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Hair Falling Out In Clumps: Causes, Diagnosis And Treatment
Dr. Ismail Ughratdar (FRCS)
Medically reviewed by
Dr. Ismail Ughratdar (FRCS)
Updated on July 3, 2024

Hair falling out in clumps can be a distressing experience. A small amount of hair loss is normal in the shower or while brushing your locks — healthy people are expected to shed 50-100 strands per day [1]. However, sudden, excessive hair loss can be alarming and may signal an underlying health issue.

Clumpy hair loss can be triggered by several factors, including stress and anxiety, nutritional deficiencies, hormonal imbalances, or certain medical conditions. If you’re experiencing clumpy hair loss, you’re not alone — and there is hope. In this article, we’ll explore:

  • Why your hair is falling out in clumps
  • Which diagnostic tests you may need
  • How a hair transplant may help
  • Which non-surgical treatments are available
  • When to seek professional help
Table of Contents

Why is my hair falling out in clumps?

There are several conditions and factors that may be causing your clumpy hair loss. Here are some of the most common culprits: 

Telogen effluvium

Telogen effluvium is a common cause of temporary hair loss, often triggered by severe stress or significant medical events, such as chronic illness, surgical trauma, high fever, and serious blood loss [2]. 

This condition drives a large number of hair follicles into the telogen (resting) phase simultaneously, leading to noticeable hair shedding 2-3 months after the triggering event [2]. Telogen effluvium is one of the most common causes of rapid hair loss [3], and up to 50% of the scalp hairs can be affected in severe cases [2].

Will my hair grow back? Generally, yes, most cases of telogen effluvium resolve without treatment in six to eight months [3].

Androgenetic alopecia 

Androgenetic alopecia (male pattern baldness or female pattern hair loss) is the most common cause of hair shedding. It affects up to 80% of men and 50% of women at some point in their life [4]. 

While androgenetic alopecia doesn’t usually cause hair to fall out in clumps, it can cause sudden and noticeable hair loss in some cases. This condition is influenced by age, genetics and hormones, particularly dihydrotestosterone (DHT) [5].

Will my hair grow back? No, unfortunately hair loss from androgenetic alopecia does not grow back naturally, but your shedding may slow or stop altogether.  

Hair loss from alopecia areata

Alopecia areata

Alopecia areata is an autoimmune disorder that can cause hair to fall out in round patches. Your white blood cells mistakenly attack hair follicles, causing clumpy hair loss. In severe cases, it can lead to complete hair loss on the scalp (alopecia totalis) or the entire body (alopecia universalis). This condition affects roughly 2% of people at some point in their lifetime [6].

This condition often resolves on its own. However, alopecia areata can be unpredictable and you may experience periods of hair loss and regrowth throughout your life. 

Nutritional Deficiencies

Certain mineral and vitamin deficiencies can contribute to hair loss. Iron deficiency, in particular, has been strongly linked to hair shedding. Low iron levels can contribute to telogen effluvium [7], and research suggests iron deficiency is more common in women with pattern hair loss than in those without [8]. 

Hair growth supplements for hair loss

Other important nutrients for hair health include vitamin D, zinc, and biotin. Many people turn to hair growth supplements to address these deficiencies, but further research is needed to determine whether these are an effective treatment for hair loss [9].

It’s worth knowing that some supplements carry the risk of toxicity and may even worsen hair loss [9]. Your hair may return once the nutritional deficiency is corrected, but unfortunately, this is not always the case. 

Thyroid Disorders

Thyroid disorders can cause hair loss because thyroid hormone plays a key role in growing and maintaining healthy hair follicles. Thyroid dysfunction (both overactive and underactive) can lead to hair loss, as well as changes in hair texture and quality [10]. 

Patients with thyroid disorders may develop dry, brittle hair. The widespread hair loss associated with thyroid dysfunction can affect the entire scalp and, in some cases, body hair and the eyebrows [10].

Hair regrowth is usually possible when the thyroid condition is treated. However, it may take several months and be incomplete [11].


Certain medications can cause rapid hair loss as a side effect. In addition to well-known chemotherapy hair loss, these include [12]:

  • Antidepressants
  • Mood stabilisers
  • Antipsychotics
  • Anti-anxiety medication
  • Lithium (causes hair loss in 12-19% of long-term users [12]

In most cases, your hair will start to grow back once you stop taking the medication causing hair loss. If this is not an option, your doctor may be able to suggest a more hair-friendly alternative pharmaceutical.

Postpartum hair loss (telogen gravidarium)
Thinning hair of a woman 4 months postpartum (telogen gravidarium) [13]

Other conditions

There are many other factors that can cause clumpy hair loss. Other common causes of hair shedding include: 

  • Scalp infections — Fungal infections like tinea capitis can cause patchy hair loss. In severe cases, this can lead to significant shedding and even scarring alopecia if left untreated [14]. Yeast infections on the scalp are also linked to hair loss. 
  • Pregnancy and postpartum hair loss — Many women experience increased hair shedding several months postpartum. This is due to the rapid drop in oestrogen levels after giving birth [15]. Research suggests up to 50% of women experience this temporary hair loss [16]. 
  • Polycystic Ovary Syndrome (PCOS) — PCOS is a disorder that can cause hormonal imbalances, leading to hair loss. Research suggests that up to 30% of women with PCOS experience hair loss [17]. 
  • Lupus — Lupus erythematosus is an autoimmune disease that can cause hair loss as a symptom. A 2018 study found that up to 50% of people with this condition experience patchy hair loss [18].

Diagnostic tests for clumpy hair loss

If your hair is falling out in clumps, you need a diagnosis as soon as possible. Hair doctors use several diagnostic trichology tests to determine the underlying cause of clumpy hair loss, which can reveal the reason your hair is falling out and identify any associated medical conditions.

Dermoscopy assessment for hair loss
Dermoscopy assessment for hair loss

Scalp examination

A thorough scalp examination is the first step in diagnosing hair loss. This may include trichoscopy, a non-invasive technique that gives a magnified view of your scalp and hair follicles. A trichoscopy can help differentiate between types of alopecia and assess how active your hair loss is [19]. 

Hair pull test 

The hair pull test is a simple way to assess active hair shedding. A positive pull test (more than 10% of pulled hairs coming out easily) may indicate active telogen effluvium or other types of alopecia [20]. 


This test involves plucking about 20-50 hairs [21] from different areas of the scalp and examining them under a microscope. It helps determine the proportion of hairs in different growth phases. 

A normal result is more than 80% anagen (growth phase) hairs and less than 20% telogen (resting phase) hairs [22]. This test can also identify exclamation point hairs, a sign of alopecia areata [23]. Research suggests that trichogram analysis can be particularly useful in diagnosing telogen effluvium and androgenetic alopecia [24]. 

Scalp biopsy

You may need a scalp biopsy if noninvasive methods don’t provide a clear diagnosis. This involves removing a small section of scalp skin to be examined under a microscope. This type of test is often required for scarring alopecias and other complex hair loss conditions [25].

Blood tests for hair loss

Hair loss blood tests

Blood tests for hair loss can help identify medical conditions that may be causing your hair to fall out [26]. These may include:

  • Complete blood count (CBC) to check for anaemia
  • Thyroid function tests
  • Hormone level tests (e.g. testosterone)
  • Nutritional deficiency tests (e.g. iron, vitamin D, zinc)

Hair transplants after severe hair loss

Hair transplantation can provide a permanent solution after severe hair loss. It involves moving hair follicles from areas of the scalp with dense growth to areas with thinning or no hair. After several months, these transplanted hairs grow naturally in their new location for a lifetime. 

A hair transplant is not the solution when hair is actively falling out in clumps. They are performed when hair loss has stabilised, not during the period of excessive hair loss. A transplant can be considered after the acute hair loss phase is over and when its cause has been established.

FUE hair transplant for male pattern baldness
Results of an FUE hair transplant for severe male pattern baldness

Skilled surgeons can perform a natural-looking hair transplant, so it’s possible to get a hair transplant without anyone knowing. This procedure is usually recommended in the following scenarios:

Androgenetic alopecia

If you have stable androgenetic alopecia and your symptoms have not improved enough with other medication or other treatments, you may be a candidate for hair restoration. Hair transplants are permanent and offer natural-looking results for people with pattern baldness [27]. 

If you have severe hair loss, you may not be able to achieve a sweeping head of hair with a transplant. However, hair restoration can significantly improve your appearance if you have enough donor hair for harvesting. 

Scalp scarring

A hair transplant may be suitable if your scalp is scarred due to burns, injuries, severe traction alopecia [28], previous surgery, or scarring alopecia. Hairs transplants into scar tissue from burns may be more successful than other types of scarring, possibly because burn scar tissue is usually less deep than other scar types [29]. Artificial hair transplants can also be a good option for scalp scars and burns.

Hair transplantation is generally not recommended if you have active, rapidly progressing hair loss, insufficient donor hair, or highly unpredictable conditions such as alopecia areata that may relapse at any time. A thorough assessment by a hair transplant surgeon is needed to determine whether you’re a good candidate for the procedure. 

Man using minoxidil for male pattern baldness

Non-surgical treatments for clumpy hair loss

While a hair transplant can be a great option for severe hair loss, many cases can be managed with non-surgical treatments. These options are often the first line of defence against hair loss and can be used alone or alongside hair restoration for best results. 

In cases where a transplant is unsuitable, such as alopecia areata, non-surgical treatments are your best bet. These include:


Minoxidil is a medication that can boost hair growth and slow hair loss for men and women with androgenetic alopecia (and certain other hair loss conditions) [30]. Originally developed as an oral medication for high blood pressure, minoxidil was discovered to increase hair growth when applied topically. 


This medication, mainly used for male pattern baldness, works by lowering the levels of DHT in your blood. A long-term study showed that finasteride can effectively prevent hair loss and promote regrowth in men with androgenetic alopecia [31]. It is not approved for use in female pattern hair loss. 

Low-level laser therapy for hair loss
Low-level laser therapy for hair loss

Low-Level Laser Therapy (LLLT)

Low-level laser therapy devices use red light to stimulate hair growth by increasing cellular activity within hair follicles [32]. These lasers encourage hair follicles to move into the growth phase of the hair cycle, promoting hair growth. 

Research suggests it is a safe and effective treatment for hair loss in men and women [32]. LLLT is suitable for most people with non-scarring hair loss, such as androgenetic alopecia. 

Platelet-Rich Plasma (PRP) Therapy

PRP hair treatment involves injecting a concentrated fraction of platelets from your own blood into your scalp. PRP has been shown to boost hair growth and prevent premature hair loss [33] — 84% of research into PRP for androgenetic alopecia shows a positive result [33].

This treatment has no recovery period, so you can return to your daily activities straight away. However, despite PRP’s high success rate, it is not a permanent treatment for hair loss and ongoing sessions are needed for maintenance every 4-6 months. 

For this reason, many people prefer a hair transplant. PRP can be combined with hair restoration surgery to promote quicker recovery and better outcomes [34]

Receding hairline before and after scalp micropigmentation
Receding hairline before and after scalp micropigmentation

Scalp micropigmentation

In some cases of severe clumpy hair loss, regrowing your hair may not be possible. However, that doesn’t mean all hope is lost. Scalp micropigmentation (SMP) involves tattooing pigment into the scalp to create the appearance of a fuller head of hair.

While not a treatment for hair loss itself, it can greatly improve its appearance. On a completely bald head, SMP creates the impression of a closely shaved head of hair. Combined with a hair transplant, it can fill areas of low density to give the impression of even more coverage [35].

When to seek professional help for hair falling out in clumps

Seek professional help as soon as possible if your hair is falling out in clumps. Whether you notice diffuse thinning, hair breakage at the crown or increased shedding in the shower, a trichologist can provide expert guidance.

Once you have a diagnosis, our experts can explore solutions with you. These range from non-surgical approaches to hair transplant procedures such as follicular unit extraction (FUE) or follicular unit transplantation (FUT).

The Wimpole Clinic works with some of the best hair transplant surgeons in the UK, who will explain the hair transplant recovery process, hair transplant success rate, and potential hair transplant side effects. They can also provide before and after hair transplant photos to showcase their expertise. Book a consultation at one of our convenient UK clinic locations to learn how you can regain thicker, healthier locks.

Hair Falling Out In Clumps: Causes, Diagnosis And Treatment, Wimpole Clinic

  1. Frequency of hair fall, its awareness and hair care practices among adult population
  2. Telogen Effluvium: A Review of the Literature
  3. Telogen Effluvium: Symptoms, Causes, Treatment & Regrowth
  4. Association of androgenetic alopecia and severity of coronavirus disease 2019
  5. A hypothetical pathogenesis model for androgenic alopecia: clarifying the dihydrotestosterone paradox and rate-limiting recovery factors
  6. Alopecia areata (Primer)
  7. The Role of Vitamins and Minerals in Hair Loss: A Review
  8. Iron Plays a Certain Role in Patterned Hair Loss
  9. Diet and hair loss: effects of nutrient deficiency and supplement use
  10. A Descriptive Study of Alopecia Patterns and their Relation to Thyroid Dysfunction
  11. Hair loss and thyroid disorders
  12. Hair Loss in Psychopharmacology
  13. Telogen effluvium
  14. Tinea capitis: A current perspective
  15. Postpartum Hair Loss: Causes, Treatment & What to Expect 
  16. Hair loss: an overview
  17. Prevalence of androgenic alopecia in patients with polycystic ovary syndrome and characterization of associated clinical and biochemical features
  18. Alopecias in lupus erythematosus
  19. Trichoscopy update 2011
  20. Original article Hair pull test: Evidence-based update and revision of guidelines 
  21. Diffuse alopecia
  22. The Diagnosis and Treatment of Hair and Scalp Diseases 
  23. Hair Loss: Common Causes and Treatment
  24. Hair Evaluation Methods: Merits and Demerits
  25. Hair and scalp dermatoscopy 
  26. Systematic approach to hair loss in women 
  27. Hair restoration surgery: challenges and solutions 
  28. Traction alopecia: the root of the problem 
  29. Hair Follicle Transplantation on Scar Tissue 
  30. Topical Minoxidil: Systematic Review and Meta-Analysis of Its Efficacy in Androgenetic Alopecia.
  31. Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10‐year follow‐up 
  32. Low‐level laser (light) therapy (LLLT) for treatment of hair loss  
  33. Platelet Rich Plasma and Its Use in Hair Regrowth: A Review 
  34. Assessment The Role Of Platelet Rich Plasma In Follicular Unit Extraction Hair Transplantation 
  35. Natural results of scalp micropigmentation: A review
Dr. Ismail Ughratdar (FRCS)
Medically reviewed by Dr. Ismail Ughratdar (FRCS)Updated on July 3, 2024
The Wimpole Clinic offers FUE Hair, Beard & Eyebrow Transplants & Trichology.
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