Why is my hair falling out?


Daniel Levy MD, Cosmetic Dermatologist


Hair, like nails, is an extension of your epidermis, the outer layer of your skin. It is composed mainly of protein. The typical hair cell stays with you for three to five years until it falls or grows out. Most of the time, it gets replaced. 

Check the drain after each shower for the amount of hair. The typical person loses from 50 to 200 hairs a day (out of 80,000 to 120,000 hairs on the head). So it’s normal to have a very small clump of hair left on the drain after washing, but if that amount starts increasing, see a dermatologist. It could mean your scalp has an infection (seborrheic dermatitis), or that hormone-driven alopecia is beginning to set in, or that you have a nutritional deficiency.

Other common factors that could play a part in hair loss are:

• Damaging effects of hair treatments or styling (contact dermatitis)
• Twisting or pulling your hair (traction alopecia)
• Prescription drugs such as blood thinners and medications for gout, arthritis, depression, heart problems and high blood pressure (drug-induced alopecia)
• Thyroid imbalance
• Iron deficiency


In pre and peri-menopausal adult women, iron deficiency is the most common cause of hair thinning.  Replacement with iron supplementation for a period of 3 months results in a noticeable improvement is hair strength and density.
If iron, thyroid hormone, and other hormone levels are optimized, the next step is to supplement your diet with the essential omega-6 fatty acid called GLA (gamma-linolenic acid) in the form of evening primrose oil.  This is taken as 500 mg twice daily for at least 2 months.

The microcirculation in the scalp is also important for preserving the growth phase of each hair.  Vasodilation can be stimulated by certain shampoos, scalp massages, shiatsu massage, and topical treatments such as Rogaine 5% foam.

Article by
Bellevue Dermatologic Surgeon