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You step into the shower and rinse your hair. You look down at the floor, and what do you see? A rather alarming number of strands that have drifted from your scalp.

Maybe you even notice clumps of hair in the bristles of your brush after your daily brushing.

Wherever it happens, excessive hair loss can be a troubling thing to deal with. If you’ve noticed clumps of hair falling out recently, here’s what could be going on inside your body and what you can do to treat it.

To understand hair loss, you need to understand hair growth.

There are three stages in the growth cycle:

  • Anagen. This is when hair is actively growing in length.
  • Catagen. This is when hair stops growing.
  • Telogen. This is when hair rests and eventually sheds.

Around 90 percent of your hair is in the anagen stage at once, and this growth phase can last for years.

The transitional phase, catagen, is much shorter —often only a few weeks —and telogen lasts for a few months.

There are around 100,000 follicles sprouting hair on the average scalp, and it’s common to lose up to 100 strands a day. Once an individual hair has shed, the follicle prepares for regrowth and the whole cycle starts again.

However, the cycle can be disrupted by the likes of aging and hormonal changes, such as menopause. As you age, some follicles no longer grow new hair, leading to a thinner look or bald patches.

Some conditions can also lead to an imbalance, where half of the hairs on the head enter the shedding telogen phase.

So what exactly is it that can lead to clumps of hair falling out? Well, there are plenty of potential culprits, and some people may have more than one issue at play.

Male and female pattern baldness

Some causes lead to permanent hair loss.

Male and female pattern baldness is one of these. One of the most common forms of hair loss, it’s often seen in more than one generation of a family.

Hormones, as well as genetics, can play a part, leading to smaller follicles that eventually stop making hair.

Men tend to notice a receding hairline and patches of hair loss on the top of the head.

For women, pattern hair loss results in thinning hair, particularly on the crown.

Stress

Stress — like that from a traumatic event, a health issue (like surgery), rapid weight loss, or pregnancy — can be a big factor in telogen effluvium.

Essentially, this means there’s temporary hair loss where more hairs enter the telogen phase than what’s typical.

It can be hard to determine stress as the cause, as the hair loss often doesn’t occur immediately, instead falling out 3 to 6 months later. That said, if you find yourself losing clumps of hair several months after a big event like the ones mentioned above, it’s a good bet stress is the culprit.

Diet

Low levels of iron, zinc, and vitamins B12 and D have been linked to hair loss. All seemingly have a role in stimulating hair growth or helping with follicle health.

Alopecia

Alopecia occurs when the immune system attacks the hair follicles, resulting in the hair falling out. Sometimes, the hair grows back on its own.

There are a few forms of alopecia:

  • Alopecia areata. This type causes patches of baldness.
  • Alopecia totalis. This type causes complete baldness on the head.
  • Alopecia universalis. This one is much rarer and causes the entire body to lose all its hair.

Thyroid disorder

Both overactive and underactive thyroids can make hair fall out in clumps. It can also go hand-in-hand with autoimmune conditions, like alopecia.

If left untreated, the hormonal changes caused can stop new hair strands from developing.

Other conditions and medications

Autoimmune diseases, like lupus and chronic infections, can also be to blame.

You may also find that medications, like chemotherapy medications, retinoids, beta blockers, and antidepressants, can lead to hair loss.

In a lot of cases, hair will grow back when you stop taking the medication.

According to the NHS, most forms of hair loss don’t need treatment. That’s because a lot of hair loss is either temporary or natural due to aging.

However, you may need to be patient. It can take months for hair to start growing back and even longer for it to look somewhat “normal” again (whatever that means for you).

That said, there are some approaches you can try to manage hair loss:

  • Look after your general health if your hair loss is caused by your lifestyle. Try to ensure you’re eating a balanced diet with enough protein (usually at least 50 grams a day), vitamins, and minerals.
  • Treat your hair and scalp gently, avoiding excessive heat styling and dying. Stick to gentle, sulfate-free products.
  • If you want to embark on specific hair loss treatment, know that no remedy is 100 percent effective. Options include minoxidil (aka Rogaine), a medication that can help counteract hair loss and slow down the likes of pattern baldness. However, you have to use it every day in order for it to be effective – if you stop using it, your hair loss will resume.
  • Try treating male pattern baldness with finasteride (Propecia), which reduces the DHT hormone for extra hair growth and less hair loss.
  • Consider steroid injections or creams and ultraviolet (UV) light treatment, which may have positive effects.

Remember: See a doctor if your hair is falling out in major clumps. They’ll be able to advise you of any effective treatment options.

Some forms of hair loss are hereditary or caused by illness, so there’s no foolproof way to prevent clumps from falling out.

But there’s no harm in taking a look at your current lifestyle and making some changes if necessary.

These changes could involve combating stress by exercising regularly or trying calming rituals, like yoga or meditation. You could also work on getting an adequate amount of sleep and enough nutrients by upping your fruit and vegetable intake.

Try to treat your hair with care, too. Stay away from potentially aggravating ingredients, like alcohol, and drying heat tools.

Losing clumps of hair can be particularly distressing. But there will always be an underlying reason, whether it’s a health condition, stress levels, or family genetics.

The best person to help you find the cause is a doctor or specialist dermatologist.

And remember: Most hair loss is temporary, and it will grow back eventually.


Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.