Each of us loses some hair each day. As a rough estimate, the average person can expect to lose 50 to 100 hairs per day. However, noticeable hair loss over time can start to become embarrassing or frustrating. For many, a hairstylist or salon professional may be the first person to whom they confide their concerns of hair loss or dry, thinning hair.
Understanding the reason for your client's hair loss is the starting point of finding a solution.
As a stylist, you may be able to help your client understand their hair loss and help them stop, slow, or disguise their hair loss. So, to help your client find answers and solutions, start by understanding the possible root causes of hair loss or thinning.
Signs of hair loss
Thinning hair or hair loss can manifest in many different ways—gradually or suddenly—depending on its root cause.
Gradual thinning on head
Gradual hair thinning is the most common sign of hair loss. Males may recede at the temples first, whereas females may broaden the part in their hair.
Circular or patchy bald spots
Some people may experience coin-sized bald spots exposing their scalp. In some cases, the skin may be itchy or painful before the hair falls out.
Sudden loosening of hair
A physiological or emotional shock or stressor can cause hair to loosen, causing handfuls to come out when combing or washing the hair.
Full-body hair loss
Some medical conditions or treatments can cause hair loss all over the body.
Scaly patches on scalp
Ringworm can cause reddening, crusting, and scaling of the scalp, leading to broken hair or hair loss. Intense itching usually occurs as well.
Causes of hair loss
Genetics and aging (androgenetic alopecia)
Research suggests that family history and age contribute to male and female pattern hair loss. Men may see a thinning at the temples, with the hair gradually receding to create the characteristic 'M' shape. Men may also notice thinning at the crown, leading to partial or complete baldness. Women may notice hair thinning all over the head, though the hairline does not often recede. Male and female pattern hair loss is a common issue as men and women enter midlife.
Hypothyroidism
Thyroid hormones regulate cellular metabolism, meaning the set of chemical reactions in our cells to maintain normal functions—including our hair and skin cells. When the thyroid gland is functioning correctly, hair follicles can regenerate themselves, going through the phases of growth, regression, shedding, then growth again. But, when the thyroid slows down (a condition known as hypothyroidism), the hair follicles may not be stimulated as much as they need, resulting in thyroid hair loss—including body hair or eyebrows. Patients can test for thyroid dysfunction with a simple at-home thyroid blood test.
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Alopecia areata
Alopecia areata is an autoimmune condition in which the immune system attacks hair follicles. This condition causes hair loss patches, possibly brought on by severe stress. A doctor can diagnose alopecia areata by looking at the hair loss and examining a hair sample under a microscope. A doctor may also perform a scalp biopsy to rule out other conditions that cause hair loss like tinea capitis, a fungal infection.
Stress (Telogen effluvium)
Telogen effluvium is a nonscarring, non-inflammatory hair loss condition caused by physiological or emotional stress. Significant stress pushes large numbers of hair follicles into a resting phase. Typically, hair is in the anagen phase for a few years, then enters the telogen phase for a few months before falling out and becoming replaced by new hair. However, telogen effluvium pushes more hairs into the telogen phase, causing more significant fallout when the time comes. Hair typically regrows once the stress is under control.
Polycystic ovarian syndrome (PCOS)
The female body produces male hormones, called androgens, which play a role in puberty and stimulating hair growth. Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women of reproductive age that causes extra androgen production. These excess androgens can also cause the hair on your head to start thinning, especially near the front of the scalp.
Iron deficiency
Iron is a mineral that the body needs for growth and development. Research suggests that there is a relationship between iron deficiency and hair loss. Iron deficiency may develop or worsen female pattern hair loss, especially in premenopausal women. However, it's currently unclear whether iron deficiency causes male pattern hair loss. Patients can detect iron deficiency through a blood test ordered by a doctor.
Medical treatments (anagen effluvium)
Anagen effluvium is hair loss during the growth phase caused by an event that impairs the mitotic activity of the hair follicle. These events could be certain medications or medical treatments—most commonly, chemotherapy. Often, the hair returns once they are off these medications or done with treatment. Physician support is essential in this situation.
Traction alopecia/extreme hairstyling
Traction alopecia is hair loss from repeatedly pulling on your hair. Hairstyling like tight ponytails, buns, or braids, especially with chemicals or heat, can cause traction alopecia. This condition is reversible by treating your hair more gently. Similarly, chemical treatments and hot oil hair treatments may also lead to hair loss.
Trichotillomania
Trichotillomania is an impulse-control disorder in which patients compulsively pull out hair, eyebrows, or eyelashes. Treatment for this condition requires controlling the underlying psychiatric condition with the help and management of a healthcare professional
How to talk to clients about hair loss
Create a safe space
Create an open and judgment-free space where clients feel safe to discuss their wants and concerns. Clients may want to talk about their hair-related symptoms with a professional but unsure how to start the conversation. You can help create the conversation with questions like:
- What do you wish you could change about your hair if anything?
- What differences have you noticed in your hair lately?
- Do you have any concerns?
Relate with empathy and compassionate boundaries
Hair loss can feel concerning, frustrating, or embarrassing. Before you jump in with solutions, listen carefully to your client's concerns to truly understand their experience. Matching their tone and mirroring their language back to them helps to build better rapport. Please pay attention to signs that a client isn't ready or willing to talk about their hair loss.
Work on a solution together
If clients feel concerned about their thinning hair or hair loss, encourage them to discuss their concerns with a medical professional. Once a client can pinpoint the root cause of their thinning hair or hair loss, then you and your client can move forward with a style plan.
A note from Paloma Health
A common symptom of hypothyroidism is hair loss on both the head and eyebrows. If your client is worried about hair loss, consider encouraging them to take an at-home thyroid blood test to understand their thyroid function.
Many labs only look at thyroid-stimulating hormone (TSH). Still, it's critical also to measure free triiodothyronine (fT3), free thyroxine (fT4), and TPO antibodies. These four markers help to understand the big picture and where specifically to make improvements.
Should the results indicate an underactive thyroid, thyroid hormone medication is usually the first step in minimizing symptoms like hair loss.
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