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── hair loss ──

causes of hair loss 


what is hair loss?

Hair Loss can occur at any time and can be very distressing & worrying.

It could present itself as shedding & thinning throughout, thinning in specific arrears, patches of complete hair loss or total hair loss all over the head.

Alopecia is the medical term used for hair loss however there is a broad spectrum of types of different types Alopecia and hair loss conditions and causes. 

When searching for a resolution with either hair extensions or a hair replacement system it is extremely important to establish the cause.

Applying additional weight to any hair in the resting phase or actively shedding can accelerate the process, leading to further loss.

Many hair loss conditions can improve once you know the underlying cause and can be tackled with the correct treatment plan. 

Hair Extensions or predominantly a Hair Replacement System can be worn whilst the hair is in recovery , they can actually help improve some conditions / causes & support you along the way as a temporary measure..

Unfortunately some hair loss conditions are progressive and will not improve with treatments.  Hair Replacement Systems will become an ongoing commitment both financially, emotionally & time allocated for regular appointments. 

Differing conditions will progress at different rates, with some you may see noticeable progressive loss at each of your refit appointments & for others the loss rate is much slower and may not be noticeable for several years. 

Some clients may have experienced hair loss & their hair has never grown back to its previous state, yet it is stable, no losses, no improvements. 

Wearing a Hair Replacement System or Hair Extensions should not have an adverse effect nor should you expect improvement.  


the hair growth cycle

It is also important to know that our hair goes through 4 stages of the growth cycle and each individual hair will be at different stages throughout the head. When the cycle is interrupted / altered by a change this will not see an immediate effect. You may not notice any change until many months later due to the timescale of each cycle.

This is the same for treatment plans, you will not notice any improvements until many months later, so you must have faith and persevere. 



Anagen is the active growth phase during which the root of the hair is dividing rapidly and adding to the hair shaft.  The hair grows approximately 1cm every 28 days during this phase. 

INTERESTING FACT: Hair grows faster during summer than in winter.


The transitional phase is where hair growth stops. This lasts approximately 10 days.  The hair follicle shrinks and detaches from the Dermal Papilla. (The Dermal Papilla are a collection of finger - like   cells which are responsible for the cycling portion of the hair follicle and generation of the  hair shaft.)


This is the resting phase which lasts approximately three months. The hair is no longer growing and the hair follicle is completely at rest and  completely cut off from the nourishing blood supply. A club hair is formed.  Club hair is the end product of final hair growth and features a bulb of keratin (protein) at the root of the hair shaft. 

The bulb remains within the follicle until it sheds .

Whilst the old hair is resting a new hair begins to form and grow beneath.

Hair can remain in the resting phase between 2 - 4 months.


This is the active shedding phase where the resting hairs are expelled from the head. 

This can last between 2 - 5 months. On average we naturally shed between  50 - 150 club hairs a day. and is considered normal hair shedding.  

*The club hairs are what is contained within the hair extension attachments as they have been unable to fall. The white bulbs are clearly visible and no cause for concern.


New hair is already formed within the follicle and as it grows it softens the anchor point of the hair shaft. holding the old club hair in place. The hair base will break free from the root and the old hair will shed.  And the hair growth cycle begins again.


genetic factors

Genetics play a huge part in hair loss. 

These are inherited age - related conditions that can trigger hair loss and can be inherited by either your Mother or your Father.


Andrgenetic Alopecia  otherwise known as Male / Female Pattern Baldness.  This is the most common Genetic hair loss condition. The amount of time the hair is actively growing. is reduced gradually thinning then receding.leaving area of total hair loss..

There is no 'cure' for hereditary hair loss as this is in your genetic code but there are treatments available. 

These may be products taken orally or topical solutions directly applied to the scalp by either in pure form or combination solutions or as an ingredient in shampoos & conditioners.

For our clients please click the link for EXCLUSIVE ACCESS to our comprehensive list of Genetic conditions, causes, and treatment options available..


non genetic hair loss

There are non genetic specific hair loss conditions which are recognised as non inherited but have been present since birth. 

For our clients please click the link to our EXCLUSIVE ACCESS page for in depth information on these conditions and treatment options available. 


medical conditions

Medical conditions can be directly or indirectly linked to hair loss.

Hair Loss can be a side effect of medications taken to treat the condition or the result of the body unable to absorb vital nutrients necessary for healthy hair growth. 

Genetic Disorders / Non Genetic Disorders  / Auto Immune Diseases / Vitamin & Nutrient Deficiencies / Hormonal Changes.  Deficiencies & Over Production / Viral Infection / Bacterial Infections / Mental Illness all come under a medical condition catagory. and many are directly linked to hair loss.


auto immune diseases

Autoimmune diseases / disorders are conditions where your immune system mistakenly attacks the body.  

The immune system acts as a protection against virus', germs and bacteria. When it senses it is invaded by any of these factors it triggers a response sending out 'fighter cells'  to attack what it considers a foreign body.

There are specific auto immune diseases which cause the body to attack the hair follicles directly whilst other conditions attack  important cells essential for healthy hair growth.. 

Some medications used to treat certain autoimmune conditions are also known to cause hair loss. 

For our clients please click the link to our EXCLUSIVE ACCESS page for in depth information on these conditions.


tinea capitis

This image displays a medical demonstration of Tinea Capitis.

Tinea Capitis is a highly contagious fungal infection otherwise known as Ringworm of the scalp. 

Infection develops on the skin & inside the hair follicles.  Ringworm can also typically effect the hands, groin, feet, toenails and torso. 

Severe infection will result in hair loss in the infected area. and requires urgent medical attention.

If treated early the hair will recover and grow back.


cancer treatment

Hair Loss is mainly attributed to the treatments used to fight the disease, although the presence of cancer can cause other medical conditions, such as nutrient deficiencies from poor appetite or inability to absorb nutrients,  which can lead to hair loss.


Not all chemotherapy drugs cause hair loss. 

Hair loss will not occur immediately  and usually takes several weeks. 

The amount of hair loss will depend on the drug, the dose and how it is administered. 

The amounts of hair loss will also vary person to person. 

Cancer cells are very fast dividing cells, chemotherapy drugs are  designed to target the cells preventing them from dividing.  Hair is the second fastest dividing cell in the body and is also targeted by some chemotherapy drugs.  

The hair usually begins to grow back 2-3 months after the final treatment and can take 6-12 months to grow back fully. 

Hair may be curlier, changed colour and texture .It may also be thinner. 

We wont fit Hair Extensions or Hair Replacement Systems until 12 months from your last treatment as the hair is often weaker to begin with and any weight can pull the hair from the head. 

We will perform a series of tests and apply test strands ahead of a full fitting to assess strength and suitability. 

In our EXCLUSIVE ACCESS page we have a list of the chemotherapy drugs which cause hair loss. 


Hair Loss will only occur in the area the radiation is targeted. 

Often the hair is shaved in advance of the area being treated.  Hair Loss will depend on the dose & method of radiation used. The hair will grow back after several months but is often thinner.  If very high levels of radiation are used the hair follicles may be destroyed and  the hair loss will be permanent. 


Targeted therapies do not usually cause complete hair loss but can cause diffuse shedding causing hair thinning. They may also change the texture of the hair making it curlier or more drier than usual. 

On our EXCLUSIVE ACCESS page we have a list of Targeted Therapy drugs associated with hair loss & changes.


Hormonal therapies do not generally lead to total hair loss but can result in diffuse shedding causing thinning.  This can happen over several months or in fact several years.

On our EXCLUSIVE ACCESS page we have a list of the Hormonal Therapies associated with hair thinning. 



Many medications can be attributed to hair loss.  Shedding an excessive amount of club hairs may be a result of  medications as some drugs can cause damage to hair follicles. or interrupt the hair growth cycle. 

It is vitally important that if you notice any abnormal hair loss you must NOT stop taking your medication. Speak to your GP / Health Care Professional who may be able to prescribe an alternative medication. 

Please read the leaflet included with your medicine which will list known side effects or contact your Health Care Professional for further advise

We have a large, comprehensive list of medications which are known to cause hair loss on our EXCLUSIVE ACCESS page. 


hormonal changes

Hormonal changes have a huge impact on the hair. 

The most common hormonal changes in women are during pregnancy and post birth and later during menopause. 

Hormonal changes can also occur with underlying thyroid conditions.

Many Contraceptives are hormone based which can disrupt the hair growth cycle. 

Changes will not be noticed immediately due to the time frame of the hair growth cycle so may not be noticeable until many months later. 

These can settle once the body regulates or it may worsen. 

Pre existing genetic conditions such as Androgenetic Alopecia (Male / Female Pattern Hair loss) related to hormone sensitivity  may find their condition is worsened. 

Any adverse changes should be discussed with your GP & alternatives explored.

We have a comprehensive list of hormonal contraceptives which have been linked to hair loss on our EXCLUSIVE ACCESS page.


As part of gender reassignment hormones are prescribed as part of the process. 

This can lead to a disruption in the hair growth cycle leading to shedding and hair loss.

This will be discussed with your GP / Health Care Practitioners prior to commencing treatment.


The Thyroid is la Butterfly shaped gland located at the base of the neck,.  When it is normal in size it cant be felt.

It is rich in blood vessels and secretes several hormones.  The main hormone is Thyroxin. 

Thyroxin plays an important part throughout the body influencing metabolism, development & growth & body temperature..

There are many diseases and conditions associated with the Thyroid which are directly linked to Hair Loss. 

In our EXCLUSIVE ACCESS area we discuss the different diseases the treatments and the hormone levels needed for healthy hair growth associated with each. 


pregnancy & post birth

We do not fit Hair Extensions on clients during pregnancy or for a minimum of 5 months post birth.  It is important for our clients to understand the reasons behind this.

During pregnancy the majority of women have trouble free pregnancies and their hair feels at its best whilst pregnant.  

Normally during pregnancy the hair remains in the growing phase for longer, so for the vast majority of women their hair feels thicker and fuller.

A common symptom and side effect of pregnancy is 'Morning Sickness' . Unfortunately for some women this does not occur simply in the morning, but all day long.  Some unfortunately experience the severe form of sickness.  Excessive sickness can lead to dehydration and malnutrition which can result in diffuse shedding & hair loss. 

(Tellogen Effluvium)


Many women experience iron deficiency anaemia during pregnancy . Iron is an essential mineral for healthy hair growth. 

Low levels can interrupt the hair growth cycle leading to shedding and hair loss. 

Heavy blood loss can also occur during birth resulting in anaemia.

Hormonal changes can cause a greasy scalp & hair which would result in excess slippage of hair extensions.


Normally during pregnancy the hair remains in the growing phase for longer, so for the vast majority of women their hair feels thicker, fuller . 

This is due to the rise in certain hormones.  Once birth occurs hairs which remained in the extended growth phase enter the resting then shedding phase.  

This can feel incredibly worrying as more shed hair than usual begins to fall.  You will have become accustomed to less natural shed hair in your brush and plug hole over the course of 9 months, combined with the thicker hair you've enjoyed.. 

Post birth not only do you return to your normal shed rate between 50 - 150 strands a day, you will also be shedding hair additional hair you retained over the course of pregnancy. 

Your hair will feel thinner as a result. 

Whilst it is alarming and can feel like huge amounts, it will settle to normal levels over a few months. 

This process may be delayed if breastfeeding and post partum shedding may not occur until breastfeeding is stopped. 

Post partum shedding will stop when the body has regulated the natural hormone levels. 

Applying hair extensions to hair in the resting or shedding phase will accelerate hair loss and can inadvertently pull healthy natural hair as the weight distribution becomes unequal.


A healthy balanced diet during pregnancy is essential  to natural hair health.

Pregnant women require higher amounts than the recommended daily dose of essential nutrients and minerals. 

We have compiled a list of the essential nutrients key to maintaining healthy hair growth during pregnancy & post birth., their function & the recommended daily doses exclusively for our clients on our EXCLUSIVE ACCESS   page.

If our clients discover they are pregnant whilst wearing our hair extensions we do not insist on immediate removal but will not refit at the next appointment. 

If however experiencing severe sickness or low iron we do advise removal.  

Post birth we will see you at 5 - 6 months and perform a series of tests to establish where your hair is in the growth cycle. We may fit test strands before booking a full fitting. 



During menopause hormone levels decrease 

Specific hormones are responsible for keeping the hair in the growth phase for longer,.  With lower levels the hair can enter a faster resting & shedding phase and regrowth is much slower causing the hair to thin.

Treatments to regulate and replace the hormones are called Hormone Replacement Therapy (known as HRT.) 

Clients beginning these treatments may also notice changes in hair density and experience shedding as the body regulates hormones and finding the correct dosage. 


stress & trauma

Stress and Trauma have a physiological and psychological effect which can have a significant impact of hair growth and trigger hair loss.

Stress will not result in immediate hair loss and won't present itself until around 6 - 12 weeks or longer after a stressful event due to the time scale factors of the hair growth cycle, 

This is why stress management is so important as stress levels can increase when hair loss occurs creating an ongoing cycle. 

When we are under stress we often neglect ourselves by not eating properly. and the body is denied of nutrients and calories for energy. 

Hair is a non essential tissue so the body will use the little nutrients & energy it is receiving to survive. As hair is non essential it is often the first thing to be negatively impacted. 

Stress effects the body's immune system making us more prone to illness. Immune system disruption can trigger hair loss.

The types of hair loss most related to stress are:

  • Telogen Effluvium (excessive daily hair shedding)
  • Alopecia Areata (hair Loss in patches)
  • Trichotillomania (hair pulling)
  • Androgenic Alopecia


(Alternative name Hydrocortisone)

Cortisol is a steroid hormone that is vital in the regulation of a wide range of processes in the body such as metabolism, acts as an anti inflammatory & immune response, influences blood pressure and controls blood sugar levels and how the body responds to stress. 


Cortisol (known as the stress hormone)  When the body perceives stress cortisol is released into the bloodstream.

The hormone triggers a flood of glucose that supplies an immediate energy source to your large muscles, but inhibits insulin production so the glucose is not stored and available for immediate use. Cortisol narrows the arteries, whilst another hormone, epinephrine, increases the heart rate. Together they force your blood to pump harder and faster as you confront the 'threat'.

This is know as 'fight or flight' as a reaction to stressful situations.

During periods of high, chronic stress your body may constantly produce and pump out cortisol.

Almost every cell contains receptors for cortisol so it has many different actions depending on each cell type.  

Out of all the years of study & research Abigail has undertaken on Hair Loss, the effects of raised Cortisol on the body & the different responses it triggers were prolific & directly linked in the causes of Hair Loss.

We discuss this further for our clients on our EXCLUSIVE ACCESS  ​page.


psychological disorders

Psychological disorders are frequently referred to as mental health disorders or psychiatric disorders. These are patterns of behaviour which impact multiple areas of life  & have a physiological and psychological effect. 

These disorders are very distressing for the person experiencing the psychological symptoms which then manifest in physical symptoms.  

The most recognised conditions linked to hair loss are:




trick-o-till-o-may-nee -ahh

Trichotillomania (self hair pulling) is a complex psychological disorder in which the sufferer has an irresistible urge to pull out their hair. (This can be from the scalp or any part of the body)

It is a very distressing mental health disorder classified under Obsessive - Compulsive & Related Disorders. 

There are many forms of Trichotillomia which we expand on for our clients on our EXCLUSIVE ACCESS page.


Anorexia is an eating disorder where the sufferer reduces or stops food intake resulting in dramatic weight loss. 

It is a complex disorder with many differential elements.  

Hair Loss occurs as a result of nutrient deficiency.


Is an eating disorder in which binge eating and gorging is followed by the sufferer taking extreme steps to compensate and 'rid ' the body of the excessive food consumed. 

Hair Loss occurs as a result of nutrient deficiency.

There are other forms of eating disorders which can lead to hair loss which we expand on in our EXCLUSIVE ACCESS page along with treatment advise.


Anxiety & depression related disorders are indirectly linked to hair loss.  Low mood and lack of motivation can result in loss of appetite resulting in malnutrition or trigger compulsive behaviours such as hair pulling. 

Stress and anxiety raises levels of the hormone Cortisol which can trigger responses within the body which can also lead to hair loss. 

Many medical approaches to psychological disorders are the prescription of anti depression medications. Whilst theses are beneficial for the disorder, many have hair loss listed as a side effect. 

Many other mental health conditions and illness' are linked to hair loss which we cover in extent in our EXCLUSIVE ACCESS area for our clients. 


psychogenic pseudoeffluvium​

PSYCHOGENIC PSEUDOEFFLUVIUM is a condition identified as 'imaginary hairloss and can be an underlying symptom of a psychological disorder.

This disorder is presented where the hair and scalp is perfectly normal with no indication of hair loss present. 

Like body dismoprphia, the sufferer obsessively and compulsively looks in the mirror for signs of hair loss and changes.

After being medically examined by dermatologists, trichologists and doctors the course of treatment is a referral to a psychologist.


nutrition & diet

 Nutrition & diet play a fundamental role in healthy hair growth. 

Nutrient deficiency is caused by poor diet, underlying medical conditions or medications thus preventing absorption of essential nutrients and minerals. 

There are many nutrients that are VITAL to ensuring healthy hair growth and many are overlooked.  

With todays busy lifestyles it can be difficult to consume a balanced diet and supplements can be taken to ensure adequate amounts of these nutrients are absorbed.


Bariatric surgery otherwise known as Weight Loss Surgery can be a primary cause of hair loss.  Usually attributed to low calorie intake, low protein intake and quite often malnutrition and inadequate absorption of essential nutrients.  Stress pre and post surgery is also likely to be a contributing factor. 

It is essential you follow the guidance of your Medical Practitioners in respect of specific Bariatric multi vitamins. 

Further information can be found on our EXCLUSIVE ACCESS on essential nutrients, supplements and those to avoid as potentially harmful post surgery.

On our EXCLUSIVE ACCESS page we cover the role of every vitamin & mineral and their role within the body to ensure healthy hair growth. 

We explain the natural food sources for each as well as 

the recommended daily amounts for men, women & pregnant women and their therapeutic doses We explain how to recognise symptoms of potential deficiencies.  

And also the healthy range of levels within the body specified in a full blood count for each.

Also covered are medical conditions / medications which prevent the absorption of certain nutrients plus the effects of over production / consumption of particular vitamins and minerals.


traction alopecia

This image demonstrates a client who came to Abigail seeking advise after experiencing Traction Alopecia through incorrectly fitted hair extensions

She had to wait almost a year until her hair had recovered enough before Abigail would agree to begin a hair in recovery fitting.

Traction Alopecia through is caused by repeated, tight pulling on the hair.

Risk factors are tight ponytails, buns, braids and incorrectly fitted or maintained hair extensions & hair replacement systems. 

The area of loss will depend on the tension points, too tight a pony tail may result in loss from the front hairline or too high and tight a ponytail from the nape.

It is vitally important to choose your hair extension professional wisely and do plenty of research before booking a fitting appointment.  

Always look / ask for 'Flip The Lid' images of the underneath of the fittings and not just the end result.


  • Clean, even sections with no crossover hairs from neighbouring sections. (This will also ensure maintenance at home can be easily performed)
  • Attachments should have distance between the scalp & section parting allowing the natural hair to move easily and freely without tension. 
  • The extensions should be an equal weight distribution to the section securing the attachment in place. 
  • Continuity in placement pattern.


Even the most beautifully correctly fitted extensions can lead to Traction Alopecia if correct aftercare procedures are not followed.   The main causes of Traction Alopecia through poor aftercare are:

  • Tying  hair up too tightly or too high. Remember the natural hair will already have attachments where the extensions are connected then pulling on those connections tightly doubles the risk.   Longer lengths or higher volume of added hair will be heavier in weight this can also add tension when regularly tied up.
  • Using elastic bands to tie hair up.
  • Matting through incorrect brushing, sleeping with wet hair or tying hair up whilst wet. Matting pulls hairs from surrounding areas and creates severe tension. 
  • Wearing extensions in for longer than the advised amount of time.  Your hair will continue the natural hair growth & shedding cycle.  Hair supporting the extensions will naturally shed, but remain trapped inside the attachments This will result in the remaining hairs supporting the extensions will be lessened over the time leaving the weight of the extensions to pull on the remaining healthy hairs. 
  • Natural shed hair trapped within the extension attachments can tangle with other shed hair trapped within neighbouring attachments. Matting can occur if incorrect brushing and separating of attachments is carried out. The risk increases the longer the extensions are in as the degree of shed hair increases. 


  • Scalp redness & irritation
  • Bumps
  • Itching ( Itching is very common post fitting as the scalp adjusts to the attachments and usually settles quickly.  Intense continuous itching could indicate traction and should be investigated) 
  • Scaling
  • Inflamed hair follicles 
  • Blisters on scalp (sometimes pus filled)


It is important to note that perfectly fitted hair extensions can also lead to Traction Alopecia if there is an underlying health issue present (known or unknown) or the hair prematurely enters the resting and shedding phase during wear.  

If you notice any changes to your natural hair during the course of extension wear it is important to contact your Hair Extension Specialist. 


Hair can fully recover from Traction Alopecia if treated quickly..  However if scarring has occurred to the scalp or damage to the hair follicles it can be permanent. 


chemical damage

Chemical damage to the hair & scalp occurs through the incorrect application of chemicals, incorrect chemicals / strengths used, over-processing through chemicals being left on for longer than recommended or being applied to hair already processed or compromised. 

Hair becomes chemically damaged generally by colouring, perming or chemical relaxants to straighten. 

The outermost protective layer of the hair shaft is the Cuticle. 

When damage occurs the Cuticle slowly wears away leaving the internal elements of the hair exposed. This damage can cause the hair to break or split. 


Perms and straightening solutions permanently change the shape of the hair.  To achieve this change the chemicals break down the Disulphide Bonds inside the hair.  Disulphide Bonds are strong connecting bonds that hold the protein structures of the hair together.  Once broken down they can be manipulated into the new shape. Further chemicals are applied in the form of a 'neutraliser ' to fix the hair in the new shape and reconnect and reform the broken disulphide bonds.

Hair colouring involves chemicals to open the Cuticle layer allowing access to the Cortex to change the colour.  A chemical reaction is triggered to allow the colour to be deposited.

Hair which has experienced chemical trauma will be dry, brittle and have a frizzy, thin & wiry appearance,  The hair snaps at the point of damage resulting in uneven thin ends. 

There are many treatments available which can reconnect broken bonds within the hair such as Olaplex (which is what we recommend) 

This can be done as a professional in salon service or products purchased to do at home. 

And deep conditioning treatments which rehydrate chemically damaged hair and smooth and close the cuticle.

When extreme damage occurs it is irreversible and the hair simply snaps off. The only course of action is to cut off the remaining damaged hair.


Chemical scalp burns following a chemical process can range from minor scalp irritation and redness, to blisters or severe chemical burns. 

The degree of burn will depend on the chemical used, the strength, length of time it was in contact  and what was used to counteract the effect and how quickly.

Irritation and redness resolves very quickly, blisters and small sores can lead to hair loss in the effected areas but if the hair follicle did not sustain severe damage they will heal and hair will grow back. Minor blisters and sores usually heal within a few days or longer. 

Severe burns can cause permanent damage to the hair follicles and scarring which result in permanent hair loss. 

Olaplex and Deep Conditioning treatments can be purchased in salon or via our online SHOP.


environmental factors

Many environmental factors can be attributed to hair loss .

The degree will depend on the amount & regularity of exposure.

These environmental factors range from  UVA & UVB  light.

Chemicals & Metals & Minerals in water,  PH level.  Oxygen, Pollution, Calcium & Hard Water..


professional medical advise

If you are experiencing any form of hair loss which is causing you concern you must contact your GP to begin investigations and relevant referrals if necessary.

Usually your doctor will order a Full Blood Count. (FBC) 

You may be referred to a Dermatologist. 

We recommend our clients visit a professional Trichologist alongside GP and hospital referral. 

It is helpful to have a recent FBC prior to visiting a Trichologist.

A Trichologist is a medical professional who specialises in diseases or issues related to the hair & scalp.

Clinical Trichologists can diagnose and treat certain conditions.

We recommend our hair loss clients to Nicola Hemsley MIT Trichologist of Exeter Trichology

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