Thinning hair or normal shedding? What to look for and what may help
Early action, such as topical treatment and lifestyle changes, may slow further loss and support regrowth.
Hair sheds every day as part of its normal growth cycle, but ongoing thinning is a sign it may be time to take a closer look. (Photos: Shutterstock, Freepik)
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Most people shed 50 to 150 strands of hair a day. That is normal, because these hairs are replaced as part of the growth cycle. But if thinning is becoming noticeable, it is worth taking a closer look.
Hair loss can begin earlier than expected. About 50 per cent of men and women under 50 experience hair loss, and it becomes more common with age. Because it often starts gradually, early changes are easy to brush off as normal shedding. The key is to watch for patterns over time – a widening parting, a ponytail that feels thinner or slower regrowth along the hairline.
What helps depends on the cause. Managing stress and switching to gentler hair care can reduce breakage and scalp irritation. For some people, topical minoxidil-based hair treatments such as Regaine may also help slow loss and support regrowth when used consistently, particularly for androgenetic alopecia, or hereditary hair loss.
WHAT MAY BE BEHIND THINNING – AND WHAT YOU CAN DO
Hair loss has many possible triggers. Hormonal changes, rapid weight loss and physical stress, such as surgery, can contribute. Scalp infections and tight hairstyles may also play a role.
The most common cause is androgenetic alopecia – male or female pattern hair loss – which is linked to genetics and hormones. It can present differently: Men tend to develop a receding hairline and thinning at the crown, while women may see thinning across the scalp.
Hair loss is sometimes linked to nutritional deficiencies, so a balanced diet is key. Protein also matters because hair is made largely of keratin, a structural protein.
Based on the Health Promotion Board’s dietary guidance, adults aged 18 to 49 need at least 0.8g of protein per kilogram of body weight a day, while those aged 50 and above need at least 1.2g per kilogram.
Hair care habits can also make a difference. Infrequent washing can allow oil, sweat, dead skin and product residue to build up, which may irritate the scalp. Use gentle, pH-balanced shampoos and lukewarm water, as very hot water can make hair more brittle and prone to breakage.
Avoid tight hairstyles that pull on the scalp. Limit heat styling, including blow-drying on the hottest setting. If outdoors for long stretches, a hat can help protect the scalp.
WHERE MINOXIDIL FITS IN
There are many hair loss treatments on the market, including serums and shampoos, and such options are relatively low-cost.
Clinical Assistant Professor Koh Wei Liang, senior consultant in the Department of Dermatology at Changi General Hospital, said many people with hair loss tend to explore over-the-counter serums and shampoos. However, he added that “some of these products lack substantial clinical evidence supporting their effectiveness”.
On the other hand, he said, topical minoxidil is an over-the-counter medication approved by the United States’ Food and Drug Administration (FDA) for hair loss.
Minoxidil is the active ingredient in products such as Regaine, which is marketed as Rogaine in the US. According to the brand, it has been available for more than 35 years* with proven results and used by more than 47,000 individuals^.
Asst Prof Koh said topical minoxidil works by acting on hair follicles and the hair growth cycle.
Clinical studies suggest topical minoxidil can improve regrowth for some people, although results vary. Randomised controlled trials have reported improvements in hair growth and density after four to 12 months, compared to placebos. Some studies have also reported visible improvements from about two months.
Asst Prof Koh said that most people tolerate minoxidil well. “However, some possible side effects include scalp irritation or dermatitis,” he said. “Some people may also see a temporary increase in hair shedding during the first one to two months of use, due to growing hairs pushing out the dormant resting hairs.”
He added that users should avoid getting topical minoxidil on the face, to reduce the risk of unwanted facial hair growth.
Topical minoxidil is also not suitable for everyone. Pregnant or breastfeeding women should not use it. People with hypertension or heart conditions should check with a healthcare professional before starting treatment.
Even for those who can use it, patience matters. Many users may be “tempted to stop treatment if they don’t see immediate results”, said Asst Prof Koh. “But it’s crucial to understand that consistent application for at least three to six months is often necessary to see noticeable hair growth.”
He added that individual results vary. “Minoxidil is not a one-off fix,” he said. “Long-term use is essential for sustaining hair growth and preventing further hair loss.”
If your hair is thinning, consider topical minoxidil such as Regaine, which is available as Regular Strength Hair Loss Treatment 2% Minoxidil Solution and Extra Strength Hair Loss Treatment 5% Minoxidil Solution. Check with a pharmacist or doctor if you are unsure which to use.
*Based on data collected since the FDA’s approval of Rogaine solution in 1988.
^Based on estimated cumulative subject exposure from completed clinical trials, using data from completed trials up to Nov 12, 2023.
