Scalp full of hairs with plenty of volume, movement, length and shine is what everyone considers healthy. SO when we have a large amount of hairs falling and noticed in the sink / drain, fallen hairs here, there everywhere creates panic and can also be a sign of some internal health issue. When we wash our hair regularly, the hairs which are loose or detached from their roots/ follicles in the scalp will shed and collect in the drain, for many it might look a lot, but you are probably seeing normal hair shedding.

With 100000-150000 hair follicles in the scalp, to lose 50-100 hairs per day is pretty natural and normal hair shedding. Generally the same amount of hair starts growing again from the resting follicles and maintains the balance in a normal healthy situation.

If you are experiencing sudden change in your hair fall and it has increased to alarming levels, large clumps of hair falling out, poor hair growth and scalp density getting down, bald spots become visible then that might be something to be concerned about and visit your dermatologist doctor. To know why you are losing excess hairs, first you need to know how hair grows and why it falls and reasons for hair loss triggers.

Normal Hair Growth

Nearly our whole body surface area is covered with hairs except only a few areas like palms, soles, lips and private parts of the mucosal surface. We have approx 50 lakhs plus hair follicles all over our body, out of which majority are colorless, tiny vellus hairs, while pigmented long and thick hairs known as terminal hairs are located on scalp, eyebrow and eyelashes only in childhood. During puberty under the influence of hormones, certain body hairs also become thick and dark giving us secondary sex characteristics of male and females.

The hair is classified into three according to ethnicity (Asian, African and European). However, in a recent research study, this classification is now divided into eight main subgroups by considering three parameters: diameter of hair curve, curl index and number of waves in particular length.

Medical term for Hair root is follicle. Each follicle grows as one, two or three hairs, or, more rarely, in groups of four or five hairs. Each follicular unit is equipped with its own oil glands, muscles, blood and nerve supplies. Each follicle has an average lifespan of three to seven years and grows approximately a half inch per month.

The follicle is the essential growth structure of the hair and it has two distinct parts: 

  • The upper part consists of infundibulum and isthmus whereas the lower part consists of the hair bulb and suprabulbar region. 
  • The upper follicle remains constant, while the lower part has continuous cycles of regeneration

Hair growth cycle is composed of 4 distinct phase:

  • ANAGEN (the average growing phase – 3-5 years), CATAGEN (period of regression,2-3 weeks), TELOGEN (RESTING period,3-4 months) 
  • EXOGEN (SHEDDING PHASE).  Each phase has its own timeline, which can be affected by age, nutrition, and overall health
  • The Telogen phase remains for 3 months. When the telogen phase is over, the hair falls out and a new anagen growth phase begins with the hair growing back.

Under normal circumstances, 90 percent of our follicles are in the active anagen growth phase, while the remaining 10 percent are going through the catagen and telogen phases.


What is hair loss?

What is alopecia or hair loss?

Alopecia refers to any form of hair loss, hair thinning, or balding anywhere in the body. There are a variety of causes which can lead to hair loss, though the most common and natural one is aging.

Hair loss often goes untreated, since it is not considered as a disease, besides regular hair fall is also a natural phenomenon. However, this can lead to unfortunate consequences, if the hair fall is more than normal.

On an average, one can lose between 80 – 100 hairs a day, of the 100,000 to 150,000 hairs on an adult head. There is a cause for concern if the hair loss is double than that.

Acute hair loss, or a sudden increase in hair loss, could occur due to many reasons such as stress, pregnancy in women, male pattern baldness, female pattern baldness, exposure to strong sunlight, anemia, hypothyroidism, vitamin B deficiency, autoimmune disorder, chemotherapy, etc.

You should look for:

  • loss of clumps of hair from your scalp
  • excessive thinning of your hair
  • unexplained loss of hair from any part of the body
  • that you are tearing and pulling out your hair (Trichotillomania)
  • incomplete hair loss on the scalp and/or eyebrows

you need to consult your family physician or a general practitioner immediately.

Depending on your condition, the general practitioner may direct you to a dermatologist, a trichologist, or even an endocrinologist if the hair loss is related to hormonal imbalance. You may also be referred to a psychologist if you suffer from Trichotillomania.

Types Of Hair Loss

Hair growth cycle is composed of 4 distinct phase:

  • ANAGEN (the average growing phase – 3-5 years), CATAGEN (period of regression,2-3 weeks), TELOGEN (RESTING period,3-4 months) 
  • EXOGEN (SHEDDING PHASE).  Each phase has its own timeline, which can be affected by age, nutrition, and overall health
  • The Telogen phase remains for 3 months. When the telogen phase is over, the hair falls out and a new anagen growth phase begins with the hair growing back.

Under normal circumstances, 90 percent of our follicles are in the active anagen growth phase, while the remaining 10 percent are going through the catagen and telogen phases.

  • ANDROGENETIC ALOPECIA: Most common form. Also known as male pattern baldness. But can occur in women as well.
  • TELOGEN EFFLUVIUM:  As common as androgenetic alopecia. Causes the person to lose more than 90% of hair.
  • TRACTION ALOPECIA: HAIRSTYles such as pigtails, dreadlocks, braids cause this condition. It causes portions of your hair to fall out at the edges.
  • ALOPECIA AREATA: Your own immune system attacks your hair follicles. Can affect people as young as 18 years old.
  • ANAGEN EFFLUVIUM: Causes shedding during anagen phase or growth stage. Most common cause is chemotherapy.

Causes Of Hair Loss

The cause is genetic 90 percent of the time, while the rest is considered “metabolic” hair loss.

The most common cause occurs in both male and females. Medical term used for this is androgenic alopecia. Hair loss genes passed down from either parent. That might activate at any time after maturity, depending on individual genetics. When activation occurs, hair becomes sensitized to di-hydro-testosterone, or DHT, a testosterone metabolite that starts a chain of events that leads to a pattern of progressive miniaturization of the hair follicle. The anagen growth phase is cut short, and the hair regresses prematurely to the catagen phase and eventual resting telogen phase. Once the telogen phase is over, a new hair grows in with a reduced diameter and an even shorter anagen growth phase. Without treatment, these hair follicles eventually will die, leading to permanent hair loss.

2. Metabolic Hair Loss:

It is quite distinct from genetic hair loss.There is no reduction in hair diameter or progressive miniaturization. With abrupt metabolic changes in the body, hair loss starts two to three months after the change. In metabolic hair loss, 20 to 50 per cent of the follicles are in the telogen stage, leading to increased hair loss. Medically, the condition is called telogen effluvium. More than 90 percent of the hair stops growing due to damage to the matrix cell in the area of the hair bulb. The shed hairs have a tapered-down look like a pencil point; this hair loss is medically referred to as anagen effluvium. Metabolic hair loss is reversed with the improvement of underlying condition.

   Conditions leading to metabolic hairloss:

  • Nutritional imbalance or deficiency: iron, protein, zinc, folic acid, vitamin C, D,B12
  • Drastic weight loss
  • Excessive stress
  • Extreme illness
  • Medications, including beta blockers, antidepressants, non-steroidal anti-inflammatories and chemotherapy drugs
  • Thyroid dysfunction
  •  Iron deficiency Anemia


Alopecia areata is a disease that develops when the body’s immune system attacks hair follicles (what holds the hair in place), causing hair loss. Which can affect your scalp, inside your nose, and in your ear,eyelashes or eyebrows.





8. TRICHOTILLOMANIA: Some people pull on their hair, often to relieve stress.

9. SCARRING ALOPECIA: This condition develops when inflammation destroys hair follicles.

10. Lifestyle

How To Diagnose Hair Loss:

1. A detailed medical history of the client: The detailed history should focus on nutritional deficiencies, weight loss or gain, current medications, symptoms of hormonal changes, current stress situation, extreme sickness, recent major surgery and family history related to hair loss.

2. Densitometer Examination: Densitometer is a high-power magnification device that provides information on hair density (spacing between follicular units), hair diameter and the degree of miniaturization. If spacing between follicular units is increased but without reduction in the hair diameter, this suggests metabolic hair loss. If the examination reveals 15 percent or more of the hair has reduced diameter, this is more suggestive of genetic hair loss.

3. Hair-Pull Test:
This is a simple diagnostic test in which the physician lightly pulls on roughly 100 hairs to determine if an excessive loss is in progress. More than three hairs pulling from the scalp is considered abnormal.

4. Hair Pluck Test:
The medical professional plucks approximately 50 hairs from the client’s scalp and examines them under a microscope. Early hair loss can be diagnosed by comparing the percentage of anagen (growing) hair to telogen (resting) hair. Telogen hair has approximately half the follicle depth of anagen hair.
ratio of telogen to anagen hair ≤10 %➠ early hair loss not in progress
ratio of telogen to anagen hair >15 %➠ early hair loss likely to take place
ratio =30 % ➠ active hair loss taking place

5. Diagnostic Lab Tests: Blood tests can help to identify if hair loss is due to a metabolic condition linked to nutritional deficiency, anemia or hormonal imbalance. A micronutrient test provides detailed information if the patient has a deficiency in major minerals, trace minerals or vitamins.

6. Scalp Biopsy: A scalp biopsy involves removing a very small section of the scalp (usually 4 mm in diameter) and examining it under a microscope.

Average hair loss in men and women

Women tend to lose more hair strands per day than men. Daily heat styling and frequent hair coloring plays a big part in how much your hair sheds. Approximately 40 percent of women lose extra hair every day because of the way they style it. Women are more likely to experience periods of increased hair shedding due to life events like pregnancy and menopause.


It’s not unusual to lose hair strands every day. But if you’re worried about clumps of hair in your hairbrush or in the shower drain, talk to your doctor. Factors like stress, medication, and underlying medical conditions can all aggravate hair loss. A professional assessment can put your mind at ease.

Consult a Specialist Today

If you are experiencing hair loss, remember that you’re far from alone. At Urban Skin Hair clinic, our expertised team of doctors will provide you thorough information about your condition and will prescribe the best suited treatment option for you.

FAQ for Female Hair Loss

To keep your hair healthy it is required to maintain proper nourishment and take good care of it. Enrich your diet with protein, vitamin. Drink sufficient water. However Hair loss due to heredity, hormonal changes, medical conditions, you are required to take dermatological guidance at hairfree and hairgrow clinics.

It generally happens around your 30s.

Yes. The nicotine and carbon monoxide present in cigarettes restrict the oxygen level in your bloodstream, resulting in poor blood flow. Smoking also leads to premature hair aging.

Alopecia, chronic illness, ringworm, puberty, poor nutrition, diabetes, anemia, styling products, medication with harsh side effects.

 Dihydrotestosterone (DHT), an androgen made from testosterone by an enzyme 5-𝛂 reductase. DHT is derived from testosterone. Testosterone is a hormone that’s present in both men and women. It and DHT are androgens, or hormones that contribute to male sex characteristics when you go through puberty. These traits include:

  • a deep voice 
  • increased body hair and muscle mass
  • growth of the penis, scrotum, and testicles as sperm production begins
  • changes in how fat is stored around your body

High levels of androgens, including DHT, can shrink your hair follicles as well as shorten hair cycle, causing hair to grow out looking thinner and more brittle, as well as fall out faster. DHT can also make it take longer for your follicles to grow new hairs once old hairs fall out.

Finasteride, Minoxidil

A type of temporary hair loss caused by a stressor or change to your body. 70% of your hair in the anagen stage prematurely enters the telogen phase, which causes hair loss.

Shedding 50 to 100 strands a day is a normal part of the hair growth cycle. If you are shedding more hair than this, it may be a matter of concern.

The hair loss pattern of men is different from women. Women are more likely to experience gradual thinning of hair all over the scalp rather than going completely bald

No, washing hair every day does not cause hair loss. The water cannot penetrate the hair root and damage it.

If you have dry hair, washing it twice a week should suffice. If you have greasy hair, you should wash it every day to prevent excess sebum from clogging the scalp pores.

Yes! Hot baths, long-term sun exposure, and very hot hair dryers increase sebaceous discharge temperature, liquefying it more and resulting in greasy hair.

No, because the hair color acts only on the hair shaft and not the root. However, hair dying may weaken the shaft, making the strands prone to split-ends and breakage.

Tools like straighteners, hairdryers, and curling wands use very high heat, eventually resulting in dry, frizzy, and damaged hair prone to breakage.

Yes! Prolonged use of tight hairstyles and hair accessories can lead to a condition called traction alopecia – hair loss induced by tight hairstyles.

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