My hair is suddenly falling out a lot. What do I do first?

If your hair is suddenly falling out a lot, start by looking at how it is falling out, all over the head or in patches, and think back over the last two to four months for something that was hard on your body or mind, such as an illness, heavy stress, giving birth or weight loss. The UK's NHS says most hair loss is either temporary and grows back, or a normal part of getting older. In the meantime, wash, brush and dry your hair gently, avoid tight styles and high heat, and see a doctor if you are worried, especially if hair comes out suddenly, in clumps or in patches, or your scalp itches and burns.

This article is for both women and men. For each cause in women in detail, read Why do women lose hair, and how much is too much?. For men whose hair is gradually thinning at the temples or on top, read Hairline receding at 30: what can men do day to day?

How much hair loss counts as a lot?

The UK's NHS says losing 50 to 100 hairs a day is normal, often without noticing, and MedlinePlus, from the US National Library of Medicine, says you lose up to 100 hairs from your scalp every day and that in most people those hairs grow back. "A lot" means clearly more than your usual amount, for example:

• Much more hair than usual on your pillow, brush or drain for several days in a row
• Hair coming out in handfuls when you wash, brush or run your fingers through it
• A smaller ponytail, or more scalp showing along your parting or hairline

All over, or in patches?

How the hair is falling out is the first thing to check, because it tells you what to do next. The rows marked "See a doctor" are the signs that nidirect, the Northern Ireland government's information site, says should be seen by a GP.

My hair is suddenly shedding. What should I look back at first?

A 2020 review of temporary hair shedding in Cureus says hair usually starts falling out two to three months after the trigger, because affected hairs first move into a resting phase and only fall out when it ends. That is why many people do not connect the two. Write down what happened in the months before you noticed.

Events in recent months

The causes in women are covered one by one in Why do women lose hair, and how much is too much?, and the months after giving birth and other hormone changes in Women's hair loss from hormone changes: when and how long?.

After giving birth

In a survey of women in Japan answered 10 to 18 months after giving birth, women who had shedding after the birth said that, on average, it started about 2.9 months after the birth, peaked at about 5.1 months and ended at about 8.1 months. The researchers note that women with shedding may have been more likely to answer.

If you take a regular medicine

If you think a medicine you take may be linked to your hair loss, talk to your doctor or pharmacist before changing anything, and do not stop it yourself.

Keep a note

The NHS says a GP may be able to tell what is causing your hair loss by looking at your hair. It helps to bring notes on:

• Roughly when you noticed more hair falling out
• Whether any of the events above happened in the two to four months before
• Any new medicines, hair treatments or hairstyles

Photos of your parting and hairline taken in the same light every so often make changes easier to see.

While my hair is shedding, how should I wash, brush and dry it?

Hair that falls out from the root after an event like those above usually slows down by itself over time. What you can do meanwhile is avoid losing extra hair to pulling and breakage. A good hair care leaflet from the dermatology department of Gloucestershire Hospitals, part of the NHS, gives this advice:

Wash with your fingertips

The leaflet advises washing and conditioning your hair with your fingertips, because using the palms of your hands can damage it, and avoiding massaging the scalp when washing because this can pull on the hair. It suggests using conditioner every time you wash, since it coats the hair and leaves a smoother surface.

Comb with your fingers or a wide-toothed comb

It recommends your fingers or a wide-toothed or detangling comb instead of a brush, because this reduces tugging and is gentler on your hair.

Let it dry naturally, or use low heat

The same leaflet says it is best to let your hair dry naturally, that gently wrapping it in a microfibre towel helps it dry more quickly, and that if you use a hairdryer you should use the lowest heat and power setting to avoid weakening the hair. A 2017 report in the International Journal of Trichology describes how high heat on wet hair can form gas bubbles inside the hair, leaving it dry, brittle and prone to breaking, in a woman who regularly blow-dried damp hair. Hair that snaps along its length has not come out at the root, but it can make hair look thinner.

Hairstyles that do not pull

A review of hair loss from hairstyles says the risk rises with how hard and how long the hair is pulled, and with chemical relaxing. Tight buns or ponytails worn often, extensions and tight braids are the highest-risk styles. The dermatology leaflet above also advises avoiding wearing your hair tightly pulled back in a bun, ponytail or braids.

How long until my hair comes back?

Shedding after an event is usually temporary and slows down by itself once the cause has passed. nidirect says much the same.

These are averages from research, and people differ. If heavy shedding is still going on after six months, see a doctor. The Cureus review describes shedding that lasts longer than that as a separate, ongoing form.

My hair looks very thin. How can I make it look less thin while I wait?

While you wait for the shedding to stop, a different hairstyle, a new parting or a hat can make thin hair less noticeable.

Wigs

The NHS describes two kinds of wig.

Before trying anything new

Hair loss has many possible causes, so it helps to know the cause first. Ask a doctor before starting to take or use anything new, especially if you are pregnant, breastfeeding or take regular medicines. The NHS also advises seeing a GP to get an idea of the cause before going to a commercial hair clinic.

When should I see a doctor, and what will they look at?

You can see a doctor whenever you are worried about your hair. nidirect advises seeing a GP if:

• you have sudden hair loss
• you develop bald patches
• you are losing hair in clumps
• your head also itches and burns
• you are worried about your hair loss

It is also worth going if heavy shedding has not stopped after six months, or you notice other changes in your body at the same time.

What happens at the appointment

The NHS says a GP may be able to tell what is causing your hair loss by looking at your hair, and suggests telling them if your hair loss is affecting your wellbeing. Bringing your notes and photos makes the conversation easier.

If hair loss is getting you down

The NHS says hair loss can be distressing, and that counselling, support groups or online forums can help.