Losing about 50 to 100 hairs a day is normal. Rambut gugur becomes a concern when you shed far more than usual or notice your hair getting thinner. In women, the most common causes are excessive shedding a few months after a stressful event such as childbirth, a high fever or a crash diet (telogen effluvium), and gradual thinning from female pattern hair loss. Iron deficiency, thyroid problems, PCOS and tight hairstyles can also play a part. The good news is that shedding after a one-off trigger usually stops on its own, and hair tends to regain its fullness within six to nine months. Pattern hair loss responds best to early treatment, such as topical minoxidil. This guide explains how to tell which type you have, what actually helps, where vitamins fit, and when to see a doctor.
How much hair loss is normal?
Every hair grows for a few years, rests, and then falls out so a new one can grow in its place. Because of this cycle, the American Academy of Dermatology says it is normal to shed between 50 and 100 hairs a day. You may see more on the days you wash or comb your hair, simply because loose hairs come out together.
Signs that it may be more than normal shedding:
- much more hair than usual on your pillow, in the shower drain or on your brush, for several weeks;
- a wider parting, or more scalp showing on top;
- a thinner ponytail;
- a receding hairline at the temples or edges;
- round, smooth bald patches.
What causes rambut gugur in women?
Excessive shedding usually shows up a few months after the stressful event, which is why many women do not connect it to the cause. If the stress continues, the shedding can last longer. Our guide to stress-related hair thinning covers this in more detail.
Hair loss after giving birth
Rambut gugur selepas bersalin is very common and usually temporary. According to the American Academy of Dermatology, new mothers often see excessive shedding about two months after giving birth, it usually peaks around four months, and hair tends to regain its normal fullness within six to nine months. Eating well, being gentle with your hair and checking for anaemia, which is common after pregnancy, all help. See our guide on postpartum hair loss, and check with your doctor before taking any supplement while breastfeeding.
Is hair loss a sign of disease?
Usually it is not, but sometimes hair loss is the first clue to another condition:
- Iron deficiency. It is the world's most common nutritional deficiency, and in women before menopause it is mostly caused by menstrual blood loss and pregnancy. A review in the Journal of the American Academy of Dermatology notes that iron deficiency anaemia should be treated, although whether low iron without anaemia causes hair loss is still debated.
- Thyroid disease. Both an underactive and an overactive thyroid can cause diffuse thinning.
- PCOS and other hormonal conditions. A review of female pattern hair loss advises checking for ovarian or adrenal problems in women with signs of excess male hormones, such as irregular periods, acne or extra facial hair.
- Scalp conditions, such as severe dandruff, fungal infections or inflammation, can also cause hair to break or fall out.
A doctor can usually work out the cause from your history, a look at your scalp, and simple blood tests such as a full blood count, ferritin (iron stores) and thyroid function.
How to stop hair loss: what actually works
- Treat the cause. Correcting iron deficiency, thyroid problems or a crash diet often matters more than any product.
- Give excessive shedding time. After a one-off trigger, shedding usually settles and the hair grows back over months, so fullness returns slowly.
- Topical minoxidil for pattern hair loss. A Cochrane review of 47 trials found good evidence that topical minoxidil increases hair regrowth in female pattern hair loss compared with placebo, with no clear difference between the 2% and 5% strengths. It needs to be used every day, results take several months, and it is generally used long term to keep the benefit, so discuss it with a doctor or pharmacist first.
- Prescription options. For pattern hair loss, a doctor or dermatologist may also consider tablets that block male hormones, such as spironolactone. A review found these, with or without minoxidil, give good results in many women with mild to moderate pattern hair loss. They are not suitable in pregnancy.
- Start early. Treatments for pattern hair loss are better at stopping further thinning than at regrowing hair that has already been lost, so do not wait years before getting help.
Be wary of products or salon treatments that promise fast regrowth. Our guide to shampoo vs inside support explains what shampoos can and cannot do.
Do vitamins for hair loss work?
Vitamins and minerals such as iron, zinc, vitamin D and the B vitamins are all needed for healthy hair growth. A review in Dermatology and Therapy concluded that a deficiency in these nutrients may be a modifiable risk factor for hair loss, but that better trials are still needed to show who benefits from supplements. In short, vitamins help most when you are actually low in them.
Biotin is the best-known hair vitamin. A review of the evidence found that biotin helped people who had a biotin deficiency or specific hair and nail conditions, but that there is not enough evidence for supplements in otherwise healthy people. Biotin also has an important safety point: in a JAMA study, healthy adults taking 10 mg of biotin a day for a week had falsely high or low results on some thyroid and other blood tests. Always tell your doctor you take biotin before any blood test.
Where supplements fit: a supplement can be one part of a hair care plan, alongside a balanced diet and treating any underlying cause, not a replacement for it. Drann Biotin + OptiMSM is a daily supplement to support healthy hair. To understand how it works and what to expect, see our Biotin + MSM guide, how long results take and who should not take it.
Everyday habits that protect your hair
- Eat enough protein and iron. Hair is made of protein, and very low-calorie diets are a common trigger for shedding. Our list of protein foods in Malaysia has affordable options such as eggs, ikan bilis, tempeh and chicken.
- Avoid crash diets. Lose weight gradually rather than through extreme restriction.
- Go easy on tension. Change your hairstyle often, avoid tight ponytails and buns, and if you wear a tudung, choose an inner cap (anak tudung) that is not too tight and vary how you pin it.
- Be gentle with heat and chemicals. Limit hot styling tools, bleaching and rebonding, which weaken the hair shaft and cause breakage.
- Look after your scalp. Treat dandruff (kelemumur) or an itchy scalp, and let your hair dry before tying it up tightly.
- Manage stress and sleep, since ongoing stress can keep shedding going.
When to see a doctor
See a doctor or dermatologist if:
- your hair falls out suddenly, in clumps, or in round patches;
- shedding lasts longer than about six months;
- your scalp is red, scaly, painful or has pus or scarring;
- you also have heavy or irregular periods, tiredness, acne, extra facial hair, or weight changes;
- you notice your parting widening or your hairline receding.
Frequently asked questions (FAQ)
How many hairs a day is normal to lose?
Shedding about 50 to 100 hairs a day is normal, according to the American Academy of Dermatology. You may notice more on wash days because loose hairs come out together.
Why is my hair falling out so much?
The most common reasons in women are excessive shedding a few months after a stressful event such as childbirth, a high fever, an operation or a crash diet (telogen effluvium), and gradual thinning from female pattern hair loss. Iron deficiency, thyroid problems, PCOS and tight hairstyles can also play a part.
Is hair loss a sign of disease?
Sometimes. Hair loss can be linked to iron deficiency anaemia, thyroid disease or hormonal conditions such as PCOS. See a doctor if your hair loss is sudden or patchy, or comes with tiredness, irregular periods, acne, extra facial hair or weight changes.
Does hair grow back after postpartum hair loss?
Yes, usually. Shedding typically starts about two months after giving birth, peaks around four months, and hair tends to regain its normal fullness within six to nine months.
What vitamin is good for hair loss?
Vitamins and minerals such as iron, vitamin D, zinc and biotin matter for healthy hair, but supplements mainly help when you are actually low in them. Reviews found that biotin helps people with a deficiency or specific conditions, with little evidence for healthy people. Ask your doctor about a blood test if you suspect a deficiency.
Can shampoo stop hair loss?
Shampoo cleans the scalp and can help with dandruff (kelemumur) or an itchy scalp, but it cannot change the hair growth cycle or reverse pattern hair loss. Treating the cause, and for pattern hair loss using a proven treatment such as topical minoxidil, matters more.
When should I see a doctor about hair loss?
See a doctor or dermatologist if hair falls out suddenly or in round patches, if shedding lasts longer than six months, if your scalp is red, scaly or painful, or if you have other symptoms such as heavy periods, tiredness, irregular periods or new facial hair.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor, dermatologist or pharmacist. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Do you have hair loss or hair shedding? — American Academy of Dermatology
- Hair loss: who gets and causes — American Academy of Dermatology
- van Zuuren EJ, Fedorowicz Z, Schoones J. Interventions for female pattern hair loss. Cochrane Database Syst Rev. 2016;(5):CD007628.
- Fabbrocini G, et al. Female pattern hair loss: a clinical, pathophysiologic, and therapeutic review. Int J Womens Dermatol. 2018;4(4):203-211.
- Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J Am Acad Dermatol. 2006;54(5):824-44.
- Almohanna HM, et al. The role of vitamins and minerals in hair loss: a review. Dermatol Ther (Heidelb). 2019;9(1):51-70.
- Patel DP, Swink SM, Castelo-Soccio L. A review of the use of biotin for hair loss. Skin Appendage Disord. 2017;3(3):166-169.
- Li D, et al. Association of biotin ingestion with performance of hormone and nonhormone assays in healthy adults. JAMA. 2017;318(12):1150-1160.
