How do I tell if I'm losing my hair?
July 24, 2016 7:35 PM   Subscribe

Female, 33, white. The last 5-6 times I've washed my hair it seems like there's an unusually large amount of hair coming out when I wash it, and when I brush it while blow-drying it afterward. Details, possibly relevant info, below.

My hair (dirty blond, very straight) is such that I only typically need to wash it on weekends. I use shampoo, no conditioner, and blow it dry. The last 5 or so times I've washed it, there has definitely been more hair coming out while washing, while brushing it afterward, and while drying it. It also seems like I'm finding more hairs on me during the day (though now I'm super paranoid so this could just be confirmation bias). My main questions are how do I tell if I'm actually actively losing my hair, and what do I do about it? I have decent health insurance and my plan doesn't require me to have a referral to a specialist if I need to go see someone. (If so, what type of doctor?)

Possibly relevant information:
1) I've been growing my hair out for the last year and a half or so. I always used to wear it short (chin-length in front, cut high in the back) but I haven't cut it since January of 2015. It's now long enough that when I push it behind my shoulders, it will generally stay there. So it's possible that I'm just not used to seeing so much hair in my brush because I was accustomed to short hair for so long (it hasn't been this long in at least ten years) but it definitely feels like there was a sudden jump in the amount of hair in my brush.
2) I haven't changed my shampoo for the last couple years (Herbal Essences Honey I'm Strong). No conditioner, no hair gel or spray or any other product. The last two times I've washed my hair I've used Neutrogena T/Gel dandruff shampoo (which I usually use maybe once every other month) because it seems like my scalp flakiness has been extra bad recently.
3) Speaking of flakiness, I've been having an issue with seriously dry skin on and off over the last year +. I have been meaning to go to a dermatologist about it. I've had very mild scalp flakiness for as long as I can remember but it definitely is considerably worse lately, and it does seem to roughly coincide with when I started noticing extra hair coming out.
4) Because of my longer hair, I've started wearing it in a ponytail or a claw-style hair clip 2-3 days a week.
5) I do blowdry my hair when I wash it. Now that it's longer I think I need to learn how to properly blowdry long hair, I used to be able to just run the brush through it several times while aiming the hairdryer at it on high, and it took about five minutes. I think I probably need a diffuser, and to spend some time on youtube looking up "how to blowdry long hair". I've been blowdrying my hair for at least two years so this is not a new development.
6) I was going to say I haven't been under any unusual stress or anything lately but that's kind of not true. I recently had a terrible bout of Irritable Bowel Syndrome that caused me to be really depressed and miss a fair amount of work. I basically ate nothing but rice and cereal for a month and am only now slowly getting back into my normal patterns of eating. So maybe I'm missing some essential vitamin or something? (I've barely eaten a vegetable for six weeks, it's no good.)

After washing it tonight (only dried it a little this time, will mostly let it dry on its own), I suddenly went from "huh, that's weird" to "omfg I'm losing my hair what the hell do I do PANIC". I honestly haven't googled it because I'm one of those people who gets convinced I have cancer every time I look up something that might be wrong with me. Any thoughts, ideas, suggestions would be greatly appreciated. Thank you!
posted by skycrashesdown to Health & Fitness (15 answers total) 2 users marked this as a favorite
Longer hair always looks like it falls out more. Before you panic, start detangling your hair (just brush it out) before getting in the shower and start combing through your hair with a wide-tooth comb in the shower once you have the conditioner in. A lot of your supposed hair loss could be hair breakage. My supposed hair loss went down dramatically when I started combing in the shower (the pre-shower brush is to make sure your hair isn't too tangled when you go to comb it).

Also, you mentioned medical problems. Look up the side effects for any medication you're taking.
posted by If only I had a penguin... at 7:40 PM on July 24, 2016 [1 favorite]

One of the fastest ways to figure this out is choose an angle to photograph yourself from - you'll capture the most real estate if you face your bathroom mirror but then take a picture of the back of your head plus the front in the mirror - under the same set of circumstances (say, every Wednesday night when you get home from work, dry hair, more or less the same styling procedure) every week or two weeks for a couple of months.

I lose a lot of hair year round because I am basically Cousin Itt, but I lose an especially alarming amount in the hot months.
posted by Lyn Never at 7:49 PM on July 24, 2016

Can you avoid brushing or combing it when it's wet? Can you also avoid blow drying it? (Can you get it cut in a style that does not require blow drying it?) I have long hair and don't do either. I do use conditioner and run my fingers gently through it in the shower, but my hair is wavy.

Yes, longer hair is more noticeable on your brush or comb, but you may not actually be losing any more than normal.
posted by mareli at 7:49 PM on July 24, 2016 [1 favorite]

Unfortunately, hair loss is a condition where some dermatologists will know what they're talking about, and others won't. Long hair definitely makes a difference in how much hair you notice yourself losing, and stress, illness, and medication can all be factors, too. (As can being the kind of person who catastrophizes this sort of thing—I often hear "If you think you are, you are" as a rule of thumb for genetic hair loss, but suffice it to say that it varies depending on the kind of thinker you are.)

If you're worried about it and you'd like to know whether it's really happening or not, somebody who specializes in hair and hair loss is going to be your best bet. (Frequently they're hair transplant doctors.) What you want is somebody who, whether it's with a microscope or a HairCheck tool, actually counts the number of fully grown hairs on different parts of your head. There are lots of sketchy people in that industry, but plenty of good ones, too.

Whoever you find, make sure it's somebody who's willing to take this as seriously as you're taking it—no more or less.
posted by Polycarp at 7:54 PM on July 24, 2016 [1 favorite]

The average human loses 100 hairs a day more or less. If you are a person with long hair this seems like ALL THE HAIR much more than it would if your hair is short. More in summertime. More if you're stressed. Besides checking the side effects of the medication you're taking and giving yourself some time to get back on a balanced diet, I'd suggest a dermatologist for the flaky scalp (if it's sticking around longer than another week or so) and asking about the hair loss while you're there. This is a concern I get a lot when my anxiety is getting higher and usually the feeling goes away. Doesn't mean that one day it might not be actually happening, but it can be a fairly common negative feeling that some of the things you describe (stress, growing out hair, summer) can exacerbate.
posted by jessamyn at 8:04 PM on July 24, 2016 [3 favorites]

Okay, so, a few thoughts, none of them scary.

1. I have super long, very straight, dry hair. I don't blow dry my hair because I've always been told it can dry it out more. I also use a lot (like a good palmful?) of conditioner every time I wash my hair (every few days). Blow drying it plus summer plus not enough conditioner could mean you are just having breakage which is more obvious when it's longer than when it's shorter. A clip or hair tie could also mean more breakage than when it was shorter and you weren't ever tying it back. (Not to say you shouldn't tie it back - I do all the time - just that, comparatively, you might have more breakage.) I was also told that you really only need to shampoo/scrub the scalp area, not all the way down to the ends, and you really only need to condition the ends, not heavily in the scalp area. This makes sense to me - any oils you have are up on your scalp, and they don't necessarily all get down to the ends - so I try to shampoo/condition accordingly.

2. There's something called telogen effluvium that can happen when people go through a stressful period, such as pregnancy/childbirth, or a really stressful few months at work - or, perhaps in your case, stressful health issues. My understanding is that, essentially, while you are stressed, the hairs that would normally be slated to fall out just as part of the normal shedding/100 hairs per day that jessamyn mentioned don't fall out. They just keep hanging out on your head (part of why pregnant women often have awesome hair). Then, when the stress is over, all the hair that would have fallen out during that period of time falls out at once. Which is annoying and alarming at first, but doesn't signal permanent hair loss or anything like that. It just is annoying until the hair grows back and then all is fine. There's a "pull test" for telogen effluvium that a dermatologist or a GP can do to check.

3. Iron deficiency, with or without anemia, can cause hair loss. Again, it's not permanent, you generally just need to get your iron up again. If you were on a super limited diet for six weeks and having IBS stuff that might have included some mild GI bleeding, you might be anemic or iron deficient. When you go to your GP, you can ask for both a hemoglobin/hematocrit test (part of a CBC, tests if you're currently anemic) and a ferritin test (a special test, determines iron stores). I had fine hemoblogin/hematocrit levels but a super low ferritin. More iron has helped a lot of my symptoms (though hair loss wasn't one of them for me).

Good luck and try not to worry about it (I know, way easier said than done). There are lots of very non-scary reasons you might have more shedding than normal.
posted by bananacabana at 8:46 PM on July 24, 2016

Yeah it seemed insane how much less hair I've found on things when it was super short and now that it's mostly buzzed+ear length on top. Like. so. much. less. hair.

Long hair on things is crazy noticeable. Plus, how often are you brushing your hair during the week if you're not washing? Are you rising it? When I go a few days between actually doing anything to my hair a ton of it will come loose when I wash/brush it again. It's like the oils keep them in place even if they're not on my scalp anymore.

+1 on the 100 hairs per day thing. I've read (and heard from my doctor) that to check if you're actually losing hair they literally have you collect all the hairs you find each day and count them.

I mean, if you're concerned about things, then for sure see a doctor but lots of hair everywhere is part of why mine is short now.
posted by Crystalinne at 8:57 PM on July 24, 2016 [1 favorite]

I have gone from pixie cut to lower-back length hair many times now. Trust me when I say, your hair has just reached a point where it feels like it's falling out at massive quantities but really isn't doing so any more than it did before. It's just that there's more length to notice now.

I am going through yet another pixie-to-long transition right now and the last few months in the shower have been "omg look at this hyuuuuuge pile of hairs!!!" experiences every single time. Yet I still appear to have a full head of hair once dry.
posted by joan_holloway at 9:35 PM on July 24, 2016 [1 favorite]

Please try not to worry too much about this. There are many reasons hair sometimes sheds excessively, stress is a big one. It does not mean you are losing your hair permently. I loose a lot of hair after very stressful times have passed. I used to think I would go bald and it really freaked me out. I know how badly this can make a person feel, but please trust me, it is VERY unlikely this loss is permanent.
posted by WalkerWestridge at 10:20 PM on July 24, 2016

it depends on how thickly your hair covered your scalp in the first place, but when i experienced what was (first large amounts then HUGE amounts) of medical hair loss, the first thing that clued me in aside from the way heavier than usual brushing/washing hair loss was that when it rained, i felt the water on my scalp immediately. usually i could be out in the rain for literally hours before my entire head got wet but once my hair started coming out big time my scalp was cold and wet within minutes of any rain starting. also i went from needing 1h or more to blowdry it to 20min.

anyway some other things that can cause severe hair loss are vitamin deficiencies (mine was iron) and physical traumas (slowly bleeding to death for example), as well as stress. it's taken mine almost 2 years to grow back and there is still an obnoxious amount that is coming in every month so i have a constant stupid fuzzy dandelion look on top of my otherwise long straight hair. it's annoying as fuck but i know my hair will be back to normal eventually.
posted by poffin boffin at 6:18 AM on July 25, 2016

I thought this was an interesting article that might explain it:

Stress can cause hairs to stop growing and get into a rest period. "Because there’s a delay between when a hair stops growing and when it falls out, there’s likewise a delay between a stressful event (which can be physical, like surgery or trauma, or emotional, like a divorce or loss of a job) and when hair loss might occur.

In human head hair, this delay lasts three months, the combined length of the the catagen and telogen phases. It’s like clockwork. And indeed, those times when I was pulling my hair out in the shower, I was always able to trace it back three months to something atypically stressful, like a breakup or a death"
posted by Thisandthat at 6:31 AM on July 25, 2016 [3 favorites]

just echoing pretty much what Thisandthat said, my friend who is a hair stylist was telling me that a big trauma or stress can freak out your head and 3 months later your hair might start coming out in clumps. She said she experienced it after giving birth to her kid.

If you are really worried, a niacin supplement might do the trick.
posted by speakeasy at 7:37 AM on July 25, 2016

Oh man, I've been through these concerns several times and still have a full thick head of hair. It's normal to shed more hair at more times than others. I wouldn't worry unless it's visibly thinning or coming out in clumps. I went to the doctor about mine once and got a blood panel and reassurance, but I felt they were rolling their eyes pretty hard at me.
posted by noxperpetua at 7:53 AM on July 25, 2016

Ok, yes, everyone else is probably right that it's just the 3-4 month post-stress hair loss after your illness. Or summer-- people can be a bit like dogs and she's more in the summer (source: my doctor).

On the other hand, this has happened to me, and based in the responses you're getting about it just being long hair? No, life doesn't work like that. Your hair has gradually been getting longer for a year, and if you are noticing sudden changes, especially after a severe health event, it is probably real.

There are other things that are worth checking out, too.
- a panel of blood tests can eliminate the possibility of a nutritional deficiency. (That might be a real concern if your diet is significantly modified by your IBS.) This should be super easy for your doctor to test.
- while you're at it, you might as well ask for a thyroid blood test during the same panel. Hypothyroidism can cause hair loss.
- and also hormone levels. PCOS and hypothyroid issues are often comorbid, and this can be checked in the same panel

These are all things worth checking, but also fairly straightforward to treat, so don't panic, but DO give your doctor a call.

As a side note, this can also be a side effect of medications. If you're taking any meds, it might be worth looking up their side effects-- you mention IBS-related depression, and I know it's a side effect of several antidepressants. Worth reading up on, perhaps? (Fwiw, I found doctors less aware of fringe side effects, and I have had better luck reading up on them myself and asking specific questions about documented side effects rather than asking "could any of my meds cause this?")

Your doctor may also refer you to a dermatologist, and if it's still really bothering you, it's probably worth pursuing.
posted by instamatic at 8:35 AM on July 25, 2016

They have done studies, humans do have vaguely seasonal moulting usually in summer after the equinox leading into the shorter days of autumn. It's to do with the cycle of hairs growing, resting then falling out. If you are worried about thinning hair the places to monitor it are your part & side burn area. If your part appears to be getting wider that could be a sign of hair loss.
posted by wwax at 8:59 AM on July 25, 2016

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