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What is Diffuse Thinning & How to Treat It

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Grace Gallagher

Published 08/21/2021

Updated 07/17/2024

Hair loss can take many forms, from a receding hairline to a bald patch that develops near the crown of the scalp.

One of the most common forms of hair loss is diffuse thinning, which is spread-out hair loss that affects the entire scalp. 

Diffuse thinning can affect the entire head of hair rather than only a certain area, such as the hairline or crown. It can give the hair a thin, “see-through” appearance. 

Diffuse thinning has several potential causes, from androgenetic alopecia (commonly referred to as male pattern baldness) to medical conditions that can cause temporary hair shedding. 

Below, we’ve explained what diffuse thinning is, as well as the common signs that you may spot if you have this form of hair loss.

We’ve also listed the most common causes of diffuse thinning, plus steps you can take to stimulate hair growth and restore your hair’s natural thickness and density.

Diffuse thinning, or diffuse hair loss, is a form of hair loss in which hair falls out from all areas of your scalp, causing your hair to take on a thin, low-density appearance. 

Male pattern baldness, the most common cause of hair loss in men, usually starts to develop as a receding hairline or bald spot at the crown. 

In contrast, diffuse hair loss usually affects the entire scalp without causing a clear receding hairline or other distinct pattern. 

Like other forms of hair loss, diffuse thinning can have a noticeable effect on the appearance of your hair and your quality of life. 

To learn a form of diffuse hair loss, check out our blog on DUPA (Diffuse Unpatterned Alopecia).

Like other types of hair loss, diffuse thinning can appear suddenly or develop over several months. 

If you’re experiencing diffuse hair loss, you may notice the following signs and symptoms:

  • Reduced hair density. The most obvious sign of diffuse hair loss is visibly thin hair. You may notice that your hair looks less dense than normal, with fewer hairs at your hairline, mid-scalp, and crown

  • Easily visible scalp. As your hair density decreases, your scalp may become easier to see. This sign is often especially visible when your hair is wet or when you look at your scalp under bright, downward-facing light.

  • Excessive hair shedding. It’s normal to lose between 50 and 100 hairs each day as a result of your hair’s natural growth cycle. If you have diffuse thinning, you may start to lose more hair than this on a daily basis. A common sign of excessive hair shedding is a large number of hair strands that can be seen on your pillowcase, in your bed sheets, or around your shower drain.

Hair Thinning Solutions

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Several different issues can cause or contribute to diffuse thinning. One of the most common is a form of hair shedding called telogen effluvium.

Telogen effluvium develops when a large amount of your hairs prematurely enter the telogen, or resting, phase of the hair growth cycle.

Healthy hair goes through a multi-phase cycle as it grows to its full length. In the anagen phase, each hair grows from the hair follicle to its full length over the course of two to six years

The hair then enters into the catagen phase — a transition phase in which the hair stops actively growing. 

Finally, the hair enters the telogen phase, during which growth stops, and the hair is eventually replaced by a new strand of anagen hair.

Normally, 85 percent to 90 percent of the hair on your scalp is in the anagen phase at any time, with the remaining hair in the telogen phase.

Telogen effluvium involves a large percentage of your hairs — often as much as 70 percent of all anagen hairs — prematurely entering into the telogen phase and shedding.

Most cases of telogen effluvium develop in response to physiologic stress, which can be caused by various factors. 

Events that may trigger telogen effluvium include:

  • Illnesses that cause fever

  • Infections, major surgery, or other injuries

  • Sudden changes in hormone levels

  • Severe or ongoing stress, or a traumatic event

  • Thyroid conditions, such as hypothyroidism

  • Crash diets that significantly reduce food intake

  • Nutritional deficiencies, such as low protein intake or iron deficiency

  • Medications such as beta-blockers, retinoids, anticoagulants, and others

When telogen effluvium occurs, hair loss usually isn’t immediate. Most of the time, the affected hairs will stop growing for one to six months, after which they’ll shed as they enter back into the anagen phase and detach from the scalp. 

Hair shedding from telogen effluvium isn’t permanent — typically, your hair will start to grow back once the underlying issue is treated.

Our full guide to telogen effluvium goes into more detail about how the condition develops and the symptoms it can cause. 

Although telogen effluvium is a common cause of diffuse thinning, it isn’t the only issue that can cause this type of hair loss. Other potential causes of diffuse thinning include:

  • Male pattern baldness. Male pattern hair loss can cause a receding hairline, balding at the crown, and/or diffuse hair loss that affects most of your scalp. Men in the later stages of the Norwood Scale often have visible, significant diffuse thinning.

    Unlike telogen effluvium, which typically causes temporary shedding, hair shedding from male pattern baldness must be treated quickly to prevent permanent hair loss.

  • Alopecia areata incognita This is a form of alopecia areata that causes diffuse, sudden hair shedding. It can develop over the course of a few weeks and is often misdiagnosed as telogen effluvium or male pattern baldness.

  • Diffuse alopecia areata. This form of alopecia areata is very similar to alopecia areata incognita but occurs over a longer period. It also causes diffuse thinning that can affect the entire scalp.

  • Anagen effluvium. Anagen effluvium is a form of nonscarring hair loss that can develop in response to certain medications and chemicals, including medications used as part of chemotherapy. 

If talking about hair loss in women, female pattern hair loss can also cause diffuse thinning. This type of female pattern hair loss usually causes hair loss around the scalp and part line (the area of the scalp where the hair splits into a left-facing and right-facing natural hairline), which can eventually progress to diffuse thinning across the scalp.

However, it’s worth noting that while diffuse hair thinning is a prominent feature of female pattern hair loss, it’s not the key determining factor in diagnosing female pattern baldness.

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Like other forms of hair loss, diffuse thinning is almost always treatable with medication, lifestyle changes, hair loss products, or a combination of different approaches. 

We’ve discussed the most effective ways to treat diffuse thinning below.

Treat the Underlying Condition

When diffuse thinning is caused by telogen effluvium, it will usually improve on its own after you identify the causative event and take steps to treat the issue causing your hair loss. 

This could mean making changes to your use of certain medical treatments and medications, adjusting your diet, reducing stress, or simply resting and recovering after an injury or surgery.

If you think you might have telogen effluvium, you should talk to your healthcare provider or schedule an appointment with a dermatologist.

They can test your hair for signs of telogen effluvium using a pull test and biopsy. Many common causes of telogen effluvium can be identified with a complete blood count, thyrotropin test, and other quick and convenient blood tests. 

Minoxidil

Minoxidil (the active ingredient in Rogaine®) is a topical hair loss medication that’s available as a liquid or foam. It works by shifting hairs into the anagen or growth phase of the hair growth cycle and stimulating the blood supply to your scalp.

If you have diffuse hair loss, applying minoxidil to your scalp often helps to stimulate growth and produce thicker, denser hair. 

In a 12-month study, 84.3 percent of balding men who used minoxidil rated it as “very effective,” “effective,” or “moderately effective” at promoting hair regrowth.

We offer minoxidil foam and minoxidil solution online. Although oral minoxidil is not over-the-counter, it could be an option following a consult with one of our healthcare providers.

Find out more about what to expect from minoxidil in our guide to how long minoxidil takes to start working.

Finasteride

Finasteride is a prescription hair loss medication. It comes in tablet form and works by inhibiting the effects of 5-alpha reductase, an enzyme that converts testosterone into dihydrotestosterone (DHT).

DHT is a hormone that’s responsible for miniaturizing hair follicles in the scalp and causing male pattern baldness.

Finasteride is very effective, but only for hair loss caused by DHT. In one study published in the Journal of the American Academy of Dermatology, researchers found that men who used finasteride for two years experienced a 15.8 percent increase in vertex scalp (that’s the crown) hair count.

We offer finasteride online after a consultation with a licensed healthcare provider who will determine whether a prescription is appropriate.

Topical Minoxidil and Finasteride

These two are a dynamic duo for treating hair loss — research shows the results are even more significant when minoxidil and finasteride are used together.

Other Hair Growth Products

Currently, FDA-approved hair loss medications such as minoxidil and finasteride are the most effective treatment options for thinning hair. 

However, other hair growth products can also help to control excessive shedding and promote healthy hair growth:

  • Growth-promoting shampoo. Many shampoos are formulated for stronger hair growth, with ingredients such as saw palmetto and ketoconazole. Our Hair Thickening Shampoo targets DHT buildup on the scalp and supports other hair loss treatments. Our guide to the best shampoos for thinning hair goes into more detail about ingredients to look for in a growth-promoting shampoo.

  • Biotin and other hair growth vitamins. As we’ve covered in our full guide to essential vitamins for healthy hair, several vitamins and minerals play key roles in growing thick, strong, and healthy hair. 

  • Our Biotin Gummy Vitamins are rich in biotin, niacin, and several other essential vitamins for optimal hair growth. 

Hair loss treatments, delivered

Several different forms of hair loss, including telogen effluvium, male pattern baldness, and autoimmune diseases such as alopecia areata, can cause diffuse thinning.

Depending on its cause, diffuse thinning may develop as thinning of hair that affects your entire scalp evenly or as a pattern of hair loss with thinning in specific areas.

If you’ve noticed your hair looking thinner than normal, it’s important to talk to your healthcare provider or schedule an appointment with a dermatologist to identify the cause.

Most of the time, hair loss treatments such as minoxidil and finasteride can stop hair loss and prevent diffuse thinning from getting worse. 

You can also look into whether scalp reduction surgery is a treatment option.

Worried you’re going bald? Our guide to the early signs of balding lists common signs of male hair loss that you may notice if you’re beginning to lose your hair, as well as the steps that you can take to slow down, stop, or reverse most types of hair loss. 

13 Sources

  1. AAD. Do You Have Hair Loss or Hair Shedding? (n.d.). Retrieved from https://www.aad.org/public/diseases/hair-loss/insider/shedding
  2. Alessandrini A et al. (2019). Alopecia Areata Incognita and Diffuse Alopecia Areata: Clinical, Trichoscopic, Histopathological, and Therapeutic Features of a 5-Year Study. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830548/
  3. American Academy of Family Physicians. (2009). Diagnosing and Treating Hair Loss. Retrieved from https://www.aafp.org/afp/2009/0815/p356.html
  4. Badri T, et al. (2021). Minoxidil. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482378/
  5. Chen L, et al. (2019). The Efficacy and Safety of Finasteride Combined with Topical Minoxidil for Androgenetic Alopecia: A Systematic Review and Meta-analysis. Retrieved from https://cdn.mednet.co.il/2012/05/the-efficacy-and-safety-of-finasterideminoxidil.pdf
  6. Ho CH, et al. (2021). Androgenetic Alopecia. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430924/
  7. Hughes EC, et al. (2021). Telogen Effluvium. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430848/
  8. Kaufman KD, et al. (1998). Finasteride in the treatment of men with androgenetic alopecia. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9777765/
  9. Rundegren J. (2004). A one-year observational study with minoxidil 5% solution in Germany: results of independent efficacy evaluation by physicians and patients. Retrieved from https://www.jaad.org/article/S0190-9622(03)03692-2/fulltext
  10. Saleh D, et al. (2021). Anagen Effluvium. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482293/
  11. Shenenberger DW, et al. (2002). Removal of Unwanted Facial Hair. Retrieved from https://www.aafp.org/afp/2002/1115/p1907.html
  12. Treating female pattern hair loss. (2020). Retrieved from https://www.health.harvard.edu/staying-healthy/treating-female-pattern-hair-loss
  13. Zito PM, et al. (2021). Finasteride. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513329/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 

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