Everything You Need To Know About Hair Loss, From The Experts Who Specialize In It

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If you’re dealing with hair loss, take heart in knowing that you’re not alone. According to the Cleveland Clinic, more than 50 percent of women will experience noticeable loss at some point in their lives. So if you’re reading this, there’s a good chance you’ll face the condition eventually (if you haven’t already).

But we get it—knowing how common hair loss is doesn’t necessarily change the fact that it takes an intense emotional toll. No matter whether your part is more noticeable, your ponytail is gradually thinning, or you’re suddenly seeing way more strands in the shower, it’s a sucky, stressful situation.

And you’re probably looking for solutions. Know that they’re out there, but hair loss is a complicated, multi-factorial condition that requires time and patience to both diagnose and treat. The good news: Understanding what’s behind your hair loss alone can be reassuring—it allows you to come up with a targeted treatment plan.

So, we tapped top dermatologists to create this comprehensive guide featuring the most common causes, top treatment options, expert-backed product picks, and even advice for how to prevent hair loss.

Consider this your starting point for alleviating tress stress.

How Much Hair Loss Is Normal

Before we go any further, it’s important to know that shedding is a natural part of a healthy hair growth cycle, says Melissa Piliang, MD, a board-certified dermatologist at the Cleveland Clinic. In fact, we lose an average of 100 hairs per day. But rather than getting hung up on a specific number, it’s more important to pay attention to what your typical baseline is. “Most of us can visualize the amount we see in our hairbrush or in the shower or how much we pick off of our clothes,” Dr. Piliang says. “So, if you notice this amount seems drastically different or you’re finding hair everywhere, all the time, that’s an indicator that something may be off.”

Not a hundred percent sure if the amount of hair you’re losing is normal? Collect all of the hair you find in a day and bring it with you to see your dermatologist when you go in for an evaluation, suggests Michele Green, MD, a board-certified dermatologist in New York City. (It’s worth noting that all the experts we spoke with underscore the importance of seeking medical attention anytime you’re worried about hair loss.) Your doctor can run blood tests, rule out underlying medical issues, and ultimately make sure you have a correct diagnosis before moving forward with treatment.

What Causes Hair Loss

How much time do you have? Jokes aside, the list of causes is lengthy and complicated. Below are four of the most common culprits, according to our experts.

Female pattern hair loss

Also known as androgenetic alopecia, female pattern hair loss (FPHL) will affect a whopping 40 percent of women by age 50, according to research. “This is a chronic and slow type of hair loss where women start to notice that their part gets wider and their scalp becomes more visible. They may also notice some recession along their hair line, typically in the shape of an M,” Dr. Piliang says.

There are multiple causes at play, including age and genetics, but hormonal shifts are the biggie. “Your levels of androgens, male hormones such as testosterone, tend to increase around menopause and are converted into DHT, a hormone that targets the hair follicle, a pore out of which a hair grows, " says Paradi Mirmirani, MD, a board-certified dermatologist in San Francisco specializing in hair disorders. "This both alters the normal hair cycle, shortening the growth phase, and miniaturizes the hair, making the diameter continuously smaller."

While FPHL does often show up as you get older, it can happen at any point, particularly if you have a genetic predisposition. And while most FPHL patients are postmenopausal, Dr. Green has seen it in women in their twenties.

Telogen effluvium

Whereas FPHL is characterized by gradual, slow hair thinning, telogen effluvium (TE) is defined by a sudden, dramatic shedding that seemingly comes out of nowhere. TE most often occurs after a particularly stressful event such as emotional stress (a break-up, the death of a loved one) or physical stress (surgery, extreme illness), says Dr. Green. More specifically, the shedding will start three months after the event. The reason why is unclear, but it’s suspected that high levels of cortisol, a stress hormone, shortens the growth phase, pushing a greater amount of hair into the shedding phase, Green adds.

The major positive to keep in mind if you’re dealing with this type of hair loss is that it’s temporary and will ultimately resolve on its own. If there are no other contributing factors at play (i.e. a nutritional deficiency; more on that in a moment) and the stress isn’t chronic, your hair growth cycle will eventually normalize. “You might experience shedding for a few months, but it should subside,” says Dr. Green.

One of the most common examples of telogen effluvium? Postpartum hair loss, when women notice that their hair starts to fall out at a rapid rate a few months after giving birth. (Talk about a major stressor that’s both emotional and physical.)

Alopecia areata

“Alopecia areata occurs when your own immune system sends the wrong signal and ends up attacking the hair follicle,” explains Dr. Mirmirani. “We don’t know exactly why it occurs, but genetics likely play a role." The positive news here: When the hair follicles are under attack, they go into a hibernation mode but aren’t permanently damaged or destroyed, meaning your hair can grow back.

The only problem is that it’s totally up in the air as to when or how this will happen. “The only thing predictable about alopecia areata is that it’s unpredictable,” says Dr. Piliang. She adds that the condition can come and go, seemingly without reason, and manifests as smooth, bald areas in dime-, quarter-, or silver dollar-sized patches on either the scalp or body. People who are battling alopecia areata tend to notice big clumps and chunks of hair falling out.

Traction alopecia

Constant tension or strain on the hair damages the follicle, impacting the ability for blood flow and nutrients to reach it and can ultimately result in permanent hair loss, Dr. Mirmirani explains. Traction alopecia occurs in women whose hair styles or practices consistently put a lot of pressure on the hair (think tight braids or ponytails or extensions).

Sporting an overly tight updo for one event isn’t going to be problematic; it’s the repeated, constant, and cumulative damage that’s the issue, Dr. Mirmirani says. It often manifests as thinning on the edges of the scalp or patches of thinning in areas where there’s repeatedly a clip or a roller. Another tell-tale sign: scalp tenderness. “If your scalp hurts, that’s a great indicator that you need to switch up your style,” says Dr. Mirmirani. “It’s like wearing high heels that hurt your feet. Ignore that pain and keep wearing them and you’ll ultimately develop a bunion.”

How To Prevent Hair Loss

You can’t do much to change your genetics, age, or hormone levels. But that doesn’t mean that things are entirely out of your control.

• Switch up your style: When it comes to traction alopecia specifically, simply changing up your hairstyle so that you’re not putting too much tension on your roots can be hugely helpful, says Dr. Mirmirani. Similarly, you also want to be mindful about consistent chemical damage to your hair via dye, perms, or relaxers, Dr. Green adds. These can compromise the strength of your hair, making it more susceptible to damage from tight styles.

• Shampoo regularly: It’s trendy advice these days to wash your hair as infrequently as possible, but this may not be the right approach if you’re battling hair loss. When allowed to build up on your scalp, oil, dirt, and pollutants can clog hair follicles and impact hair growth, says Dr. Piliang. So, make sure you’re cleansing regularly with a gentle non-drying shampoo. She adds being judicious with heat styling to the list of other smart preventative strategies.

5 Best Gentle Shampoos For Hair Loss

Ultra-Gentle Shampoo with Oat Milk

A sulfate-free formula with nourishing oat that softens, cleanses, and moisturizes hair with a soft touch.

Soothe & Soften Shampoo

Ideal for those with fine or fragile hair or a sensitive scalp, this soothing shampoo is free of dyes, parabens, and sulfates.

The Shampoo

Infused with hyaluronic acid, aloe vera, and niacinamide, this shampoo is non-drying, non-stripping, and ubergentle.

Skin-Caring Shampoo

Designed by a dermatologist to be noncomedogenic and non-irritating to scalp skin.

Mineral Moisturizing Shampoo

In this bottle? Twenty-six healing minerals (the same mix found in Israel's renowned Dead Sea) that promote a healthy scalp and gentle cleanse.

• Take care of yourself. Aside from those specifics, the best things you can do to set yourself up for tress success are general health and wellness tips that aren’t particularly groundbreaking. The high-level summary: What’s good for your overall well-being is good for your hair, too. “Exercising and managing stress as best you can ensures you have the best hair possible and maximizes your genetic predisposition and age,” Dr. Piliang says. Keeping stress in check, in particular, prevents cortisol levels from spiking, helping to potentially avoid telogen effluvium. While it’s understandably easier said than done, finding stress management techniques that work well for you—whether that's exercising, meditation, yoga, or journaling—is paramount. There’s no current research demonstrating a direct correlation with hair loss, but it's well-known that these practices do help to reduce stress. (Take this study, which showed that people who regularly practiced yoga had lower cortisol levels.)

• Pay attention to nutrition. While there’s a lot of talk on the Internet about which vitamin deficiency causes hair loss, the answer isn’t exactly cut-and-dry. Vitamin deficiencies (specifically vitamin D, iron, and zinc) can certainly play a supporting role in contributing to hair loss, but they're unlikely to be the sole reason for dramatic hair loss since the average U.S. diet covers most of our nutritional needs, says Dr. Green. That being said, a vitamin deficiency definitely won’t help matters if you’re already predisposed to FPHL or experiencing any type of hair loss, which is why the experts we spoke with point out that it’s a good idea for anyone dealing with hair loss issues to have their bloodwork checked, eat a balanced diet, and take a multi-vitamin.

Tech-y looking tools may look wacky—but there's real science behind their effectiveness.

The Best Hair Loss Treatments

As mentioned above, it’s important to seek the professional help of a board-certified dermatologist if you’re battling hair loss. Only she can pinpoint what’s behind your shedding—and come up with an effective treatment plan. These are some of the most effective over-the-counter and in-office options.

At-Home Treatments

Effective hair loss solutions are just a click away.

1. Topical minoxidil: This is as close to a silver bullet as you could ask for. “Minoxidil is the only FDA-approved topical hair loss treatment, but even today we still don’t know exactly how it works,” says Dr. Mirmirani. “We do know it’s a vasodilator, because it was originally given as an oral medication to treat high blood pressure and hair growth was a side effect,” adds Green, noting that increased blood flow to the follicle may be at play. It’s available topically without a prescription in 2 percent and 5 precent concentrations (the docs we talked to say 5 percent tends to be more effective). It may take a few months to work, so patience and consistency are key, and if you stop using it, that new hair growth will stop, too. Find it in: hers Hair Regrowth Foam Treatment 5% Minoxidil.

2. Laser Devices: Most of these at-home devices rely on red light and there is some data indicating that they can help with female pattern hair loss. Again, we don’t understand exactly why, but one theory is that they may combat the oxidative stress that plays a role in hair loss, adds Dr. Piliang. (Just like we know that free radical damage is no good for your skin, it also doesn’t do your scalp any favors, damaging the hair follicle and negatively impacting healthy hair growth.) They’re generally safe, but they can be expensive, and research suggests they’ll work even better when paired with topical minoxidil. Try: LaserCap SD, which Dr. Green recommends to her patients. Use it every other day for 30 minutes.

3. Supplements: Again, start with a good multi-vitamin. "My biggest issue with hair-specific supplements is that they’re pricey," says Dr. Mirmirani. “There’s likely no harm in taking them, but you’ll also probably do just fine with an over-the-counter multivitamin." She suggests starting there and, if after six months you don’t see a difference—and you have the money to spend—consider moving onto something more expensive.

One to try is Nutrafol Women. Dr. Green was skeptical about the hype surrounding this popular supplement…until she started taking it herself and was impressed with the results. “I do think there’s a place for it for most patients. It’s good for overall hair follicle health, which is important for any type of hair loss,” she says. Just keep in mind that it’s not cheap, it takes three to six months to see results, and requires a regimen of four pills daily.

4. Anti-Dandruff Shampoo: Even if you think you don’t have dandruff or see any visible flakes, you can have it and not know it. A formula like this is effective for keeping yeast and inflammation in check, which may help keep hair loss at bay. In fact, one study showed that men with male pattern hair loss experienced an improvement in hair growth after using an anti-dandruff shampoo. Try Head & Shoulders Classic Clean Anti-Dandruff, which contains a 1 percent concentration of pyrithione zinc, the studied ingredient.

Best Hair Regrowth Treatments

2% Minoxidil Topical Solution

This solution contains 2% minoxidil, the only FDA-approved topical ingredient to deal with hair loss. A great first-line treatment.

Hair Regrowth Treatment for Women

For those who need a little extra power, this foam is enriched with 5% minoxidil.

Ultima 12 LaserComb

Research shoes that laser light can reverse hair loss. Run this comb through your hair three times a week for eleven minutes to get results.

Women's Hair Growth Supplements

A blend of vitamins, zinc, selenium, marine collagen and more that target the major causes of hair loss, including stress and nutrition.

Classic Clean Daily-Use Anti-Dandruff Shampoo

Dandruff shampoo helps to quell inflammation and scalp yeast at bay—and may help improve hair loss too.

Suffering from loss? You've got plenty of at-home options.

In-Office Treatments

When you need a bit more help, talk to your doc about these.

1. Prescription oral medications: Oral meds are often a first-line treatment, with low-dose oral minoxidil (which is used off-label) being the most popular. “It offers an improved result for many patients because topical minoxidil needs to be converted by an enzyme to work—and many people have low levels of this enzyme, says Dr. Mirmirani. Oral finasteride, which is FDA-approved to treat hair loss in men but not in women, is another off-label option. Again, we don’t know the exact mechanism of action, but we do know that it blocks an enzyme that’s necessary to convert testosterone into DHT, explains Green. (As a reminder, increased DHT is associated with female pattern hair loss.) Spironolactone is yet another common oral medication used for its hormonal effects, as are birth control pills.

2. PRP Injections and/or microneedling: Platelet-rich plasma is often talked about in skincare, but it can be good for the scalp, too. “The idea here is that the growth factors in the PRP help stimulate hair growth,” says Green. It can either be injected directly into the scalp or delivered via microneedling, a treatment during which thousands of tiny needles create miniscule holes in the skin (the theory is that the micro-injuries trigger a wound-healing response that can also help with hair re-growth, says Dr. Mirmirani).

The dermatologists we talked to agree that PRP injections tend to yield better results. Dr. Green says she typically treats patients with four monthly treatments followed by yearly or bi-yearly injections thereafter depending on the results. Still, this remains best used as an add-on to oral meds or topical minoxidil. “I’ll always start with minoxidil plus a good oral medical regimen, then add this in as an adjunct treatment,” says Dr. Mirmirani.

3. Hair transplant surgery: This is the most permanent solution of the bunch, but it’s not as cut and dry as it may seem, or often is for men. For a hair transplant to be successful you need to have enough donor hair. “Men typically only have thinning on top and denser hair in the back so they have more hair that can be transplanted while women often experience thinning all over so there’s less hair to harvest,” says Dr. Piliang. However, in the right candidate who does have severe enough thinning to warrant a transplant and also has enough thick donor hair to move, it can be a successful option.

The Bottom Line

Hair loss is complicated, with no shortage of causes and potential factors at plan. And it’s an undeniably tricky condition to treat. Part one of your plan is to figure out what's behind your shedding—nine times out of 10 that involves seeing your dermatologist. By doing a complete assessment, evaluating your hair loss, checking labs, and considering your medical and family history, she can help you get to the root of the issue as quickly as possible. Once that’s figured that out, they’ll help you determine the most effective treatment path to take, be that a mix of prescription meds, at-home products, or in-office procedures.

So yes, hair loss is extremely stressful and emotionally taxing. But don’t despair—you do have options.

Meet our experts: Melissa Piliang, MD, a board-certified dermatologist at the Cleveland Clinic, Michele Green, MD, a board-certified dermatologist in New York City, Paradi Mirmirani, MD, a board-certified dermatologist in San Francisco specializing in hair disorders

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