What are the early signs of hair loss?

What are the early signs of hair loss? With most hair loss conditions the prognosis is better if the condition is treated as early as possible. It would be useful to be able spot the early signs, so you can visit a Trichologist to get the condition diagnosed and possibly treated.

As a Trichologist, a condition I see regularly is reflective hair loss. This generally presents as diffuse thinning of the hair, often the first signs the patient will notice are a general lack of body and volume in the hair. Being able to see the scalp through the hair. When the hair is shampooed ,more hair than usual is noticed in the basin drain, if the hair is combed or brushed afterwards, hair will be noticed in the brush or comb. Hair on the pillow in the morning or on furniture. I actually see patients who have collected all this excessive hair loss and bring it with them to show me, this is not necessary as I can usually see for myself what has happened when I observe the empty follicles in the scalp.

When some autoimmune hair loss conditions start, there can be small areas of denuded scalp (bald) often the patient hasn’t noticed this  for them selves, it is usually the hairdresser who notices when the hair is sectioned during cutting. Some of these conditions involve inflammation of the scalp and the patient will notice the scalp has become sore, prompting then to notice the hair loss.

The classic male and female hair loss tend to start in a specific way, in female pattern baldness it tends to be the top of the head where the loss is first noticed, giving the look of a wider parting and yet the front hair line is often retained. In male pattern hair loss its usually the classic bi temporal recession ,where the front hairline recedes. Often at the same time the hair will look thinner at the crown. There are scales which have been developed to chart the progress of androgenetic hair loss, Ludwig for women and Hamilton for men, the early stages are shown as i or ii. Just to add a little confusion some men present with a female pattern loss and some women with the male patten. This is where the Trichologist can help to identify and categorise. Any of the treatments for androgenetic hair loss, have better efficacy if the treatment is started early.

Some forms of traction alopecia, where the patient inadvertently pulls the hair out when tying the hair back or from having hair extensions in for a prolonged period of time. This can start as the hairline moving further back, there can also be an appearance of wispy hair that has broken off. Counterintuitively this appearance of wispy broken hair can be the hair be regrowing as in reflective hair loss for example. meaning the patient has lost some hair and the hair has started to recover before the patient has notice it. So rather ironically, recovery of hair loss can be one of the first sign that the patient notices they have some hair loss.