Whether you experience pattern baldness or just observe that your hair isn't as thick as it once was, hair thinning is something most of us (regardless of gender) will encounter as we age — and it might begin sooner than expected.
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We consulted leading doctors and a biologist to understand why our hair thins over time and what influences when this process starts.
The quantity and thickness of hair we start with are determined early on. Several factors influence the amount and density of hair, whether we end up with a thick head of hair or finer strands. Genetics is the main factor, as Dr. Paradi Mirmirani, a dermatologist at Kaiser Permanente in Vallejo, California, explained.
The thickness and amount of hair one begins with are based on the number of hair follicles present at birth and the diameter of those follicles. "We are born with a certain number of hair follicles on our head," Dr. Mirmirani said, which sets the potential for how much hair we can have.
The diameter of the hair follicles determines how thick or thin each strand will grow, according to Dr. Zafer Çetinkaya, a hair transplant surgeon at EsteNove in Turkey. Larger follicles produce thicker strands, while smaller follicles result in finer hair.
Dr. Mirmirani added, "Genetics also determines the shape and color of each hair strand produced by each follicle."
However, genetics is only part of the story. Other factors can also affect hair growth, color, and shape. Nutrition plays a significant role; Dr. Mirmirani emphasized that you "can’t produce a hair strand perfectly if you lack the necessary building materials." Medications and chronic illnesses may also impact the quantity and type of hair grown.
Why does hair thin as we get older? Regardless of initial hair density, hair is bound to thin as we age. “This process is known as hair miniaturization,” Dr. Mirmirani said.
Ben Greulich, an assistant professor of biology at Mercer University who teaches about cell biology and genetics, explained, "Some follicles will eventually stop producing hair. The remaining strands may become thinner as well."
Dr. Mirmirani elaborated, "As the hair follicle decreases in size over time, it produces smaller, finer, shorter hair fibers that cover less of the scalp."
Typically, this happens at several points in life, often due to changes in hormones and age-related bodily functions.
Firstly, although it’s common to think hair thinning starts in old age, it can actually begin much earlier. "In some cases, thinning may start as early as puberty," Dr. Mirmirani said.
The surge of androgen hormones that occurs during puberty for men can lead to hair miniaturization in genetically predisposed individuals, either in their teenage years or during their 20s and 30s, she explained.
Secondly, hormonal shifts in the 40s and 50s can lead to hair thinning as well. In women, declining estrogen levels during menopause may “cause changes in hair thickness and texture,” according to Dr. Mirmirani.
For men, ongoing exposure to androgens, such as testosterone and dihydrotestosterone (DHT), beginning in puberty, affects hair growth and quality over time. By age 50, 30-50% of men experience some hair loss, leading to a condition known as male androgenetic alopecia.
Thirdly, other age-related shifts, including declines in vascular and metabolic functions that are essential for optimal hair production, also contribute to thinning hair as we age, generally starting in the 60s, Dr. Mirmirani noted.
Additionally, hormonal fluctuations can affect hair during pregnancy and after childbirth, as Dr. Çetinkaya pointed out.
Professor Greulich added, "During pregnancy, women experience very high levels of estrogen, which typically results in increased hair growth until estrogen levels drop sharply after childbirth. This sudden decrease in estrogen is linked to postpartum hair loss, which is similar to the hair loss some women experience after menopause."
Is hair thinning a cause for concern? For most people, hair thinning is simply a natural part of aging and is not typically a health concern. Dr. Mirmirani described normal changes in hair growth and quality as “slow and gradual.”
However, if you experience a sudden change in hair density, it may indicate an underlying health issue, so it’s wise to consult a doctor, Dr. Mirmirani advised.
Hormonal imbalances such as thyroid disorders, deficiencies in nutrients like iron, zinc, or vitamin D, autoimmune diseases, and stress can contribute to early or rapid hair loss, Dr. Çetinkaya explained.
When does hair thinning stop? Dr. Çetinkaya said, "Hair thinning due to age or hormonal factors is generally progressive. It doesn’t necessarily ‘end’ but can level off as follicles shrink to the point where new hair growth becomes minimal." The degree of hair thinning varies widely among individuals.
Is it possible to prevent hair thinning? For those genetically predisposed to hair thinning, stopping the process entirely may be unrealistic, but slowing it may be possible, Dr. Mirmirani explained. For those concerned about hair thinning, she recommends managing stress, avoiding harsh treatments like heat styling or chemical exposure, and following a nutrient-rich diet that includes biotin, vitamin D, and iron.
Other interventions are available for those interested in additional measures, but Dr. Mirmirani cautions that these methods can have varying levels of effectiveness, and the best results are often achieved with early treatment.
Options include prescription medications like minoxidil or finasteride, hair transplants, or platelet-rich plasma therapy to promote hair growth. Dr. Mirmirani added that new research on stem cell treatments shows potential for significantly increasing hair thickness, while low-level laser therapy is also being explored as a treatment.
Before trying any treatment, it’s essential to consult with a board-certified dermatologist for professional guidance.
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