Category: Hair Loss Causes

This is a comment we received to a post from last week — Settling In to a Hair Loss Pattern:

“and even the balding patients who start as a class 5 may not go much further”

I am a little confused about this comment, does not everyone who start balding start at a class 2 which progresses towards a 3, then 4 and so on. how can a person start at class 5 if they already have a considerable amount of hair loss as class 5?

Sorry about that. I thought it was pretty clear. In the post you’re referencing, I said the “Norwood chart is not to be seen as a progression of hair loss chart, but rather the final patterns seen in a large male population.” Here’s what I meant…

When you bald, a pattern will develop and at times it may look like those patterns on the Norwood chart. If it isn’t visibly evident, the loss may show with a microscopic exam of your hair at various areas on your scalp. This is what we call the miniaturization study.

A patient can just start thinning all over the scalp like a class 5 or a 6 from the beginning of his hair loss process. It doesn’t have to go Norwood 2, then 3, then 4, and so on. A microscopic assessment of your hair (miniaturization study) will show much more than what your naked eye sees in the early stages of hair loss.

I’ve always read that we lose 50-100 hairs a day but how much of that hair comes from the scalp or do we really lose 50-100 hair from the scalp? It would certainly explain the 30+ strands of hair that gets caught on my comb whenever I brush my hair.

We typically lose 100 scalp hairs each day… and most of that loss may occur when you are outside with the wind blowing through your hair doing your everyday activities. We are born with approximately 100,000 hairs on our scalp. While you may be losing 100 scalp hairs a day, your body is also growing 100 scalp hairs that you cannot see to keep things on a balance.

If you’re seeing 30+ hairs each time you comb your hair, I have to wonder if you’re wearing a hat or using gel/wax that could trap the hair that would normally fall out during the course of your day. Or perhaps you’ve got some sort of hair loss.

I recently moved to US (bay area) and have been noticing a lot of hair fall. Slightly pulling my hair causes them to come out. I have no serious illness etc. What could be causing the increased hair loss?

Thanks!

It could be a variety of things. Perhaps it is your genetics and the timing was coincidental to the move… or it could be stress-induced (moving can do that)… or it could be allergy… etc, etc. I really have no way to know based on your email with limited information. You should see a doctor if you’re concerned.

Hi, Dr. Rassman. Thanks for answering all of our questions.

My question is, How likely is it for someone to “settle in” to a level of hair loss (Norwood 3A, for example) and not see any more rapid loss for a period of time (years, for example)? Do some people get to a certain level of hair loss beyond a mature hairline and stay that way without medication? Or is your fate essentially sealed after you reach a certain level?

Let me clarify what I see as your misunderstanding. The Norwood chart is not to be seen as a progression of hair loss chart, but rather the final patterns seen in a large male population.

Some people do seem to go from a Norwood class 3 to a 4 and then to a 5 pattern, but you may just “settle in” to your Norwood 3A state, as an example. There is really no 100% certainty, but a good doctor with a good miniaturization study and examination can give you a better assessment of what hair may go with time. Here’s the Norwood chart so we’re all on the same page:

Your “fate” was sealed in your genetic code when you were conceived many, many years ago. Very few patients become a Norwood class 7 pattern, and even the balding patients who start as a class 5 may not go much further, even at the age of 100 or so. So for example, there’s no “point of no return” that says if you reach class 4 by this certain age, you’re guaranteed to be a class 7 later in life.

I was born with a bald spot on the side of my head. About the age of 14 I noticed that some hair in the middle of the bald spot grew and is long. Now at age 23 it’s still there and some strands of hair if you look closely here and there. What caused this and why did some hair grew back.

I don’t have a clue without seeing just what you are talking about. I’ve gotten similar questions in the past, and the only thing I could think might’ve been the cause is a birthmark or some kind of trauma. As to why some hair grew in… again, I’d have no clue. Not everything can be explained (and I’m even more limited because this is the Internet and I’ve never seen you).

There are some areas where there are typical inherited patterns and others that are not typical. For those that are typical, we might be able to tell you more about the cause.