What are the first signs of hair thinning?

The most obvious sign of hair thinning is less hair on your head. If you're concerned about hair loss, examine your scalp in the mirror. Use a hand mirror and a wall mirror to look at the back, sides and top of your head as well as your hairline. Can you see more skin than usual through your hair? If you aren’t sure, snap some selfies to compare side by side with older photographs.

Different types of hair loss start in varying spots on the scalp. Knowing where to look for signs of hair loss can help you identify thinning. Here is a rundown on how common types of hair loss generally start and progress:

• Male pattern baldness, caused by sensitivity to male sex hormones called androgens, may begin at the crown of the head and extend outward in a circular pattern, or it may start at the hairline and move toward the back of the scalp.

• Female pattern baldness, caused by sensitivity to androgens, usually begins along the center of the scalp and progresses outward.
• Telogen effluvium, caused by emotional or physical stress, usually occurs all over the scalp.
• Alopecia areata, caused by immune system dysfunction, can occur anywhere on the scalp but it usually causes patches of hair loss concentrated in one or more spots.
• Traction alopecia, caused by repeated pulling on the hair, often develops along the hairline in individuals who wear tight ponytails, buns or braids.

Your hair provides natural protection from damaging UV rays. If you begin developing sunburn after routine sun exposure, it could mean that your hair has thinned. However, new sun sensitivity can also be caused by allergies or medications.

Shedding is a normal part of the hair's natural renewal process. Most individuals lose 50 to 100 hairs daily. Shedding that exceeds this level may indicate thinning hair, and hair that comes out in clumps is more likely to be a sign of hair loss rather than routine shedding.

During your bathing or showering routine, you may notice signs of thinning, such as: 

• More hair coming out in your hands when you shampoo or condition
• Excess hair on the floor of the shower or tub
• New problems with backed up drains caused by excess hair in the trap
• Finding more hairs than usual on towels that you use to dry your hair

Your hairstyling routine can also uncover signs of hair thinning, including:

• More hair in your brush or comb than normal
• More hair coming off in your hands when you work in styling products
• More hair stuck to the plates of your flat iron or barrel of your curling iron

Check these areas for the presence of shed hair:

• Your pillow
• The lint trap in your dryer
• Your vacuum cleaner bag
• Upholstered furniture
• The headrest on your car seat
• Your clothing at the end of the day
• The insides of your hats and headwear

Some types of hair loss may be gradual and don’t produce noticeable signs of shedding.

If you’re experiencing any of the signs of hair thinning, see your healthcare provider for an evaluation. Your provider will discuss your symptoms with you. They may order blood work or perform further testing to help determine the cause of your hair loss. Your provider will then discuss treatment options that may reduce thinning and/or promote regrowth.

Published December 2022.