> Quick Answer: Hair thinning refers to reduced hair density and finer strands—you have the same number of hairs, but each is thinner. Hair loss (alopecia) means actually losing hair follicle output or the follicles themselves. Thinning often precedes loss and is easier to treat early. Both can occur together, especially in female pattern hair loss.
Why the Distinction Matters
Understanding whether you're experiencing thinning, loss, or both helps determine:
- The underlying cause
- The urgency of treatment
- Which treatments will be effective
- What outcomes to expect
Many women notice hair changes but struggle to articulate exactly what's happening. This guide will help you identify and understand your specific situation.
Hair Thinning Explained
What Is Hair Thinning?
Hair thinning refers to a reduction in hair strand diameter and/or overall hair density without significant follicle death. The hair that grows is finer, lighter in color, and less robust—but follicles are still producing hair.
Signs of Hair Thinning
At the individual hair level:
- Strands feel finer between your fingers
- Hair lacks the body it used to have
- Ponytails feel smaller in circumference
- Hair doesn't hold styles as well
- Individual hairs are lighter in color or almost transparent
At the scalp level:
- Scalp more visible through hair
- Wider part line
- Less overall volume
- Hair looks "flat" or limp
- Light shines through hair more easily
What Causes Thinning?
Follicular Miniaturization
This is the hallmark of androgenetic alopecia (pattern hair loss). Hair follicles gradually shrink, producing progressively finer hairs1.
In women, this often appears as:
- General thinning across the top of the scalp
- Preserved hairline (unlike men)
- Gradual progression over years
Hormonal Changes
Estrogen supports thicker hair. Declining estrogen (perimenopause, menopause, postpartum) can lead to finer strands:
- Research shows hair diameter decreases by 10-30% after menopause2
Nutritional Factors
Hair requires specific nutrients for optimal thickness:
- Protein deficiency leads to thinner shafts
- Iron deficiency affects hair quality
- Biotin supports keratin structure
Aging
Natural aging affects hair diameter:
- Hair thickness peaks in our 40s
- Progressive thinning is common after 50
- The anagen (growth) phase shortens with age3
Hair Loss Explained
What Is Hair Loss?
Hair loss (alopecia) refers to actually losing hair—either the hairs themselves (excessive shedding) or the capacity of follicles to produce hair (follicle death or dormancy).
Signs of Hair Loss
Increased shedding:
- More than 100 hairs per day in brush, drain, pillow
- Clumps coming out when washing
- Noticeable increase from your normal baseline
Reduced coverage:
- Visible scalp in new areas
- Patchy bald spots
- Receding in specific patterns
- Inability to cover thinning areas with styling
Follicle changes:
- Smooth, shiny scalp in affected areas (indicates follicle death)
- No small "baby hairs" growing in
- Permanence of the baldness
Types of Hair Loss
Telogen Effluvium (Temporary Shedding)
Triggered by stressors that push follicles into the resting phase:
- Major illness, surgery, or fever
- Extreme stress
- Significant weight loss
- Childbirth
- Medication changes
This is typically reversible once the trigger resolves.
Androgenetic Alopecia (Pattern Hair Loss)
Genetic predisposition combined with hormonal influences:
- Gradual miniaturization leading to thinning
- Eventually, some follicles stop producing hair
- Progressive without treatment
Alopecia Areata (Autoimmune)
Immune system attacks hair follicles:
- Patchy, round bald spots
- Can occur suddenly
- May be reversible
Scarring Alopecia
Follicles are permanently destroyed:
- Smooth, scarred scalp
- No regrowth possible
- Requires professional evaluation
The Overlap: Thinning Leading to Loss
In female pattern hair loss, thinning and loss occur along a continuum:
Stage 1: Miniaturization Begins
- Hair follicles start to shrink
- Individual strands become finer
- May not be visibly noticeable yet
Stage 2: Visible Thinning
- Reduced hair diameter is apparent
- Part line may widen
- Less overall volume
- Follicles still active
Stage 3: Progressive Loss
- Some miniaturized follicles stop producing
- Visible scalp in more areas
- Combined thinning and loss pattern
Stage 4: Advanced Pattern
- Significant visible scalp
- Remaining hairs very fine
- Many dormant follicles
How to Assess Your Situation
Self-Assessment
For thinning:
- Compare current hair strand thickness to old strands (if you have them)
- Look at photos from 5-10 years ago
- Ask your hairstylist if your hair diameter has changed
- Notice if products that used to weigh hair down no longer do
For loss:
- Count hairs lost in a day (collect from brush, drain, pillow)
- Part hair and photograph—repeat monthly to track changes
- Note if you can see scalp where you couldn't before
- Check if hair is actually missing vs. just thinner
Professional Assessment
A dermatologist can use:
- Trichoscopy: Magnified scalp examination showing hair diameter and follicle health
- Pull test: Determines if excessive shedding is occurring
- Blood tests: Checks for hormonal or nutritional causes
- Scalp biopsy: For unclear cases
Treatment Implications
Treating Thinning
Since follicles are still active, treatments focus on:
- Reversing miniaturization: Minoxidil can increase hair diameter4
- Nutritional support: Biotin, vitamin D, and iron support thicker growth
- Hormone optimization: If hormonal cause identified
- Early intervention: Better outcomes when started before significant loss
Treating Loss
Depends on the type:
- Telogen effluvium: Address trigger; hair typically regrows
- Androgenetic alopecia: Minoxidil, anti-androgens, or combination therapy
- Alopecia areata: Corticosteroids, immunotherapy, JAK inhibitors
- Scarring alopecia: Prevent progression; hair transplant for restoration
Treating Both (The Common Scenario)
Most women with pattern hair loss have both thinning and loss. Effective treatment:
- Addresses multiple mechanisms
- Supports existing follicles
- Stimulates dormant follicles
- Improves hair quality
Lush Lox combines oral minoxidil (to reverse miniaturization and stimulate follicles) with biotin (to support keratin production) and vitamin D3 and K2 (to support follicle health).
The Importance of Early Treatment
Both thinning and loss respond better to early intervention:
For thinning:
- Miniaturization can be reversed before follicles become dormant
- Maintaining current follicle count is easier than restoring lost ones
- Treatments work faster on active follicles
For loss:
- Dormant follicles can sometimes be reactivated
- Once follicles scar over, they're permanently lost
- Every month matters when follicles are at risk
Research shows that starting minoxidil earlier in the hair loss process leads to better outcomes5.
What to Do Next
If You're Experiencing Thinning
If You're Experiencing Loss
If You're Unsure
Start by documenting:
- Take consistent scalp photos monthly
- Note changes in hair texture and volume
- Count shed hairs for several days
- Consult a dermatologist for evaluation
The Bottom Line
Thinning and loss are related but distinct conditions. Thinning often serves as an early warning sign that, when addressed promptly, can prevent progression to permanent loss. The key is recognizing changes early and taking appropriate action.
Explore our clinically-studied hair treatments
References:
This article is for informational purposes only and does not constitute medical advice. Consult with a healthcare provider for diagnosis and treatment recommendations. Compounded medications are not FDA-approved finished drug products.