Hair in the shower drain. Strands on your pillow. A brush that fills up faster than it used to. Most of us notice it and immediately worry, but not all hair shedding is cause for concern. The challenge is knowing the difference between normal hair cycling and a condition that genuinely needs treatment.

The Normal Hair Cycle

Every strand of hair goes through four phases:

1. Anagen (growth): 2–7 years. About 85–90% of your hair is in this phase at any given time.

2. Catagen (transition): 2–3 weeks. The follicle shrinks.

3. Telogen (resting): 3–4 months. The hair stops growing and eventually sheds.

4. Exogen (shedding): The old hair falls out as a new hair begins to grow in the same follicle.

Losing 50–100 hairs per day is completely normal and expected as part of this cycle. If you have thick, long hair, the shed hairs may look alarming simply because of their length and volume, but the number may be well within normal range.

What Is Hair Fall vs Hair Loss?

Hair fall typically refers to temporary, increased shedding, more hairs entering the telogen phase at once, often triggered by:

• Illness, fever, or COVID-19 (telogen effluvium, typically starts 6–12 weeks after the triggering event)

• Extreme stress (a major life event, surgery, significant weight loss)

• Nutritional deficiency, iron, ferritin, Vitamin D, B12, zinc

• Hormonal shifts, pregnancy, post-delivery, thyroid imbalance, PCOS, stopping contraceptives

• Crash dieting

In most cases of telogen effluvium, hair fall resolves on its own within 3–6 months once the trigger is addressed. The follicles are healthy, they just need time to reset.

Hair loss (alopecia) refers to a more permanent process where follicles are progressively miniaturising or being destroyed:

• Androgenetic alopecia (AGA): The most common form, male and female pattern baldness. Driven by DHT (dihydrotestosterone) acting on genetically sensitive follicles. Progressive and permanent if untreated.

• Alopecia areata: Autoimmune, the immune system attacks hair follicles, causing patchy loss

• Traction alopecia: Caused by consistent tension from tight hairstyles, gradually damages the follicle

• Scarring alopecias: Inflammatory conditions that destroy follicles permanently

The critical difference: telogen effluvium is reversible. Androgenetic alopecia and scarring alopecias are not, but they can be slowed and partially reversed with early treatment.

Warning Signs That Warrant a Dermatologist Visit

See a dermatologist if you notice:

• Widening parting or thinning crown, classic early signs of female pattern hair loss

• Receding hairline, in men, the hairline migrating backward at the temples

• Patches of complete hair loss, could be alopecia areata

• Scalp itching, burning, or scaling with hair loss, may indicate a scalp condition driving the fall

• Hair fall persisting beyond 3–6 months without a clear trigger

• Increased shedding post-pregnancy lasting beyond 6 months

• Diffuse thinning all over without obvious cause

What a Dermatologist Assesses

A proper hair loss consultation isn't just a scalp check. At Youthville Clinic, we:

1. Take a detailed history, duration, pattern, recent illness, diet, stress, medications, family history

2. Examine the scalp with trichoscopy, magnified assessment of follicle density, miniaturisation, and scalp health

3. Run blood tests, ferritin, serum iron, Vitamin D, B12, thyroid function (TSH, T3, T4), hormonal panel for women (LH, FSH, testosterone, prolactin if needed)

4. Determine the type of hair loss, because the treatment differs completely

Treatment Options

Depending on the diagnosis:

For nutritional deficiencies and telogen effluvium:

• Targeted supplementation (often oral iron, Vitamin D, biotin-based nutritional supplements)

• Scalp health treatments to optimise the environment for regrowth

For androgenetic alopecia:

• Topical minoxidil (evidence-backed; available for both men and women)

• Oral medications (finasteride for men; spironolactone or oral minoxidil for women)

• GFC (Growth Factor Concentrate) therapy, injecting concentrated growth factors from your own blood to stimulate follicle activity

• PRP (Platelet Rich Plasma), a related approach using platelet-rich plasma

• Hair transplant, for advanced cases where follicles are too miniaturised to respond to medical treatment

Early intervention makes a significant difference. Follicles that are miniaturising can often be preserved; follicles that are completely gone cannot be revived.

If you're concerned about hair fall or thinning, book a trichoscopy consultation with Dr. Shruti Chavan at Youthville Clinic, Oshiwara, Andheri West, Mumbai.