Hair loss: what's normal, common causes and when to see a GP

Not medical advice. This guide is general information from the sources listed, not a diagnosis or a substitute for a pharmacist, GP or dermatologist. If you are worried, or symptoms are severe or not improving, get advice. Read our health information policy.

Some shedding is normal

Hair grows in cycles, and old hairs fall out to make way for new ones. The NHS says we can lose between 50 and 100 hairs a day, often without noticing (other sources give slightly different ranges). Losing hair is not usually anything to be worried about — but it can be upsetting, and occasionally it's a sign of a medical condition.

The main types

• Male and female pattern hair loss — gradual thinning that usually runs in families. In men it typically starts with a receding hairline and thinning on top; in women it usually shows as a widening parting. It's permanent without treatment.
• Telogen effluvium — sudden, all-over shedding, often about three months after an illness, high fever, childbirth, surgery, crash dieting, stress or a change in medication. It usually settles by itself.
• Alopecia areata — sudden, round, smooth bald patches, thought to be autoimmune. Hair often regrows, but it can come back.
• Traction alopecia — thinning, often at the hairline, from hairstyles that pull for a long time. Reversible if caught early.
• Other causes the NHS lists include illness, stress, cancer treatment, weight loss and iron deficiency. In children, scalp ringworm (a fungal infection) can cause scaly patches with broken hairs and needs a GP.

What treatment can — and can't — do

The NHS says most hair loss doesn't need treatment, because it's either temporary or a normal part of ageing, and hair lost because of a medical condition usually grows back once you've recovered. Where treatment is possible:

• No treatment is 100% effective, and many aren't available on the NHS, so you may have to pay.
• For pattern hair loss, the main medicines are minoxidil (a lotion or foam you can buy) and, for men only, finasteride tablets (private prescription). Both only work for as long as you use them.
• Wigs, hairpieces and camouflage products are recognised options. Some wigs are available on the NHS, though you may have to pay.
• If hair loss is affecting how you feel, the NHS says a GP may be able to arrange counselling, and charities such as Alopecia UK offer support.

Looking after thinning hair

There's no special routine that stops genetic hair loss, but you can avoid adding damage: be gentle when brushing wet hair, keep heat and bleaching moderate, avoid tight styles, and protect a thinning or bald scalp from the sun. NICE guidance for GPs says hair can be washed as often as you like without making pattern hair loss worse.