Hair Shedding: The types of hairs shed depend on the underlying diagnosis

Hair Shedding: What types of hairs should I expect to see?

If you follow the world of hair medicine, you’ve probably come to realize that somewhere between 25 and 100 hairs are normally released or “shed” from the scalp on a daily basis. The types of hairs that are normally released from the scalp are not always the same. The types of hairs differ according to the background type(s) of hair loss the patient has. 

To understand this better, let’s take a look at a helpful analogy. If I asked you to draw me a picture of the types of cars that were released from the car manufacturing factory, you’d probably tell me that you can’t really draw a proper picture unless I tell you what type of factory it is. Does the manufacturing factory make Toyotas? Do they make BMWs? Do they make Fords? Once tell you the factory is a factory that makes Bugatti Veyron Super Sport 16.4 cars, you can draw me a nice picture of these racing/sports cars being loaded on a transport truck ready to be  released to the sales center. 

 In fact, if I asked you to draw me a picture of the types of products that were released from any sort of manufacturing factory, you’d probably tell me that you can’t really draw a proper picture unless I tell you what type of factory it is.  

And so, if I ask you to draw me a picture of the types of hairs that are released from the scalp it should come as no surprise that you should respond by asking me “What type of scalp does the patient have? Does the patient have any underlying hair loss issues?” In other words, you should be asking (and thinking) “What type of manufacturing factory is up there in the scalp?”

 The normal scalp manufactures and releases thick and long hairs. These are called “terminal telogen hairs.” They are around 70-90 micrometers in thickness. And so, if I tell you the patient has no underlying hair loss issues, you might draw a picture like the one on the left. However, the hairs that are released from the scalp in patents with androgenetic alopecia are different. What gets released is a mix of thinner “miniaturized” hairs (so called “telogen miniaturized hairs”) and very short vellus hairs (so called “telogen vellus hairs”) like shown on the right side of the diagram. The more advanced along the course of balding, the thinner hairs and the more tiny vellus hairs that will be seen. 

The types of hairs that are shed from the scalp depend on the patient’s type of hair loss.