I am 43, female. Why is my hair shedding and getting oily?

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on your description and attached picture (attachment removed to protect the patient’s identity), this pattern raises concern for a significant active hair shedding process, most commonly telogen effluvium, but there are several important possibilities we need to carefully differentiate.

Telogen effluvium often presents with sudden, diffuse shedding, hair coming out in handfuls during washing, and increased scalp oiliness because fewer hairs are absorbing sebum. Common triggers include hormonal changes (perimenopause, menopause, stopping or starting hormones); recent illness or infection, including coronavirus disease 2019 (COVID); psychological stress; rapid weight change; nutritional deficiencies (especially iron, vitamin D, vitamin B12, or protein); thyroid disorders, or medication changes within the past two to four months.

Another important consideration is androgenetic alopecia with acute shedding, where hair loss is exaggerated, and oiliness increases due to androgen sensitivity, particularly in the 40s. Inflammatory scalp conditions such as seborrheic dermatitis or scalp psoriasis can also cause excessive oiliness and shedding, especially if there is itching, burning, scaling, or tenderness.

Because your shedding is described as drastic and ongoing, this is not something to ignore.

I know this is scary, but please remember, sudden hair loss does not mean permanent hair loss in most cases. With the right evaluation and targeted management, regrowth is very possible.

I am giving you general, supportive care you can start right away while the cause of your hair shedding is being evaluated. These steps are safe and focused on protecting the scalp, minimizing further breakage, and supporting regrowth.

Be very gentle with your hair, especially when wet, as wet hair is at its weakest. Avoid rubbing with a towel; instead, gently squeeze out excess water and use a soft microfiber towel or cotton t-shirt. Do not brush or comb immediately after washing; wait until hair is slightly damp and use a wide-tooth comb, starting from the ends and working upward.

Wash your scalp regularly (every one to two days if oily) using a gentle, sulfate-free shampoo. Frequent washing does not worsen hair loss and can actually help when oiliness is increased. Focus shampoo on the scalp rather than the lengths, and avoid heavy conditioners or oils near the roots. Apply conditioner only to the mid-lengths and ends.

Avoid heat styling, chemical treatments, bleaching, straightening, perms, or tight hairstyles during this period, as these can significantly worsen shedding and hair shaft fragility. Let your hair air dry whenever possible.

Do not aggressively massage or scratch the scalp. If there is itch or oiliness, keep the scalp clean and avoid applying home remedies, essential oils, or multiple over-the-counter products, which can inflame the scalp.

Support your hair from within by ensuring adequate protein intake, regular meals, and good hydration. Until labs are checked, avoid starting high-dose supplements on your own, especially iron or biotin, unless advised by a healthcare professional.

Try to manage stress and prioritize sleep, as stress alone can amplify shedding and prolong recovery. Gentle daily routines, breathing exercises, and consistent sleep can make a real difference in hair cycling.

Most importantly, remember that sudden heavy shedding is often temporary and reversible once the underlying trigger is addressed.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.