Why is my hair falling out? All your hair loss questions—answered by an expert
No can 'do
Bald spots materialising out of thin hair? You may be experiencing hair loss. Don’t let your worries get ahead of yourself just yet—if you're looking for answers, we're here to deliver. We spoke to Dr Lee Kim Siea, Reconstructive Plastic & Cosmetic Specialist Surgeon at the M Clinic who happens to know a thing or two about hair loss.
Ahead, Dr Lee covers everything from the aetiology of each type of hair loss to the importance of SPF in the prevention of balding—there is no stone left unturned here.
What are the signs of hair loss?
“Usually, losing around 50 to 100 strands a day is normal. Obviously, the closer to 50 you are the better, but anything up to 100 hairs is usually okay—as long as the scalp can regenerate the hair. If you find that you're losing more than this, then you may have a problem.
"In terms of 'signs', it really depends on the aetiology of each case—there are different patterns for each kind of hair loss. It could just be the visual thinning of the hair, where we see the general pattern of thinning right on the crown of the head or just above the forehead. That’s the area that usually sees a lot of loss in male pattern baldness. Alternatively, it could just be a circular patch that is lost. Other times, you may just have sudden, total hair loss—it can be an extreme shock when it happens that way.
"It can also be due to drugs (like patients undergoing chemotherapy) or a disease—ringworm infections that can cause hair loss and patches of scaly scalp. If you’re not seeing any of these patterns, then it’s probably due to stress or nutritional issues. Also, we do naturally suffer hair loss as we grow older."
What are the different types of hair loss?
"The different types of hair loss are usually related to their many causes. The first is hereditary hair loss—this includes male pattern baldness and, on occasion, female pattern baldness.
“The second is hormonal changes. You may experience hair loss during pregnancy and menopause or if you have thyroid problems.
"If you have autoimmune issues like alopecia areata, you are also predisposed to hair loss as your immune system attacks your hair follicles. If you’re under radiation treatment or certain medications (chemotherapy and arthritis medications in particular), that can also lead to hair loss for obvious reasons. Fungal or bacterial infections like ringworms can also cause hair loss in addition to scalp flaking."
"Finally, stress (both physical and emotional) is also a big factor in a lot of cases. This can be poor nutrition, emotional stress, harsh environmental factors, smoking and even using too-tight hairstyles and hair treatments that put stress on the hair follicles (traction alopecia). There is also the hair loss that comes inevitably with age, which actually happens as your body becomes less and less able to cope with these stressors over time."
"Although it's less common, sometimes we even see hair loss in patients with burns over the neck and jaw. The burns actually tighten up the skin, which puts pressure on the scalp, reduces blood supply and thus leads to hair loss."
How can you prevent hair loss?
"Again, it’s dependent on the aetiology. In general, I think we should take it in steps. First, we identify the risk factor, and from there we can see what we can do. If you can determine the cause, then you need to remove it to prevent hair loss. For example, if your hair loss is rooted in stressful conditions and poor nutrition, all you have to do is avoid these things and your condition will improve."
"This means avoiding stressful situations at work or home, eating right and protecting yourself against harsh environmental factors like sunlight, coldness or strong wind. I'd actually really recommend that you use SPF, or if you can't, at least use a hat. While you’re at it, you should stop smoking as well. Similarly, if you’re on medication which causes hair loss as a side effect, consider shifting onto a new medication."
"If, however, your hair loss is caused by genetics, you have to accept that one day you will probably lose your hair, but there are also treatments that you can do to delay the inevitable so you can enjoy your hair for longer."
"You can also prevent it or slow down the rate by being gentle with your hair—stopping things like heat styling and tight hairstyles will reduce stress on the follicle."
This interview has been edited for clarity and length.