“I’m Losing a Lot of Hair in the Shower, but I Don’t Have Any Bald Patches – Should I Be Worried?”
Reader question:
Over the past couple of months I've noticed a lot more hair coming out when I shower. It's in my hands when I shampoo and there seems to be loads of it around the plughole afterwards. I don't have any bald patches and my hairline looks the same, but I'm worried I'm starting to lose my hair. Is this normal or should I be concerned?
Hair Loss Review Centre answers:
Finding a clump of hair in the shower can be alarming, but increased shedding doesn't necessarily mean you're going bald.
We naturally shed hair every day as individual hairs reach the end of their growth cycle. Washing your hair can simply make that shedding much more noticeable, particularly if you don't wash it every day.
However, if you're genuinely shedding considerably more hair than usual and it's been happening consistently for several weeks, it's worth paying attention to.
Why am I suddenly shedding more hair?
One possibility is telogen effluvium, a common form of temporary hair shedding.
Telogen effluvium occurs when a greater-than-usual number of hairs move into the resting and shedding phase of the hair cycle at around the same time.
The interesting part is that the trigger may have happened several months before you notice the shedding.
Potential triggers include:
Significant emotional or physical stress
Illness or a high fever
Surgery
Rapid weight loss or restrictive dieting
Iron or other nutritional deficiencies
Hormonal changes
Pregnancy and childbirth
Certain medications
Sometimes there isn't an immediately obvious cause.
But I don't have any bald patches
That's actually an important distinction.
Telogen effluvium generally causes diffuse shedding across the scalp rather than creating clearly defined bald patches. You might notice your ponytail becoming thinner, less overall volume or more scalp showing through your hair, even though there isn't one obviously bald area.
Male and female pattern hair loss can also develop gradually without producing distinct bald patches, so the absence of patches doesn't completely rule out other forms of hair loss.
How can I tell if I'm shedding too much?
Don't become obsessed with counting individual hairs.
The amount of hair someone normally sheds varies considerably, and counting hairs in the shower can quickly become stressful without telling you very much.
Instead, look for a change from what's normal for you.
If you've always found some hair in the shower, that's very different from suddenly noticing two or three times as much hair every time you wash it.
Photographs can also help. Take pictures of your hairline, parting and crown under the same lighting every few weeks. This gives you a much more objective way of seeing whether your overall density is actually changing.
When should I see my GP?
If the increased shedding continues, becomes severe or you're visibly losing density, it's sensible to speak to your GP or a dermatologist.
It's particularly worth seeking advice if the hair loss is accompanied by symptoms such as scalp redness or pain, unexplained tiredness, significant weight changes, changes to your menstrual cycle or other changes in your general health.
Depending on your circumstances, your doctor may consider whether blood tests for things such as iron levels or thyroid function are appropriate.
Can I do anything to support my hair?
Start with the basics.
Make sure you're eating an adequate and varied diet, getting enough protein and avoiding extreme calorie restriction. Treat your hair gently and avoid excessive heat, bleaching or hairstyles that repeatedly pull tightly on the roots.
A good nutritional hair supplement may also help support normal healthy hair growth where appropriate, but supplements shouldn't be used as a substitute for investigating unexplained or persistent shedding.
The bottom line
More hair in the shower doesn't automatically mean you're going bald.
If there's been a genuine and sustained increase in shedding, however, don't ignore it. Think back over the previous few months for possible triggers such as illness, stress, dieting or hormonal changes.
In many cases, excessive shedding can be temporary. But if it persists or you're beginning to notice a reduction in your overall hair density, getting the cause properly assessed is the best next step.
This article is for general information only and isn't intended to diagnose a medical condition. If you're experiencing sudden, severe or persistent hair loss, seek advice from an appropriately qualified healthcare professional.
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