Research Team

Early Signs of Hair Loss | Diagnosis, Causes & Treatments

Although hair loss is not fully understood by mainstream science yet, there’s one thing all experts agree on:

It is much easier to keep the hair you already have than to regrow lost hair.

There are a few reasons for this, which will be discussed later in this article, but the point is that those with early stage hair loss should act now to prevent further loss or face a much tougher time in the future trying to get back hair that’s already gone.

For those at an early stage of losing their hair, this article will show you how to properly diagnose whether you are losing hair permanently or just going through a shedding phase.

Sometimes, even the lighting of a particular mirror can make it seem like you’ve lost hair, when in fact, your hair is as healthy as ever.

We’ll get to the bottom of each particular type of hair loss in this article.

If it does appear you’re losing your hair, you’ll learn about the possible causes so you have an informed understanding of what you can do next.

Finally, this article will review specific actions you can take which may help prevent further loss of hair and protect your hair well into the future.

Are You Balding or Just Going Through a Phase?

It’s easy to get overly-focused on whether your hair is thinning or not — after all, this is your hair we’re talking about.

But a few hairs on the pillow is not necessarily a sign that you’re going bald — there’s usually more than one factor that you can consider when deciding whether or not your hair is thinning.

Let’s examine the most common signs of early balding.

Hair Loss in a Pattern

Androgenetic Alopecia (AGA) is called Male Pattern Baldness (MPB) for a reason.

The typical pattern of AGA sees hair thinning at the temples and the forehead in a horseshoe shape, where it eventually recedes.

The wispy, thin character of the hair in these areas is due to a process called hair follicle miniaturization, which is characteristic of AGA (1).

In short, you can have a sensitivity to the androgen hormone, di-hydrotestosterone, or DHT. This sensitivity causes inflammation of the hair follicle, resulting in thinner, weaker hair, and finally, hair loss (2).

In addition, DHT can cause hair to go into the resting, or telogen phase, so when hair falls out it isn’t replaced with new growth.

Excessive Shedding

Seeing hair in the shower or on your pillow is normal. In fact, you can lose up to 100 hairs per day (3).

If you’re losing more than that, or your hair is falling out in clumps, you may be experiencing Telogen Effluvium (TE), which is a temporary hair loss that occurs one to six months after a stressor (4).

You could also be suffering from another type of hair loss, Alopecia Areata (AA) (5).

However, for females with Female Pattern Hair Loss (FPHL), excessive shedding can indeed be a sign of thinning.

In a study conducted in 2016, women were asked to choose from pictures of hair clumps representing the amount of hair shed per day. The least amount was shown in Picture 1, and the greatest in Picture 9 (6).

Researchers discovered that women with no FPHL had mean shedding scores of 2.5 for short hair, 2.35 for medium hair and 2.4 for long hair. This means the amount of hair they shed was closest to that in Picture 2, generally. Picture 2 contains few hairs.

Women with FPHL had mean shedding scores of 7.25 for short hair, 7.0 for medium hair and 7.14 for long hair. This group lost the amount of hair closest to Picture 7. Picture 7 contains considerably more hairs than Picture 2.

Itchy, Flaky Scalp

If you find that you’re scratching your head more often or you see little white flecks on your scalp, you could have a build-up of sebum.

Sebum is a naturally-occurring substance produced by the sebaceous glands located alongside your hair follicles (7).

Sensitivity to DHT and other factors, like improper hygiene, can cause overproduction of sebum. This can lead to clogged follicles and can increase your chances of hair loss (8).

Slow Growing Hair

If your hair seems to take forever to grow out after a haircut, it might be because more of your follicles are entering the resting phase, where there is little growth.

Many people with MPB, particularly at the early stages, will have more hair in the telogen phase, causing slow growth (9).


Do people in your family (either side) have a history of baldness? If so, the hair loss you’re seeing might be a sign that you are genetically predisposed to MPB (10).

If you see one or more of these signs, you may have early hair loss.

Treating hair loss at the earliest sign is important, since keeping the hair you have is easier than getting back what you’ve lost.

Before we talk about ways to encourage hair health and growth, let’s examine some common types of hair loss.

The Different Types of Hair Loss

Hair loss can be caused by many different factors. Also, you can have more than one of these factors contributing to your hair loss at any given time.

Each type of hair loss is managed differently and can manifest in specific instances. Some are easier to treat, and reverse, than others.

Let’s examine the main causes of hair loss.

Androgenetic Alopecia

Androgenetic Alopecia (AGA) is the most common cause of hair loss among men and women (11).

AGA is characterized by the miniaturization of follicles in a classic “M-shaped” pattern for men, and a diffuse thinning pattern for women, that occurs due to a combination of sensitivity to DHT and genetic factors.

The age of onset is typically in the 30s and 40s, but hair loss often manifests immediately after puberty and continues progressively (12).

Long-term hair loss of this type often leads to follicle death, meaning that no regrowth is possible. This means that it’s even more critical to nurture your follicles while they are still producing hair (13).

Alopecia Areata

Alopecia Areata (AA) in an autoimmune disease that has fascinated immunologists, dermatologists, and researchers for decades.

Despite much research, the pathobiology of AA is uncertain, with no universally accepted idea on pathogenesis among physicians.

In fact, some investigators wonder if AA is, in fact, an autoimmune condition, or if it’s a pattern of response by normal hair follicles to damage that has been immunologically mediated (14).

Typically, AA manifests as round patches of hair loss on the scalp and is thought to have an inflammatory component. There are two other types of AA: Alopecia Totalis and Alopecia Universalis.

In Totalis, the subject experiences total baldness of the scalp; in Universalis, all of the hair on the body is lost (15).

Hair regrowth sometimes occurs spontaneously in AA, and, unlike AGA, follicle death is uncommon. Generally, follicles are simple irritated and inflamed to the point at which they cease to function.

Other symptoms associated with AA include burning, itching, or throbbing scalp and even small dents in your fingernails (16).

Traction Alopecia

Traction alopecia is caused by wearing tight braids, hair weaves, and even hats — anything that exerts a pulling force on the hair (17).

Traction can contribute to hair thinning and hairline recession in two ways.

Sometimes, the entire shaft of hair is removed. If you see a small, white bulb on the end of a fallen hair strand, you’ll know that this has occurred.

In other cases, the traction causes hair breakage. This is characterized by a lack of the white bulb and shortened, frizzy hair ends.

Areas in which the pulling is significant enough to cause removal of the shaft can be subjected to inflammation, which can contribute to hair miniaturization and eventual loss (18).

Hairs that are constantly under stress from an external force are also less likely to be able to uptake needed nutrients, leading to weak hair and loss.

Telogen Effluvium

Your hair has three stages in each cycle of growth. They are (19):

  • Anagen. The phase of active growth and the longest stage of the cycle, lasting anywhere from 3 – 5 years.
  • Catagen. The transitional phase and the shortest in the cycle, lasting only about 10 days.
  • Telogen. The resting phase which includes shedding, lasting a few weeks to a few months.

In individuals with healthy scalps, only a small portion of their follicles are in telogen phase at any given time. The majority are in anagen.

When it comes to hair loss conditions, though, the number of follicles in the telogen phase can increase. As such, more hair than the usual 80 – 100 per day is shed. This leads to thinning.

Telogen effluvium (TE) can be a sign of early balding, or it can be a response to a stressor that occurred one to six months prior to the hair shed. Typical stressors include dieting, illness, hormonal changes, hospitalization, or an extreme emotional event (20).

Nutritional Deficiencies

Nutrition has an enormous impact on hair health. Hair loss has been associated with a host of deficiencies, including (21):

  • Iron
  • Niacin
  • Zinc
  • Selenium
  • Vitamin D
  • Omega-3 fatty acids
  • Amino acids
  • Antioxidants

In addition, eating processed foods, foods high in saturated fat, foods fried in greasy oils (i.e., the standard Western diet) results in a low-quality, low-nutrient diet that is poor nourishment for healthy hair (22).

Hormonal Imbalances

AGA is thought to be caused by a sensitivity to the androgen hormone, DHT. DHT is, in turn, related to testosterone levels (23).

Other hormones – like testosterone, estrogen, and progesterone – can play a key role in hair thinning and loss for both men and women (24)(25)(26).

Hormonal imbalances tend to occur at puberty and also at meno- or andropause, two times when hair loss is exacerbated (27)(28).

Hormone therapy can be used to mitigate, or reverse, hair loss in some individuals (29)(30)(31).


A hospital stay or injury, which is a stress to the body, can result in TE that is temporary. However, there are several diseases and conditions that have thinning hair as a hallmark. These include:

  • Polycystic Ovary Syndrome (PCOS)
  • Hyperthyroidism (including Grave’s disease)
  • Hypothyroidism (including Hashimoto’s)
  • Lichen Planus (skin rash)
  • Hodgkin’s disease (a blood cancer)
  • Hypopituitarism (low pituitary function)
  • Lupus (systemic autoimmune disease)
  • Addison’s disease (damage to the adrenals)
  • Celiac disease (gluten intolerance)
  • Syphilis (sexually transmitted disease)

Of course, there are numerous other medical conditions that can affect the health of your hair, but these are some of the most prevalent.

There are also medications that can cause hair loss, such as:

  • Chemotherapy
  • Hormones
  • Beta-blockers
  • Anti-depressants
  • Anti-clotting medications
  • Gout medications

There are many others that can cause both short- and long-term hair loss, particularly if a patient happens to have a sensitivity to one or more substances in the medication (32)(33)(34).


Chronic stress and anxiety take a toll on your body – and your hair. Stress impacts hormone regulation, resulting in hormone imbalance (35).

In addition, evidence suggests neurohormones, neurotransmitters, and cytokines released during stress can significantly influence the hair cycle, contributing to loss and thinning (36)(37).

Things to Do Now to Preserve Your Hair

Now that you understand how to determine if your hair loss is actually early balding and, if it is, what might be the cause — it’s time to discover the things you can do to increase your chances of stopping — and even reversing — the loss.

Proper Hygiene

Washing your hair every day can cause over-production of sebum and contribute to hair loss. In addition, many shampoos contain chemicals that are harsh and may strip your hair and scalp of natural oils (38).

Wash your hair no more than four times per week (one to two times is optimal) and use a simple apple cider vinegar rinse, rubbed into the scalp, or a caffeine shampoo with natural ingredients to boost growth.


Microneedling has been used extensively for anti-aging and wrinkle prevention. Now, it’s been studied — and found effective — for hair growth.

Microneedles Can Stimulate Skin Cell Proliferation

The dermaroller and dermastamp are devices used to make tiny pin pricks in the skin. The pricks penetrate into the dermal layer, just deep enough to stimulate new cell production and boost circulation, but without causing damage or pain.

The process is also known as ‘microneedling’.

In 2012, American researchers explored the role that microneedling had on skin cell proliferation. This is beneficial in the treatment of wounds, scars, hyperpigmentation, and even in hair growth (39)(40).

Since then, numerous other studies have confirmed the efficacy of microneedling for stimulating hair growth (41)(42)(43)(44).

Now, back to the devices and how to use them.

The dermaroller is a rolling drum covered in tiny needles that you pass over your scalp, while the dermastamp is a rectangular block embedded with tiny needles. The block is at the end of a handle for ease of use.

Aside from the obvious structural differences, the dermastamp has some benefits over the roller.

In particular, the stamp is easier to manipulate when using it on yourself. This is especially true for hard-to-reach areas, such as the sides and back of the scalp.

The dermastamp also presents less risk of damaging the surrounding hair follicles and removing healthy hair strands, which can occur with the dermaroller if hair gets wrapped around the drum during use.

In addition, some dermastamps are adjustable so you can choose the right length needles for optimal results.

After you use your dermastamp or dermaroller, you’ll want to follow up with your topical products, as they are more easily absorbed after microneedling.

However, it’s best to wait at least six hours before applying topical solutions to avoid burning or stinging sensations.

Massage and Exercises

Scalp massage and exercises can be performed daily and they work by increasing blood flow as well as stretching your dermal papilla cells to stimulate hair follicles (45).

How to Perform Scalp Massage

You can use either a scalp massager or your fingers to stimulate circulation.

A scalp massager is a metal tool with rubber caps that can be used to massage the scalp in multiple places at once. To use, place the massager on the outer edges of your hairline and around the scalp, and slowly move the tool up and down.

While the scalp massager can be useful, it isn’t the most effective at targeting specific areas of the scalp. To do that, you can use your fingertips.

Begin by placing your thumb, index, and middle fingers on the sides of your scalp. Use gentle, circular motions to move your fingers around the area, and then slowly move them towards the crown.

Continue these movements for one to two minutes in each location, and then move onto the hairline, back to the sides of the head, and finally to the base of the skull.

In total, the massage should take 10 minutes per session.

How to Perform Scalp Exercises

To further increase blood circulation and to reduce tension, scalp exercises can also be included in your hair care routine. These will help to improve skin elasticity as well.

To perform scalp exercises, place your thumb and index finger on your scalp a few inches apart. Gently pull your thumb and index fingers together without lifting them from the skin. You can then slowly increase the distance between the fingers until they’re back in their original positions.

These movements will slowly stretch the skin. You can also use your muscles – namely, your eyebrow muscles – to further induce stretching. Here’s how.

  1. Using your eyebrows, slowly lift them up towards the hairline as high as they can go. Hold in place for one minute, and then return them to neutral position. You can repeat this movement 5 – 10 times per session.
  2. Next, furrow your eyebrows deeply and hold in place for one minute. Return them to neutral position, and repeat as needed.

You can also alternate exercises, first by lifting your brows and then furrowing them without stopping in the neutral position first.


The above techniques are a great start when it comes to addressing the issue of early hair loss. However, they may not always put a stop to recession. One way to do so is with the help of the FDA-approved hair loss drug minoxidil (46).

Minoxidil, more commonly known by the brand name Rogaine, is a topical solution that is applied to the scalp daily. It’s not known exactly how the drug works, though lengthening of the hair growth cycle and increasing blood circulation are both believed to play a role (47).

Most importantly for hair loss sufferers, minoxidil has been shown to slow hair loss and even promote hair growth (48).

This has been proven in both short-term and long-term studies (49, 50).

How to Use Minoxidil

If you decide to add minoxidil to your hair care routine, then you’ll want to be sure to use it most effectively.

Minoxidil is available in two formulations: liquid solution, and foam. Even further, the liquid solution is available over-the-counter in 2 percent and 5 percent strengths.

So, which should you use for best results?

For sufferers of early hair loss, the lower-strength solution is likely to be enough to maintain their hairline while also reducing the risk of side effects.

This is especially true for women, as minoxidil 2 percent is the only strength approved for their use.

To use minoxidil, you’ll simply apply to the scalp each morning. On a dry scalp, use the dropper to apply the liquid solution to the treated area. Let dry (about 20 minutes) and then continue with your usual styling routine.

If you’re using the foam, you’ll apply half a capful onto the affected area and massage in. And just as above, wait until the area dries before continuing with your usual hair care routine.

Do not shampoo your hair for at least four hours after applying.


Not all hair loss means you’re heading for early balding, but the faster you catch progressive hair thinning, the easier it will be to maintain, and even reverse, your hair loss.

There are many factors that can contribute to hair loss — from a genetic predisposition to disease, deficiencies, stress, and even diet.

If you’ve determined you are experiencing abnormal loss of hair, it’s critical to begin treating your loss immediately for best results.

As you’ve read, proper hygiene goes hand-in-hand with scientifically proven therapies such as dermarolling, massage, and minoxidil to give your hair the help — and health — it needs for vigorous growth.

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