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Sure, we’ve all seen loose hair strands, whether on our hairbrush, our pillow or circling the drain. But a hair strand with a little clump or white bulb at the end might make you do a double take.
Your next move might be to Google “What is the white bulb at the end of the hair?” which landed you here. Don’t worry, you’re (probably) perfectly normal (whether your friends agree or not is a different story).
Hair falling out with a white bulb can be normal shedding, but there are cases where it may be a red flag.
Below, we’ll get into how hair grows, the root causes of when shedding is actually hair loss and what you can do to treat it. Bookmark our guide on female pattern hair loss if you think this could be what you’re dealing with.
That white bulb at the end (or should we say beginning?) of a hair is the hair root.
Let’s get into a little anatomy — hair anatomy, that is. Every hair has a hair shaft and root. That shaft is the strand you can see protruding from your scalp.
The hair root is in the scalp and extends even lower into the hair follicle (a skin and connective tissue structure) and is connected to a sebaceous gland.
Cool fact: that nearby sebaceous gland is why hair gets oily over time—but that’s a different story for another day.
The hair root widens at the base of the individual hair, giving it a round, bulb-like appearance. New hair cells are constantly being made in the hair bulb. These cells stick together and harden, creating keratin, and the hair shaft develops from this group of hardened hair cells. The dermal papilla is found at the bottom of the bulb and supplies the hair root with blood.
Think of the papilla like a captain of the ship: It’s a key player in the type of hair shaft produced. Hormonal hair loss can target the papilla and eventually lead to hair follicular miniaturization (a fancy way to say your follicles get smaller and produce finer vellus or thin hairs).
Since new hardened cells keep attaching to the hair from below the scalp, it’s gradually pushed out of the skin, allowing your hair to keep growing longer. Eventually, as part of your normal hair growth cycle (more on this below), the hair is pushed out and shed.
At the base of the freshly emptied follicle, cells multiply to form a new hair and the growth cycle begins again. Rinse, wash and repeat.
While that little white bulb may look suspicious, it’s just a normal part of your hair. But if you’re seeing a lot more of those hairs falling out in the shower on your pillow, you might want to take a closer look at potential causes.
To understand why your hair is falling out with a white bulb, it’s helpful to understand the hair growth cycle and how it works. Every hair on your scalp and body goes through three stages, referred to as the anagen, catagen and telogen phases.
Anagen phase. In the anagen phase, your hair actively grows from the follicle to its full length. This is also known as the growth phase. About 90 percent of your hair is in this phase at any given time. The length of the anagen phase differs depending on where a hair is located and determines how long your hair can grow before it detaches from the follicle and falls out. For scalp hairs, the anagen phase can last several years. For body hairs, it may only last a few months. This is why your body hair only grows a short length before shedding.
Catagen phase. The catagen phase comes next. This transitional phase lasts for two to four weeks after hair has grown to its full length. In this stage, a club hair is formed. If many club hairs form at once and are subsequently shed, it can give the appearance of thinning. This may be due to issues like hypothyroidism, hyperthyroidism, stress, vitamin deficiencies or hormonal changes after childbirth.
Telogen phase. Lastly, the telogen phase (also known as the resting phase) is when follicular activity is quiescent. When the follicle is reactivated, it signals the end of the telogen phase. Exogen is sometimes considered a fourth phase of the hair cycle and refers to the active process of releasing and shedding the hair.
Different factors can affect hair growth, including age, genetics and race. Cool, right? Learn more about hair growth rate by age for a deeper dive into the hair cycle.
When you start shedding lots of white bulb hairs at once, and it feels like sudden hair loss, it may actually be a sign of telogen effluvium. This type of hair loss and temporary hair shedding is often caused by a stressful event to the body.
Telogen effluvium doesn’t discriminate against age, and the causes of telogen effluvium can really vary. It can be brought on by any type of stressful event to the body, which from surgery, childbirth and drastic weight loss to a toxic boss or marital issues.
This condition usually takes two to three months to see excessive hair loss after the triggering event, and it can last for up to six months.
Thankfully, telogen effluvium is usually not permanent, and when the stressful element is removed, your hair should go back to normal. If you think you may be dealing with stress hair loss, check out this guide for more details.
Even your diet can cause telogen effluvium, as deficiencies in protein, iron and biotin (among other vitamins and minerals) can affect hair growth. Your dermatology provider can run blood tests to see if you’re deficient and recommend a supplement to help round out your diet.
Additionally, certain drugs can have side effects that bring on telogen effluvium hair loss. Speak to your healthcare provider if you feel like your hair has started thinning since starting a new medication.
Chronic telogen effluvium may have a shedding period that lasts longer than the typical six months if triggering factors stay persistent — like if you’ve been at a toxic job for a long time.
A white bulb is not a sign of permanent hair loss, so you don’t need to Google “hair transplant options” just yet. It also doesn’t mean the hair follicle is dead or can’t regrow new hair.
Unlike androgenetic alopecia, telogen effluvium is typically reversible once the stressor is removed. (So yes, practice those deep breaths to help encourage healthy hair growth). You can speak with your dermatology provider to rule out any other root causes.
Thankfully, telogen effluvium can typically be reversed. While hair falling out with a white bulb isn’t the end of the world, seeing your hair falling out in clumps might be shocking. Acting early is vital.
Minoxidil, commonly sold under the brand name Rogaine®, is a topical or oral medication that stimulates hair growth. Though its exact mechanism of action is still unknown, it’s believed to encourage more oxygen, blood and nutrients to the hair follicle.
Minoxidil is approved by the Food and Drug Administration (FDA) as a treatment for female pattern hair loss and is often used in the treatment of telogen effluvium. It comes in several varieties, including:
Minoxidil drops. This dropper-style format makes it easy to target a bald spot or a wider part.
Minoxidil foam. This easy-to-apply foam can be quickly worked onto the scalp for diffused hair thinning.
Oral minoxidil. This once-daily pill has been shown to be as effective as topical minoxidil and can be a great pick for someone who doesn’t want to change their styling routine.
Learn more about the ways you can stop hair shedding in our comprehensive guide.
While hair falling out with a white bulb can seem like some type of funky bodily issue, it’s typically normal.
But if it seems like there may be a bigger issue going on, there are a few things you can do:
Consider your stressors. Large amounts of hair falling out with a white bulb can be a signal of telogen effluvium (hair loss brought on by a stressful event).
Eat your greens. Make sure to eat plenty of green veggies and all the other foods your mom would be proud of, as nutritional deficiency can bring on telogen effluvium.
Act fast. If you’re noticing hair fallout, find the right hair loss treatments to help address it and promote new growth before it gets baaaad.
If you’re ready for a game plan recommended by a healthcare provider, start your consultation today. And if you’d like to learn more about hair loss in women, this comprehensive guide covers all the bases.
Sara Harcharik Perkins, MD, FAAD is a board-certified dermatologist and Assistant Professor in the Department of Dermatology at the Yale School of Medicine. She is the director of the Teledermatology Program, as well as the Associate Program Director of the Yale Dermatology Residency Training Program. Her research focuses on telemedicine and medical education. Her practice includes general medical dermatology, high-risk skin cancer, and procedural dermatology.
Dr. Perkins completed her undergraduate education at the University of Pennsylvania and obtained her medical degree at the Icahn School of Medicine at Mount Sinai. She completed her medical internship at the Massachusetts General Hospital, followed by residency training in dermatology at Yale University, after which she joined the faculty.
Ahmad, M., Christensen, S. R., & Perkins, S. H. (2023). The impact of COVID-19 on the dermatologic care of nonmelanoma skin cancers among solid organ transplant recipients. JAAD international, 13, 98–99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518328/
Ahmad, M., & Perkins, S. H. (2023). Learning dermatology in medical school: analysis of dermatology topics tested in popular question banks. Clinical and experimental dermatology, 48(4), 361–363. https://academic.oup.com/ced/article-abstract/48/4/361/6869515?redirectedFrom=fulltext&login=false
Belzer, A., Leasure, A. C., Cohen, J. M., & Perkins, S. H. (2023). The association of cutaneous squamous cell carcinoma and basal cell carcinoma with solid organ transplantation: a cross-sectional study of the All Of Us Research Program. International journal of dermatology, 62(10), e564–e566. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16700
Ahmad, M., Marson, J. W., Litchman, G. H., Perkins, S. H., & Rigel, D. S. (2022). Usage and perceptions of teledermatology in 2021: a survey of dermatologists. International journal of dermatology, 61(7), e235–e237. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16209
Asabor, E. N., Bunick, C. G., Cohen, J. M., & Perkins, S. H. (2021). Patient and physician perspectives on teledermatology at an academic dermatology department amid the COVID-19 pandemic. Journal of the American Academy of Dermatology, 84(1), 158–161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491373/
Belzer, A., Olamiju, B., Antaya, R. J., Odell, I. D., Bia, M., Perkins, S. H., & Cohen, J. M. (2021). A novel medical student initiative to enhance provision of teledermatology in a resident continuity clinic during the COVID-19 pandemic: a pilot study. International journal of dermatology, 60(1), 128–129. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753449/
Cohen, J. M., Bunick, C. G., & Perkins, S. H. (2020). The new normal: An approach to optimizing and combining in-person and telemedicine visits to maximize patient care. Journal of the American Academy of Dermatology, 83(5), e361–e362. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316470/
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