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Extreme Hair Loss: Causes and Treatments

Katelyn Hagerty FNP

Medically reviewed by Katelyn Hagerty, FNP

Written by Our Editorial Team

Last updated 5/12/2021

Hair loss can be stressful and traumatic. And when it happens suddenly, it can be particularly scary. 

What’s worse is that extreme hair loss happens, too. There are a few known causes of sudden and extreme hair loss. 

Depending on what’s causing yours, it may resolve itself, or you could find an effective hair loss treatment after receiving a proper diagnosis. 

Defining Extreme Hair Loss 

Extreme is a relative and subjective term, so it’s important we define what exactly it is we’re talking about throughout this article, to ensure you’re getting the right information — especially since if you’re the one losing your hair, it likely feels “extreme” no matter how it’s happening. 

It’s not necessarily a medical term, but for our purposes, extreme hair loss is hair loss that happens relatively suddenly and dramatically. 

Male pattern baldness, or androgenetic alopecia, on the other hand, happens gradually, typically beginning as thinning hair in certain areas that spread over time.

While this form of hereditary hair loss can be disruptive and troublesome, androgenetic alopecia is not extreme hair loss — at least, not for the purposes of this article. 

When we talk about hair loss that is extreme, we’re talking about clumps of hair falling out in the shower, or in otherwise noticeable amounts not seen previously. If this is new to you and your hair loss is happening rapidly, it’s likely you’re experiencing extreme hair loss. 

Causes of Extreme Hair Loss 

So what causes this kind of hair loss? There are a few potential culprits. 

Telogen Effluvium

One type of sudden and extreme hair loss is called telogen effluvium. This could be the cause of your problem if you’ve recently suffered a traumatic or extremely stressful event or period of emotional stress. 

Generally speaking, telogen effluvium causes about 70 percent of scalp hairs to shed a few months after a shock to the system.

This shock could be illness or severe infection, serious psychological stress, thyroid problems, or dietary insufficiencies. 

Medications can also cause this extreme form of hair loss. Such drugs include retinoids, beta blockers, anticoagulants, anticonvulsants, and antithyroid medications used to treat thyroid disease.

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Alopecia Areata 

Another form of extreme hair loss is alopecia areata. Alopecia areata may not happen as suddenly as telogen effluvium, but results in dramatic patches of baldness. Sometimes it can result in complete baldness, in a form called alopecia totalis.

The causes of alopecia areata aren’t completely understood, but it’s believed to be an autoimmune response, caused by an autoimmune disease or condition. It may happen once and never again, or you can experience remission and recurrence of alopecia areata.

We’ve talked more about alopecia areata in our guide to Autoimmune Diseases That Cause Hair Loss.

Anagen Effluvium

Anagen effluvium can be extreme, but when it occurs it rarely comes as a shock. This is because anagen effluvium is primarily caused by chemotherapy, most often used as a cancer treatment. Most people who receive chemotherapy understand hair loss is one potential side effect.

Other Forms of Hair Loss

Other forms of hair loss occur more gradually and therefore may not be considered “extreme.” These include androgenic alopecia, tinea capitis (also known as scalp fungus), trichorrhexis nodosa and trichotillomania. 

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Getting a Diagnosis for Extreme Types of Hair Loss 

Before you can fix your “extreme” hair loss, you have to know for certain what it is you’re dealing with. A healthcare professional such as a medical doctor or dermatologist can help whether you’re suffering from excessive hair loss or a more gradual loss of hair. 

Diagnosing hair loss involves chatting with a healthcare professional about your hair loss symptoms, including when they started and whether you’ve experienced any traumatic or stressful events over the past several months that could contribute. 

They will also examine your scalp to help determine how your hair loss is happening, looking carefully at your hair follicles, hair shaft and any patterns apparent in your hair loss. 

They may also look at your skin and fingernails for clues. 

If they suspect it could be caused by an underlying health condition, they may suggest additional lab tests. 

Once a cause is determined, your healthcare provider can recommend appropriate treatment.

Treatments for Extreme Hair Loss 

There’s good news if it’s determined your hair loss is caused by telogen effluvium: it generally resolves itself without treatment. 

Addressing the underlying cause (stressful or traumatic event or what we call stress hair loss) that led to the body’s shock can help you move on while your hair is regrowing. 

Most often, telogen effluvium resolves itself within two to six months.

If alopecia areata is the culprit, your healthcare provider may recommend injections to speed remission. 

They may also prescribe medications such as steroids, immunotherapy, or minoxidil, one of the most well-known and widely accepted treatments for hair loss. 

However, this condition also often resolves itself in a matter of time.

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The Bottom Line on Extreme Hair Loss 

Losing your hair suddenly is scary. Even gradual thinning of hair is scary, but when hair loss happens quickly it can be a shock. 

The best course of action involves chatting with a medical doctor or other healthcare professional about your hair loss symptoms. They can best recommend a course of treatment and discuss your various options. 

The only good thing about sudden and extreme hair loss is it may resolve itself with time. 

But talking with a professional will help rule out important and potentially serious causes such as medical conditions that could lead to permanent hair loss. 

3 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. American Academy of Dermatology Association. (n.d.) Hair Loss: Diagnosis and Treatment. Retrieved from https://www.aad.org/public/diseases/hair-loss/treatment/diagnosis-treat
  2. American Osteopathic College of Dermatology. (n.d.) Telogen effluvium hair loss. Retrieved from https://www.aocd.org/page/telogeneffluviumha
  3. Phillips, T., et. al. (2017, Sept.) Hair loss: Common causes and treatment. American Family Physician 96(6): 371-378. Retrieved from https://www.aafp.org/afp/2017/0915/p371.html

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.