Reader question: How can I tell if I’m facing hair loss or hair thinning? Do they require different treatments? —Carolyn Rutherford When your scalp starts to become more visible and hair begins to feel less present, it can be difficult (and stressful!) to pinpoint exactly what’s going on. Hair loss and hair thinning in particular are often jumbled up in the same category, but there is a distinction to be made between the two. Hair loss is probably the most self-explanatory—it’s when you lose hair at the root. It’s important to note that everyone goes through some level of hair loss that is totally normal—in fact, we lose up to 100 strands of hair a day. However, hair loss can become concerning when it becomes excessive—“this can happen for a variety of reasons and can be/usually is temporary until the cause is resolved,” says William Gaunitz, FWTS, certified trichologist and founder of Advanced Trichology. On the other hand, hair thinning is when the density of hair becomes thinner and more brittle, and hence falls out faster. “Hair thinning is a prolonged decrease in the density of the overall volume of hair,” says Gaunitz. This is a more gradual process and is typically followed by a receding hairline from the crown. Hair thinning happens naturally with old age, so it’s a bit more difficult to avoid. And then there’s hair breakage, which is different from hair loss and hair thinning mainly in that it does not happen at the root. “While hair loss and hair thinning is an issue with the absence of hair growing from the scalp and hair follicle, hair breakage is a break in the hair shaft below the surface of the scalp, which can be caused by a variety of reasons, including a malformation of the hair shaft itself, chemical treatments, excessive tugging, or styling issues,” says Gaunitz. Since hair breakage is the easiest to resolve, we’ll start from there. “Breakage is usually our fault (i.e. not naturally caused); it’s from some sort of chemical or heat damage,” says Stephanie Angelone, master stylist at RPZL Hair Extension & Blowout Bar in New York. Damaged hair is more prone to becoming brittle and snapping off, so it’s important that you’re enforcing extra protection via a very good leave-in conditioner and heat protector. “I recommend more intensive coconut oil treatments weekly to help with the integrity of your hair so the breakage doesn’t go any further,” adds Angelone. If your hair damage is more severe due to bleaching, Gaunitz notes that keratin chemical treatments can help. When it comes to dealing with hair loss and hair thinning, it’s less about getting different treatments for each and more about finding the underlying cause. In fact, hair loss and hair thinning can be caused by the same underlying reason, according to Gaunitz. “You must identify the underlying reason, whether that be genetics, nutrition, or inflammation. Each warrants different treatments, and in many cases, people may have two or three different underlying causes.” Hair loss often happens due to major lifestyle changes, such as hormonal disruptions, new medications, or an increase in stress. In this case, the goal is to promote new hair growth at the scalp (in addition to eliminating the trigger, if possible). When it comes to natural remedies for hair growth, studies have shown that a hot oil treatment or even a quick scalp massage with oils can promote hair growth and thickness by mechanically stimulating and penetrating hair follicles. The experts recommend castor oil, which has a consistency able to penetrate all the way down into the hair follicle, or green tea oil, which contains catechins that help reduce dihydrotestosterone (DTH). All that being said, there is a good chance that hair thinning, especially when it’s gradual and there doesn’t seem to be any outstanding lifestyle changes, can simply be chalked up to natural age and genetics. “If there are genetic underlying issues, I would use DHT blockers to help,” says Gautniz. These types of ingredients can range from niacin, saw palmetto, vitamin D, tamarind seed extract, Brazilian ginseng, lemon balm extract, essential orange, and lavender oils. You can also reach for hair-thickening products, like Oribe Maximista Thickening Spray ($39; amazon.com), which often contain co-polymers to create fullness and body without weighing down the hair. If you’re wanting something more intensive with immediate results for your hair thinning or hair loss, your two best bets are minoxidil (an FDA-approved topical drug clinically proven to regrow hair) and PRP injections (an in-office procedure where your own blood is separated and injected into the scalp). Whether you’re battling hair loss, hair thinning, or hair breakage, the universal thing to keep in mind is to stay calm and be patient. Hair growth takes time—usually only a half-inch per month. If it still isn’t improving after a few months, book an appointment with a trichologist or dermatologist who can help. “I usually encourage people to get blood work done for possible internal causes, including low zinc, vitamin D3, or ferritin, and address it internally,” says Gaunitz. “From there, you can come up with the most tailored diet and scalp treatment plan.”
