Hair Falling Out With White Bulb: Causes and Remedies

Sure, we’ve all seen loose hair strands, whether on a hairbrush, a 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.

Hair falling out with a white bulb can be normal shedding, but if you’ve noticed excessive hair shedding, i.e., more than is normal for you, there are potential underlying causes to consider. Either way, you’re in the right place. 

We’re exploring the basics of how hair grows, what’s considered normal shedding, and how to recognize when excessive shedding might be a sign of an underlying issue. We’ll also help differentiate between temporary hair shedding and other forms of hair loss and what you can do to treat them. If you’re concerned about hair loss, bookmark our guide on the different types of hair loss in women.

That white bulb at the end of a strand of hair is the hair root encased by a clump of keratin (a type of protein). Because the clump around the root gives the hair a club-like appearance, these shed hairs with a white bulb are often called “club hairs.”

Let’s get into a little hair anatomy. First, every hair is made up of a hair shaft and a root. The shaft is the visible part of the hair that protrudes from your scalp.

The root is the part of the hair located beneath the skin that extends down into the hair follicle (a skin and connective tissue structure). The follicle is also 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 fill with a protein called keratin — the main structural component of hair — before hardening through a process called keratinization. The hair shaft develops from this group of hardened hair cells.

The dermal papilla is found at the bottom of the bulb. Its primary function is to supply the hair root with essential nutrients and oxygen through its rich blood supply.

Think of the papilla as captain of a ship. It regulates hair growth, nourishes the follicle, and influences hair characteristics based on its size and interaction with hormones.  In cases of hormonal hair loss, certain hormones interact with the dermal papilla, leading to hair follicle miniaturization — a fancy way to say the follicles get smaller and produce shorter, thinner hairs.

As new hardened cells continuously form at the base of the hair beneath the scalp, the hair gradually lengthens and emerges through the skin. It continues to grow longer until the growth phase of its cycle ends. Eventually, the hair sheds as part of the normal hair growth cycle — more on this below.

After the hair sheds, the follicle regenerates, cells in the hair bulb start multiplying to form a new hair, and the growth cycle begins again. Wash, rinse, and repeat.

Though that little white bulb may look suspicious, it’s a normal part of your hair growth cycle. The bulb is composed of keratin-filled cells that surround the hair root, and it indicates that the hair has entered the resting phase before being shed. 

Seeing some hairs with white bulbs each day is normal. But if you’re seeing a lot more of those hairs falling out in the shower or on your pillow, it may be worth exploring potential causes with a healthcare professional. 

The Hair Growth Cycle

To understand why your hair is falling out with a white bulb, it’s helpful to understand the natural hair growth cycle and how it works.

Every hair follicle on your scalp and body cycles through three stages, referred to as the anagen, catagen, and telogen phases:

• Anagen phase. In the anagen phase, your hair grows from the follicle to its full length. This is also known as the growth phase. About 85-90 percent of your hair is in this phase at any given time. The duration of this phase determines how long the hair will grow before it sheds, and varies depending on where on the body the hair is located. For scalp hairs, the anagen phase can last several years. For body hair, it may only last a few months. This is why your body hair only grows a short length before shedding. When anagen ends, the follicle moves into the catagen phase.

• Catagen phase. During this transitional phase, the hair slowly stops growing. The follicle detaches from its nutrient supply — the dermal papilla — and starts moving towards the scalp surface. At the same time, keratin-filled cells clump around the root, forming a club hair, which is a hair with a white bulb at the end. This phase typically lasts two to four weeks and is followed by the telogen phase. 

• Telogen phase. The telogen phase (also known as the resting phase) is when follicular activity is at rest. During this phase, the small white bulb at the base of the hair helps hold the hair in place within the follicle until it is shed. For scalp hair, this phase typically lasts two to three months. Usually, around five to 15 percent of all scalp hairs are in the telogen stage at any given time.

The exogen phase (shedding phase) is when the hair actually sheds from the follicle, often with the white bulb still attached. It’s often described as an extension of the telogen phase, but sometimes, it’s described as a distinct fourth phase of the hair cycle. After the hair sheds, the follicle reactivates, and new hair begins to grow.

Different factors, including age, genetics, and race, can affect hair growth. Learn more about hair growth rate by age for a deeper dive into the hair cycle.

Telogen Effluvium Hair Loss

If you’re shedding a noticeably increased number of hairs with white bulbs at the end, and it feels like sudden hair loss, you may be experiencing telogen effluvium. This condition occurs when more hair than usual enters the telogen phase of the hair cycle, leading to increased shedding over time. 

These hairs are triggered to prematurely enter into the telogen phase by some sort of physical “shock” to the body (such as giving birth or surgery) or severe emotional distress (such as that associated with a death in the family or a divorce). 

Usually, you’ll notice the excess hair shedding beginning two to three months after the triggering event, and it typically lasts up to about six months. 

In chronic telogen effluvium, the shedding period may last longer than the typical six months, especially if the underlying trigger persists — for example, if it’s due to a particular medication you are taking. 

What Are the Symptoms of Telogen Effluvium?

If you have telogen effluvium, note that your scalp typically remains healthy, with no signs of irritation like redness or peeling skin. If you do have these symptoms, it could indicate another issue.

Here are some typical signs that may point to a transition from normal daily shedding to telogen effluvium:

• Sudden onset of increased hair shedding.  While normal hair shedding is typically 50-100 hairs per day, individuals with telogen effluvium may experience two to three times that amount or more. This increased shedding is often noticeable through excessive hair on your brush, in the shower, on your pillow, or when simply running your fingers through your hair. 

• White bulbs on shed hairs. If you have telogen effluvium, many of the shed hairs will have a small white bulb at the root (club hairs).

• Diffuse hair thinning. Telogen effluvium causes hair to thin evenly across the scalp. You might notice a reduction in hair volume, which can be particularly noticeable when you put your hair in a ponytail.     

The good news is telogen effluvium is usually temporary, and the hair typically regrows once the underlying trigger is resolved.

What Causes Telogen Effluvium?

Telogen effluvium can affect people of any age and can be triggered by a wide range of physical or emotional stressors.

Common causes include:

• Surgery

• Hormonal imbalances related to childbirth, menopause, or polycystic ovary syndrome (PCOS)

• Drastic weight loss

• Severe psychological stress, such as a divorce or the death of a loved one

• Discontinuing birth control pills

• Thyroid issues, including both hypo and hyperthyroidism

• Infections or illnesses with high fevers

• Certain medications, including antidepressants, beta-blockers, calcium channel blockers, oral retinoids, and nonsteroidal anti-inflammatory drugs (NSAIDs)

What you’re eating (or not eating enough of) can also contribute to telogen effluvium. Nutrient deficiencies in protein, iron, and biotin (among other vitamins and minerals) can affect hair growth.

A dermatologist can evaluate your hair loss and recommend blood tests to identify deficiencies. Based on the results, they may suggest supplements to help round out your diet. You could also meet with a dietitian if you’re concerned about your overall nutrition. 

If you think you may be dealing with stress hair loss, check out our guide to stress and female hair loss for insight.

No, a white bulb isn’t a sign of permanent hair loss. It also doesn’t mean the hair follicle is dead or can’t regrow new hair. In most cases, hairs with white bulbs will be replaced by new hair growing from the follicle. 

However, if you’re suddenly shedding a large amount of hair with white bulbs, it may indicate telogen effluvium. This temporary condition is usually reversible once you address the underlying cause.

In contrast, female pattern hair loss (androgenetic alopecia) is a form of hair loss that is gradual and permanent. Although some shedding with white bulbs may occur in female pattern hair loss, the presence of white bulbs alone does not directly indicate this condition.

If you have concerns about ongoing hair loss, it’s a good idea to consult a dermatologist for an evaluation to identify potential root causes.

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.

Thankfully, telogen effluvium is usually temporary and tends to resolve on its own. However,  if the underlying cause is unclear or the shedding persists, it’s a good idea to consult a healthcare provider.

Minoxidil for Women’s Hair Loss

Minoxidil, commonly sold under the brand name Rogaine^®, is a topical medication that stimulates hair regrowth. Though its exact mechanism of action is not fully understood, it’s believed to work by increasing blood flow to the hair follicles, improving oxygen and nutrient delivery, and thus promoting hair growth. 

The Food and Drug Administration (FDA) has approved topical minoxidil as a treatment for female pattern hair loss. However, it is often used off-label to treat a number of other hair loss conditions, including telogen effluvium. While telogen effluvium will generally resolve on its own, it can take many months. Minoxidil may help hair regrow more quickly. 

Minoxidil comes in several forms, including:

• Minoxidil drops. This dropper-style minoxidil liquid format makes it easy to target a bald spot or a wider part.

• Minoxidil foam. Easy-to-apply minoxidil foam can be quickly worked onto the scalp for diffused hair thinning.

• Oral minoxidil. This once-daily minoxidil pill can be a great pick for someone who doesn’t want to change their styling routine. Studies suggest that it is just as effective as 5% topical minoxidil. Just FYI, oral minoxidil isn’t FDA-approved for hair loss, but it can be prescribed off-label for this purpose.

Learn more about how to stop hair shedding in our comprehensive guide.

If you have a concern about the underlying cause of any hair loss you may be experiencing — white bulb or not — it’s a good idea to reach out to a healthcare provider or a dermatologist. 

They can help assess your hair loss and recommend appropriate treatments based on the type you are experiencing — or reassure you that your hair loss is temporary and part of the natural hair cycle. 

While hair falling out with a white bulb can seem like some type of funky bodily issue, it’s most often normal. However, if it seems like a bigger issue is going on, there are a few things you can do:

• Consider your stressors. Large amounts of hair falling out with a white bulb can signal telogen effluvium (hair loss brought on by a physically or psychologically stressful event).

• Eat your greens. Eat plenty of green veggies and other nutrient-dense foods, as a nutritional deficiency can bring on telogen effluvium. 

• Get treatment. If you notice hair shedding or thinning, find the right hair loss treatments to help address it and promote new growth. We recommend speaking with a healthcare provider to identify the root cause and to recommend the appropriate treatment. 

If you’re ready to take action toward regaining healthy hair, do an online hair loss consultation today. And if you’d like to learn more about hair loss in women, our comprehensive guide covers all the bases.