Question:  How come I just can’t seem to grow my hair long? It just never gets past a certain length and then either breaks off or never gets longer. Why is that?

shutterstock_197763182Answer:  Every little girl and subsequent teenager has, at some point or another, wanted to grow their hair out as long as possible.  Many characteristics about how your hair grows are fixed and genetic and then there could also be some environmental reasons your hair is not growing as long as you wish.

To grow your hair as long as possible, it helps to understand that hair growth occurs in a regular repeating cycle which can be disrupted by many things.

The normal hair growth cycle:

  • Anagen Phase: This is the active growing phase of your hair which lasts for an average of 3 years (1000 days), but can be anywhere from 2-6 years and determines the length of your hair. The longer the growth cycle, the longer hairs can grow before being shed. The reason you cannot see hair growing is because the average growth rate is just 0.37mm per day.
  • Catagen Phase: During this time, lasting 1-2 weeks on average, hair follicles undergo a transition from the growing phase to a resting phase during which all growth activity ceases. Whatever length the hair is, it will not grow any longer.
  • Telogen Phase: This is the final resting phase and hair follicles remain in this phase around 3-4 months, or 100 days on average, before they are pushed out by new hairs growing underneath or pulled out by a hairbrush or other mechanical action causing friction such as shampooing.

Your scalp normally contains 100,000 hairs, and the average number of hairs shed daily is 100-150.  Hair (unlike nails) does not grow continuously but stops growing after a pre-determined period of time and is replaced by new hair. While many things can disrupt the normal growth cycle, halt hair growth and increase fall out, nothing, including medications, shaving techniques or menstruation can make hair grow faster. And, since the number of hair follicles is pre-determined in utero and does not increase after birth, there’s nothing you can do to increase the amount of hair that you have, despite what many websites and products may have you believe.

Hair grows normally, and at different rates, on all skin surfaces except palms, soles of hands and feet and specific genital areas. In addition, terminal (dark, course) hair is always present on men’s face, chest and abdomen. The duration of hair growth cycles (and hair length) vary with the anatomical location of the hair, for example, scalp growth lasts for 3-5 years and the eyelash cycle averages just 3-5 months.

Lifestyle factors that can affect your hair growth cycle

Aside from a genetic set point that determines your personal hair growth cycle and hair length, here are some other factors that may be inhibiting your hair’s growth and health:

  • Unnecessary roughness. Sometimes hair doesn’t appear to be growing because it breaks off in the middle or at the ends. This can be caused by rough treatment in shampooing, toweling wet hair, combing and brushing, tight pony tails and braids and use of heated appliances all causing hair to weaken as it ages (the ends) and simply break off. Any injury such as a burn or laceration to the scalp can also cause a scar resulting in permanent hair loss to the area contributing to a shorter look.
  • Telogen Effluvium. Any physical or emotional trauma can shock your body (and your hair follicles) which halts the hair growth phase and pushes it straight to the telogen phase causing a shedding of a larger than normal amount of hair (which thankfully and  usually reverses).  Some of the most common causes are extreme crash diets, child birth, menopause, chemotherapy and even a prolonged high fever along with emotional traumas such as death of a loved one or a traumatic divorce or other life change.
  • Hair loss diseases. Systemic, skin disease and deficiencies can affect the scalp, the hair shaft and the hair follicles. These include folliculitis (an infection of the hair follicles which can involve just one inflamed follicle or spread to others), autoimmune conditions such as alopecia areata, psoriasis or lupus that result in patchy hair loss, seborrheic dermatitis, fungal infections and even trichotillomania (a compulsive disorder characterized by a secret compulsion to pull hair out from the head and body parts), among other skin and hair diseases.
  • Medications. Some medications are known to have the side effect of diffuse (all over the head) hair loss.  These include beta-blockers (blood pressure medications), certain oral birth control pills, isotretinoin (for treatment of acne), antidepressants (serotonin reuptake inhibitors, or SRIs) and some cholesterol-lowering drugs. Hair loss will not occur in everyone, but if you experience it, work with your doctor to evaluate different medications and dosages to improve or stop the hair loss.

How a dermatologist diagnoses hair loss conditions:

  • Hair care and lifestyle evaluation. We can determine the causes of telogen effluvium or medication side effects and educate you about treating hair gentler.
  • Hair pull test. If a gentle tugging of the hair produces more than 6 hairs at a time we consider that an abnormal hair loss condition.
  • A thorough visual examination. This is how we rule out skin and scalp hair loss diseases.
  • Scalp biopsy and culture. If we notice any lesions, papules or pustules we will culture and biopsy the area to rule out scalp infections, fungal infections and carcinomas.

So, while you may never have hair as long as a mermaid, you can make the best of the hair you have by maintaining a healthy lifestyle of nutrition and exercise and being gentler on your hair at all times.

-Jodi