Hair breakage vs hair loss: how to tell

Finding hair on your pillow, in your brush or around the shower drain can be worrying. But not all of that hair has come out of the scalp. Some of it may have snapped along the strand. Breakage and hair loss look similar at first, yet they have different causes and need different care. This guide shows you how to tell them apart.

Two different problems

Hair breakage happens along the hair shaft, the part of the hair you can see. The follicle under the skin keeps working normally. Breakage is usually caused by damage from the way hair is handled, styled or treated.

Hair loss happens at the root. The whole hair, including its root end, comes out of the follicle. This can be a normal part of the hair growth cycle, or it can be a sign of a condition that affects how hair grows.

DermNet lists several broad groups of hair loss, including shedding of resting hairs, thinning of thick hairs into finer ones as in pattern hair loss, and acquired hair shaft defects. It notes that hair shaft defects can be caused by injury such as excessive brushing, hairdryer heat, relaxing chemicals and bleach ¹.

How to check a fallen hair

Pick up a few fallen hairs and look closely at the ends.

Signs of breakage

• The hair is shorter than the rest of your hair.
• Both ends look blunt, frayed or split, with no bulb.
• You see many short pieces of different lengths.
• The ends of your hair feel rough, dry or frizzy.

Signs of shedding from the root

• The hair is full length.
• One end has a small, white or pale bulb. DermNet describes a resting hair that has been shed as having a bulb at the end, called a club hair ¹.
• You may notice a wider parting, a thinner ponytail or more scalp showing.

You may have both at once. Damaged hair breaks easily, and thinning hair is fragile ².

Common causes of breakage

The AAD lists everyday habits that can damage hair and lead to breakage ³:

• Rubbing shampoo into the full length of the hair
• Skipping conditioner
• Rubbing hair dry with a towel
• Brushing hair while it is wet (for straight hair)
• Using a blow-dryer, hot comb or curling iron often
• Long-hold styling products
• Tight ponytails, buns or braids
• Heavy weaves or extensions
• Colouring, perming or relaxing
• Brushing 100 strokes a day or tugging on hair

In Malaysia, frequent rebonding, colouring and daily flat ironing are common causes. See hair fall after rebonding, hair dye and hair loss and heat styling damage. Chlorine and pool water can also damage the hair surface. See swimming and hair.

Common causes of hair loss from the root

Shedding from the root has many possible causes. DermNet notes that excessive shedding of resting hairs (telogen effluvium) usually appears 2 to 6 months after a trigger such as childbirth, fever, weight loss, surgery, illness, psychological stress or some medicines ¹. After having a baby, many women shed more hair, which usually peaks around four months after birth ⁴.

Other causes include pattern hair loss, alopecia areata and scalp conditions. See sudden severe hair fall, genetic hair loss, hair loss after illness and alopecia areata.

What to do about breakage

The good news is that the AAD notes simple changes can prevent further hair damage ³. Hair that has already broken will not mend, but new growth can stay healthier.

• Wash gently. Massage shampoo into the scalp and let it flow through the lengths as you rinse.
• Condition every time. Use conditioner after every shampoo ³. A leave-in conditioner or detangler can also help reduce breakage, split ends and frizz ².
• Dry gently. Wrap hair in a towel instead of rubbing it, and let it air dry when you can.
• Comb with care. Use a wide-tooth comb. If your hair is straight, let it dry a little first. If it is curly or textured, comb while it is damp.
• Turn down the heat. Use the lowest dryer setting and limit flat irons and curling irons.
• Space out chemical treatments. Allow more time between colouring, perming or relaxing, and have only one service at a time.
• Wear looser styles. Use covered hair ties and avoid styles that pull. See traction alopecia.

DermNet also advises avoiding injury to the hair shaft by drying hair naturally or on a cool setting, keeping chemical treatments to a minimum and using loose hairstyles ¹.

Trimming damaged ends can make hair look and feel healthier as it grows.

What to do about hair loss

If you think you are shedding from the root, the AAD recommends seeing a dermatologist. Hair loss has many causes, and the sooner the cause is found, the better your chance of getting results ². Gentle hair care still helps, because thinning hair is fragile and easily damaged.

When to see a doctor

See a doctor or dermatologist if:

• You see full-length hairs with bulbs coming out in large amounts
• You notice bald patches or a widening parting
• Your scalp is itchy, sore, red or flaky
• Changing your hair care does not help your hair look healthier ³

A dermatologist can examine your hair and scalp, and hair shaft problems can be checked with dermatoscopy or a microscope ¹.

The bottom line

Breakage is damage along the hair strand, usually from styling, heat or chemicals. Hair loss is shedding from the root, often linked to the hair cycle, health or genetics. Look at the ends of fallen hairs to get a clue. Gentle care helps with breakage. For shedding from the root or bald patches, see a doctor to find the cause.

Frequently asked questions

How can I tell breakage from hair loss?

Broken hairs are short with no bulb. Shed hairs are full length with a small bulb at the root, called a club hair ¹.

What causes hair breakage?

Common causes include rough towel drying, heat tools, tight styles and colouring, perming or relaxing ³.

Can broken hair be repaired?

Broken hair does not mend, but simple changes can prevent further damage to new growth ³.

When should I see a doctor?

See a dermatologist if you shed full-length hairs in large amounts, notice bald patches, or your scalp is sore or flaky ².

Educational content. Not medical advice.