentle washing or brushing were lost anyway.  

“It is completely normal to lose up to around 100 hairs a day; hairs in the resting phase fall out when a new hair growing beneath pushes the hair from the follicle. 

“Whilst this shedding process happens throughout the day, if hairs have not fallen, then the number of hairs lost when showering can appear dramatic.  

“This effect can become magnified if the hair is left unwashed for longer, which often causes a vicious cycle.”

When to see a doctor

Consultant Dr Adam Friedmann said there are a number of indicators of hair loss other than your usual handful.

This includes patches of hair loss, itchiness or redness on the scalp and hair loss on other parts of the body, such as the eyebrows.

You may also notice “dramatically” more hair gathering in the shower, on the brush or on your pillow.

Dr Friedmann said: “The general trigger for someone to see a dermatologist will be when their condition is starting to interfere with their quality of life.  

“The psychological and social impact of hair loss in adulthood can be profound. 

“The degree of psychological stress caused by alopecia is usually related to the extent of alopecia and the ease (or lack thereof) with which the condition can be covered or hidden.

“The most important part of treatment is to make the correct diagnosis and there is nobody more qualified than a consultant dermatologist. 

“So, forget the wonder creams and supposed miracle shampoos, visit a dermatologist to discover the actual cause of your hair loss and whether it’s treatable.”

Causes of hair loss 

There are various forms of hair loss, some of which are explained below.

Anagen effluvium hair loss

This type of hair loss is caused by medications that poison a growing hair follicle. 

It includes substances that are toxic to the hair, including chemotherapy. 

The hair is damaged in its growing phase, making the loss of hair rapid. Sometimes it is permanent.

Telogen effluvium hair loss

This type of hair loss is usually caused by physical or emotional stress or shock to the body.

It includes surgery, illness (including Covid), mental illness, thyroid problems or hormonal changes such as due to pregnancy or menopause. 

Drastic weight loss or extreme stress can also cause telogen effluvium hair loss. 

People often do not connect the dots between their thinning hair and what’s going on in their life. 

Medications – such as for gout or high blood pressure – can also trigger this hair loss.

Alopecia and pattern hair loss

There are many forms of alopecia – a condition which is considered fairly common.

Androgenetic alopecia is often referred to as 'Male Pattern Hair Loss' or 'Female Pattern Hair Loss'.

It is the most common type of hair loss, affecting approximately 50 per cent of men (over the age of 50) and women (over the age of 65). But young people are also affected. 

The condition is caused by both genetic and hormonal factors, and tends to be seen through families. 

The hair follicles are permanently damaged, which means the hair will not grow back.

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