Hair Fall in Men and Women: What Is Normal and What Is Not?

Hair fall is one of the most common reasons patients walk into my clinic, and it's also one of the most anxiety-inducing. Every patient who comes to Skintressa with hair concerns asks the same questions: "Is this normal?" "Will I go bald?" "Can it be treated?"

After years of managing hair loss cases and training in hair transplantation as part of my IADVL fellowship, I can tell you this with certainty: not all hair fall is equal. Understanding what's normal versus what requires intervention is the first step to protecting your hair.

How Much Hair Fall Is Normal?

Let me start with a basic fact: you're losing hair right now. As you read this, hairs are falling from your scalp. This is completely normal.

The normal hair growth cycle means losing 50–100 hairs per day. These hairs naturally shed and regrow within 3–6 months. Most people never notice this because it's distributed throughout the day—a few in the shower, a few while combing, a few on your pillow.

But here's where it gets important: concern arises when you notice a change from your baseline.

Red flags that indicate abnormal hair fall:

At Skintressa, I use a simple assessment: if you're seeing significantly more hair on your pillow, in your shower drain, or in your brush than usual—or if others are commenting on visible thinning—it's time for an evaluation.

Understanding the Hair Growth Cycle

Before diving into causes, it's important to understand how hair grows. The hair growth cycle has three phases:

Anagen (Growth Phase): Hair actively grows for 2–6 years. About 85–90% of your scalp hair is in this phase.

Catagen (Transition Phase): Hair stops growing and begins to detach from the follicle. This lasts 2–3 weeks.

Telogen (Resting Phase): Hair rests in the follicle for 2–3 months before shedding. About 10–15% of hair is in this phase.

When something disrupts this cycle, multiple hairs can shift from anagen to telogen prematurely. This is why you notice sudden, excessive shedding 2–3 months after a stressful event—even if you can't immediately connect the two.

Common Causes of Hair Fall

Understanding the cause is everything. Different causes require completely different treatments. Let me walk through what I see most commonly in my practice.

1. Telogen Effluvium (Stress-Induced Hair Fall)

This is temporary hair shedding triggered by physical or emotional stress. Common triggers include:

How it presents: Patients often describe sudden, noticeable hair fall 2–3 months after the triggering event. The good news? It's usually reversible.

In my practice, I counsel patients that telogen effluvium typically resolves within 3–6 months once the stressor is managed. I focus on stress reduction, ensuring adequate nutrition, and sometimes adding supportive treatments like vitamins or scalp therapies.

2. Nutritional Deficiencies

Hair is made of protein, and it's metabolically demanding. When your body lacks key nutrients, hair growth suffers. I screen for these commonly:

Iron Deficiency: Low ferritin (iron stores) is one of the most common causes of hair fall, especially in women. Menstrual bleeding, vegetarian diets without proper iron supplementation, or malabsorption can deplete iron. Without adequate iron, hair follicles can't maintain the anagen phase.

Vitamin D Deficiency: Multiple studies show correlation between low vitamin D and hair loss. In India, despite abundant sunlight, many people have suboptimal vitamin D levels due to sun avoidance, dietary factors, or malabsorption.

Protein Deficiency: Hair is primarily made of keratin (a protein). Crash diets, restrictive eating, or insufficient protein intake directly impacts hair quality and growth.

Zinc, B12, and other micronutrients: These cofactors are essential for hair follicle function.

My approach: Before prescribing any hair treatment, I recommend basic blood work—hemoglobin, iron profile (serum iron, ferritin, TIBC), vitamin D, vitamin B12, and thyroid function. I've corrected many cases of hair fall simply by addressing nutritional deficiencies.

3. Hormonal Imbalances

Hair is highly sensitive to hormones. Several conditions can trigger hair loss:

Thyroid Disorders: Both hyperthyroidism and hypothyroidism can cause hair fall. The hair cycle is disrupted when thyroid hormones are abnormal.

PCOS (Polycystic Ovary Syndrome): The androgen excess in PCOS can cause androgenetic alopecia in women—hair loss that resembles male pattern baldness but occurs in women with hormonal disorders.

Pregnancy and Postpartum: Pregnancy increases estrogen, which keeps more hairs in the anagen phase. After delivery, estrogen drops suddenly, causing postpartum telogen effluvium. Patients are often shocked by hair fall 3–4 months postpartum, but it's usually temporary.

Menopause: Declining estrogen can trigger or worsen androgenetic alopecia in women.

Oral Contraceptives: Some hormonal contraceptives can trigger hair fall, particularly those with androgenic progestins. If you notice hair loss after starting birth control, inform your dermatologist and gynecologist.

At Skintressa, if I suspect hormonal causes, I collaborate with endocrinologists or gynecologists to optimize hormone levels, which often improves hair growth.

4. Androgenetic Alopecia (Genetic Pattern Hair Loss)

This is the most common cause of hair fall, affecting both men and women. It's driven by genetic predisposition and sensitivity to DHT (dihydrotestosterone), an androgen metabolite.

In men: Typically presents as receding hairline, crown thinning, or both. Can progress to significant baldness if untreated.

In women: Often presents as diffuse thinning on the crown and parting, rather than receding hairline. Many women don't realize they have androgenetic alopecia because it doesn't look like male pattern baldness.

The critical point about genetic hair loss: early treatment is preservation therapy. Once a hair follicle miniaturizes (shrinks), it can't recover. The goal of early treatment is to prevent further miniaturization and ideally stimulate regrowth in partially affected follicles.

5. Scalp Conditions

The health of your scalp directly impacts hair. Several scalp conditions increase hair fall:

Seborrheic Dermatitis: Chronic inflammation of the scalp with dandruff, redness, and itching. The chronic inflammation can push hairs into telogen phase prematurely.

Fungal Infections: Conditions like tinea capitis (fungal scalp infection) cause inflammation and hair loss. Untreated fungal infections can scar the scalp, leading to permanent hair loss.

Psoriasis of the Scalp: Autoimmune inflammation affecting the scalp can increase hair shedding.

Folliculitis: Bacterial infection of hair follicles causes inflammation and temporary hair loss. Recurrent folliculitis (often from poor hygiene, excessive sweating, or immunosuppression) can eventually damage follicles.

At Skintressa, scalp evaluation is part of every hair consultation. I examine the scalp with dermoscopy to identify underlying inflammation, infection, or conditions that need specific treatment.

6. Other Medical Conditions and Medications

Sometimes hair fall is a symptom of underlying disease or medication side effect:

Autoimmune Conditions: Alopecia areata, lupus, and other autoimmune diseases can cause hair loss.

Medications: Some blood pressure medications, chemotherapy, anticoagulants, and certain psychiatric medications can trigger telogen effluvium.

Chronic Illness: Diabetes, thyroid disease, or systemic infections can impact hair growth.

This is why thorough history-taking and, sometimes, investigations are important.

When Is Hair Fall NOT Normal? When to Consult a Dermatologist

You should schedule a consultation if you experience:

Don't wait for complete baldness. Early consultation dramatically changes outcomes.

Why Early Treatment Is Critical

This is perhaps the most important message I share with patients:

Hair follicles don't regenerate. Once a follicle is damaged or completely miniaturized, it cannot be restored with medication alone. The goal of early treatment is preservation and stabilization—preventing further loss and ideally stimulating regrowth in follicles that still have potential.

The progression problem: Without treatment, hair loss typically worsens over time. What starts as subtle thinning at the crown can progress to significant baldness. In women with androgenetic alopecia, if untreated for years, the hair loss can become severe enough to cause emotional distress and significantly impact quality of life.

Early intervention means:

I've seen patients delay treatment by years due to denial, cost concerns, or not recognizing the severity. Then they arrive at my clinic with extensive hair loss that could have been prevented with early intervention. This is preventable suffering.

Personalized Treatment Approach at Skintressa

Treatment for hair fall is not one-size-fits-all. At Skintressa, my approach is systematic:

Step 1: Thorough Diagnosis

Step 2: Address Root Causes

Step 3: Medical Treatment

Minoxidil (topical): Stimulates hair growth and prolongs anagen phase. Effective for both androgenetic alopecia and other causes. Takes 3–4 months to show results.

Finasteride (oral, for men): Blocks DHT conversion, slowing androgenetic alopecia. Most effective in early stages.

Anti-androgens (for women): Sometimes prescribed for hormonal hair loss.

Targeted scalp treatments: Anti-dandruff, anti-inflammatory, or antifungal treatments as needed.

Step 4: Advanced Therapies

PRP (Platelet-Rich Plasma): Harnesses growth factors from your own blood to stimulate hair follicles. I recommend PRP for patients with early to moderate hair loss who want an extra boost.

GFC (Growth Factor Concentrate): A newer, more concentrated form of growth factor therapy. Some patients respond better to GFC than PRP.

Mesotherapy: Microinjections of vitamins, minerals, and medications directly into the scalp.

Laser therapy: Low-level laser stimulates hair follicles and reduces inflammation.

Step 5: Hair Transplant (if needed)

In advanced androgenetic alopecia where significant permanent hair loss has occurred, hair transplant is an excellent option. As someone trained in hair transplantation, I can discuss whether you're a candidate and what to expect.

The key: early detection means you might never need transplant.

Common Myths I Address in Clinic

Myth 1: "Oiling will stop genetic hair loss"

Reality: Oiling is beneficial for scalp health and might reduce breakage, but it cannot reverse genetic miniaturization. If you have androgenetic alopecia, you need minoxidil or finasteride—not coconut oil.

Myth 2: "Shampoos can cure hair fall"

Reality: Shampoos can support scalp health, but they cannot treat the root cause of hair loss. Using an anti-dandruff shampoo might help if dandruff is causing shedding, but it won't address nutritional deficiency, hormonal imbalance, or androgenetic alopecia.

Myth 3: "Frequent hair washing causes hair loss"

Reality: Washing hair doesn't cause hair loss. You might see more fallen hairs in the shower because of the physical manipulation, but this is shedding that would happen anyway. Clean hair and scalp are actually important for hair health.

Myth 4: "Hair loss always means you're going bald"

Reality: Not all hair loss is permanent. Telogen effluvium, nutritional deficiency, and scalp conditions often cause reversible hair fall. Even with androgenetic alopecia, early treatment can significantly slow or halt progression.

Myth 5: "Hair grows back on its own"

Reality: Some causes of hair fall do resolve (telogen effluvium after stress, postpartum shedding). But progressive conditions like androgenetic alopecia worsen without treatment. Waiting doesn't help—it makes things worse.

Men vs. Women: Different Presentations

Hair loss presents differently in men and women, and the psychological impact is equally significant.

Men with hair loss:

Women with hair loss:

At Skintressa, I emphasize that hair loss in women is common, treatable, and nothing to be embarrassed about. Many of my female patients have excellent responses to treatment when addressed early.

Red Flags Requiring Urgent Consultation

Seek dermatological care sooner if you have:

The Bottom Line: Timing Is Everything

In my years of practice, the most common regret I hear from patients is: "Why didn't I come earlier?"

Hair loss is one of the few dermatological conditions where early intervention truly changes outcomes. This isn't about cosmetics—it's about preserving what you have and potentially recovering what you've lost.

The message is clear: if you notice changes in your hair, don't wait. Early diagnosis and treatment can save your hair.

At Skintressa, we approach hair fall with:

Your hair matters—not just aesthetically, but for your confidence and well-being. Let's preserve it.

Schedule your hair consultation at Skintressa today.

Dr. Bharti Aggarwal is a Consultant Dermatologist with specialized training in hair disorders and hair transplantation (IADVL Fellowship). She founded Skintressa to provide evidence-based, personalized care for hair loss, combining clinical expertise with advanced therapeutic options.