When Hair on the Pillow Becomes a Pattern
Finding a few strands of hair on your pillow, in your hairbrush, or in the shower is completely normal. In fact, it’s part of the natural hair growth cycle most people lose between 50 and 100 hairs each day without even noticing. But if you’ve recently started to see more hair than usual gathering on your pillow each morning, it can be a cause for concern.
Maybe it’s enough hair to form small clumps. Maybe you’re noticing it consistently every day, and the sight of it is starting to feel a little alarming. If that sounds familiar, you’re not alone and you’re right to pay attention.
While mild, occasional shedding is a routine part of healthy hair turnover, a noticeable increase or sudden spike in hair loss can be a sign of something more serious. It might indicate stress, hormonal imbalance, a nutritional deficiency, a scalp condition, or even an underlying medical issue that requires attention.
Understanding the difference between normal hair shedding and abnormal hair loss is the first step toward addressing the problem. Knowing what to look out for and when to consult a dermatologist can make all the difference in stopping the cycle before it leads to thinning or permanent damage.
How Much Hair Loss Is Normal?
It’s easy to overlook how much hair we lose on a daily basis until we start noticing it more often. Whether it’s strands left behind on your pillow, clumps in your shower drain, or loose hairs stuck to your clothes, the sudden visibility of hair loss can trigger alarm bells. But before you panic, it’s important to understand what’s actually considered normal.
For most people, shedding between 50 and 100 hairs a day is completely natural. Hair goes through a cycle that includes growth (anagen), rest (telogen), and shedding (exogen). At any given time, around 10% to 15% of your hair is in the shedding phase, meaning it’s being released to make way for new hair growth. This is your body’s way of renewing and refreshing your scalp and it’s not something to fear.
There are also certain situations where a bit more shedding than usual is expected. These include:
- Seasonal changes: Many people notice increased shedding during the transition from summer to autumn, or winter to spring. This is a natural response to environmental changes, similar to how some animals shed fur.
- Postpartum period: After giving birth, many women experience postpartum hair loss due to hormonal shifts. While it can feel drastic, this shedding is usually temporary and resolves within a few months.
- Periods of high stress: Emotional or physical stress can push more hair into the shedding phase a condition known as telogen effluvium. This might include things like illness, surgery, or emotional trauma.
- Tight hairstyles or harsh haircare: Wearing tight ponytails, braids, or extensions frequently can lead to traction alopecia, a type of hair loss caused by tension on the scalp. Overuse of heated styling tools or harsh chemical treatments may also contribute to temporary shedding.
Telogen Effluvium: The Most Common Culprit
If you’re noticing an unusual amount of hair on your pillow, in your shower drain, or caught in your brush, there’s a strong chance that telogen effluvium could be to blame. This is one of the most common types of hair shedding and the good news is, it’s usually temporary.
Telogen effluvium occurs when a large number of hair follicles prematurely enter the resting phase (called the telogen phase) of the hair growth cycle. Under normal circumstances, only a small percentage of your hair is in this stage at any given time. But when your body undergoes a shock be it physical, emotional, or medical it can push a disproportionate number of follicles into this phase all at once. A few weeks or months later, the hair begins to fall out in larger-than-normal quantities.
So, what exactly triggers this sudden shift?
There are several common causes, including:
- Major illness or surgery: A high fever, significant infection, or a surgical procedure can stress the body and disrupt the normal hair cycle.
- Childbirth: Postpartum hair shedding is one of the most widely recognised forms of telogen effluvium. After giving birth, hormonal changes often cause women to shed noticeable amounts of hair, typically around 2–4 months later.
- Rapid weight loss or crash dieting: Drastic changes in diet or calorie intake can deprive the body and scalp of essential nutrients needed for healthy hair growth.
- Chronic stress or emotional trauma: High levels of stress whether from grief, anxiety, or a major life event can disrupt hormonal balance and affect hair follicles.
- Nutrient deficiencies: Low levels of iron, zinc, vitamin D, protein, or biotin can all negatively impact hair health. Your hair is not essential for survival, so it’s often the first to suffer when nutrients are in short supply.
- Thyroid dysfunction: Both hypothyroidism and hyperthyroidism can lead to thinning hair or increased shedding.
- Medications: Some common drugs including antidepressants, beta-blockers, anticoagulants, and even some forms of birth control may list hair loss as a side effect.
Androgenetic Alopecia: Gradual, Hereditary Thinning
If your hair seems to be slowly thinning over time especially around your crown, temples, or parting line you may be experiencing androgenetic alopecia, also known as male pattern baldness or female pattern hair loss. This is the most common cause of permanent hair thinning, and unlike telogen effluvium, it tends to develop gradually over months or years.
This type of hair loss is hereditary, meaning it runs in families. If you have close relatives who experienced hair thinning or balding, there’s a higher chance that you might too. Both men and women can be affected, although the pattern of hair loss often differs by gender.
Typical signs of androgenetic alopecia include:
- Gradual thinning at the crown or temples in men, eventually forming a receding hairline or bald patch
- Widening part, reduced hair density, and overall volume loss in women, especially along the top of the scalp
- Family history of similar hair thinning, balding, or pattern hair loss
- A noticeable change in hair texture, where hair feels finer or grows more slowly over time
This condition is driven by a genetic sensitivity to androgens, particularly a hormone called dihydrotestosterone (DHT). DHT binds to receptors in hair follicles, gradually causing them to shrink (a process known as miniaturisation). As the follicles get smaller, the hair they produce becomes thinner, shorter, and lighter until eventually, they stop producing hair altogether.
Although androgenetic alopecia is not caused by stress or poor haircare habits, it can be worsened by age, hormonal changes (like menopause), and even certain health conditions. Unfortunately, without treatment, the thinning often progresses.
The good news? Early action makes a big difference.
If diagnosed early, there are clinically proven treatments that can slow the progression of hair loss and, in some cases, promote regrowth:
- Topical minoxidil (available over the counter) helps extend the growth phase and improve hair density
- Oral medications, such as finasteride (for men) or spironolactone (for some women), may help by blocking DHT
- Low-level laser therapy (LLLT) devices stimulate hair follicles to encourage healthier growth
- PRP (platelet-rich plasma) treatments use your own blood plasma to rejuvenate hair follicles
- Hair transplants offer a surgical solution for more advanced cases
Alopecia Areata: Patchy Hair Loss from the Immune System
Alopecia areata is a relatively common autoimmune disorder that results in sudden, patchy hair loss. In this condition, the body’s immune system mistakenly attacks healthy hair follicles, causing them to shrink and slow down hair production. Over time, this leads to visible bald patches that may appear round or oval.
These bald spots can emerge very suddenly sometimes overnight and most often affect the scalp. However, alopecia areata doesn’t stop there. It can also affect other areas of the body, including the eyebrows, eyelashes, beard, or even arm and leg hair.
The extent of hair loss varies widely from person to person. For some individuals, hair loss is minimal and temporary, with full regrowth occurring within a few months. Others may experience more extensive hair loss that comes and goes in cycles over the years. In more severe forms like alopecia totalis (loss of all scalp hair) or alopecia universalis (loss of all body hair), regrowth may be much slower or incomplete.
What makes alopecia areata particularly distressing is its unpredictability. New bald patches may form even as old ones start to regrow, making it emotionally and psychologically challenging for many people.
Fortunately, a dermatologist can help manage the condition. Treatment often involves medications to suppress the immune response, such as topical corticosteroids, injectable steroids, or newer therapies like JAK inhibitors. In some cases, treatments are also used to stimulate regrowth and reduce inflammation around the follicles.
Early intervention may help minimise hair loss and promote faster recovery. If you notice any sudden or unusual patchy hair loss, don’t hesitate to consult a skin specialist for a proper diagnosis and personalised care plan.
Traction Alopecia: Hair Loss Caused by Styling
Not all hair loss is rooted in genetics or health issues sometimes, it’s simply the result of how we wear our hair. Traction alopecia is a form of hair loss caused by continuous physical tension on the hair follicles, often due to styling habits. Unlike other types of hair loss that stem from internal causes, traction alopecia is entirely external and in many cases, preventable.
This condition develops gradually over time. It starts when hairstyles place repeated strain on the roots of your hair, especially around the hairline, temples, and nape of the neck. At first, the hair may just feel sore or tender after styling. But if the stress continues, the follicles become inflamed, weakened, and eventually stop producing new hairs altogether.
Common high-risk hairstyles and habits include:
- Tight ponytails or buns, especially when worn daily or for long periods
- Braids and cornrows, particularly if they’re very tight or applied to already fragile hair
- Hair extensions or weaves that pull on the scalp or add extra weight
- Frequent use of headscarves, helmets, or hats that apply pressure on the same areas
- Repeated use of chemical relaxers or heat styling in combination with tension-based hairstyles
You don’t have to completely avoid these styles, but it’s important to wear them with care and give your scalp regular breaks. Many people aren’t even aware of the damage until they start seeing changes, which is why early detection is so important.
Early warning signs of traction alopecia include:
- Thinning along the hairline, especially near the temples
- Redness, bumps, or irritation in areas where tension is applied
- Broken hairs or patchy bald spots that worsen with repeated styling
- Scalp sensitivity or tenderness after wearing tight styles
Switching to gentler styles can often reverse the damage if caught early.
Hair Loss After COVID-19
If you’ve noticed more hair than usual on your pillow or in the shower after recovering from COVID-19, you’re not alone. Many people have reported experiencing noticeable hair shedding in the weeks or months following their recovery especially those who went through severe illness, high fever, or intense stress during the pandemic.
This type of hair loss is commonly identified as telogen effluvium, a temporary condition in which a large number of hair follicles prematurely enter the resting (telogen) phase of the hair growth cycle. After about 2–3 months, those resting hairs fall out, leading to increased shedding and thinning, often all at once.
The trigger in COVID-related hair loss is typically a combination of physical and emotional stress, including:
- The body’s inflammatory response to fighting the virus
- High fever, which can shock the hair follicles
- The psychological toll of illness, isolation, and uncertainty
- Nutritional changes or reduced appetite during illness
- Medications used during treatment or recovery
The encouraging news is that this kind of hair loss is usually temporary. Most individuals start to see visible signs of hair regrowth within 3 to 6 months, and full recovery is common within 6 to 9 months, especially with a balanced diet, good scalp care, and minimal stress.
If you’re still experiencing excessive shedding after several months, or if your hair is not regrowing as expected, it may be worth speaking to a dermatologist or trichologist. They can help rule out other underlying causes, such as iron deficiency, thyroid imbalances, or long COVID symptoms that may be prolonging the issue.
Hormonal Hair Loss: When Imbalances Take a Toll
Your hormones have a huge effect on your hair. Imbalances may be caused by:
- Polycystic ovary syndrome (PCOS)
- Perimenopause or menopause
- Post-pregnancy hormone drops
- Thyroid disorders
Signs include diffuse thinning, a widening part, or changes in hair texture. Blood tests and hormonal panels can help diagnose the issue.
Treating the hormonal imbalance often restores hair health.
Poor Nutrition or Crash Diets
Hair needs fuel to grow. If your diet lacks protein, iron, omega-3s, or essential vitamins, your follicles go into survival mode and shed.
Watch for:
- Sudden hair thinning after a dramatic diet
- Breakage and brittle strands
- Slower regrowth or dull texture
Balanced nutrition supports healthy growth. In some cases, supplements may help but it’s best to test for deficiencies first.
Stress and Mental Health: The Invisible Trigger
It’s not just physical stress emotional stress can impact your scalp too.
Chronic anxiety, burnout, or trauma may disrupt the hair growth cycle, pushing strands into the shedding phase.
Managing stress through therapy, mindfulness, or lifestyle changes can benefit both your mind and your hair.
When to See a Dermatologist About Hair Loss
It’s time to speak to a professional if:
- You’re losing more hair than usual, consistently
- Bald patches, visible scalp, or excessive pillow hair is becoming regular
- You’re experiencing pain, itching, or redness on your scalp
- You’ve tried over-the-counter solutions with no success
- Hair loss is affecting your confidence or mental wellbeing
The sooner you act, the better the chance of stopping or reversing the cause.
What to Expect From a Dermatology Appointment
Your dermatologist may:
- Examine your scalp and hair density
- Ask about family history, lifestyle, and recent events
- Run blood tests to check for hormonal or nutritional imbalances
- Recommend scalp treatments, medication, or topical solutions
- Provide long-term guidance for hair and scalp health
Early intervention is key especially for conditions that cause permanent damage if untreated.
Final Thoughts: Don’t Ignore the Signs
Noticing more hair on your pillow can be scary but it doesn’t mean you’re powerless.
Understanding the root cause is the first step to finding a solution. Whether it’s stress, hormones, or something more complex, help is available and treatment options are constantly improving. Reach out to us today to schedule a consultation with one of our experienced dermatologists and take the first step toward healthier skin and hair.
References:
- Malkud, S., 2015. Telogen Effluvium: A Review. Journal of Clinical and Diagnostic Research, 9(9), pp. WE01–WE03. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606324/
- Trüeb, R.M., 2017. Female pattern hair loss. Journal of Clinical Investigation Dermatology, 135(4), pp.995–1007. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367873/
- Cranwell, W.C. et al., 2019. Alopecia areata: pathogenesis and management. Clinical, Cosmetic and Investigational Dermatology, 12, pp. 387–403. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700789/
- Almohanna, H.M. et al., 2019. The role of vitamins and minerals in hair loss: A review. Dermatology and Therapy, 9(1), pp.51–70. Available at: https://link.springer.com/article/10.1007/s13555-018-0278-6
- Asghar, F. et al., 2020. Telogen effluvium after COVID-19 infection: a case report. Cureus, 12(5), p.e8340. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370091/