Cosmetic procedures, such as shampooing too often, perms, bleaching, and dyeing hair can contribute to overall hair thinning by making hair weak and brittle. Tight braiding, using rollers or hot curlers, and running hair picks through tight curls can also damage and break hair. However, these procedures don't cause baldness. In most instances hair grows back normally if the source of the problem is removed. Still, severe damage to the hair or scalp sometimes causes permanent bald patches.
The pull test helps to evaluate diffuse scalp hair loss. Gentle traction is exerted on a group of hairs (about 40–60) on three different areas of the scalp. The number of extracted hairs is counted and examined under a microscope. Normally, fewer than three hairs per area should come out with each pull. If more than ten hairs are obtained, the pull test is considered positive.[27]
Telogen effluvium - occurs mainly due to the body’s reaction to stress, brought about by, illnesses such as cancer, mental and emotional disturbances, medications such as blood thinners, hormonal imbalances, stress during childbirth and so on. In this condition hair thinning occurs on the scalp. The hair usually regrows after the stress period is over.
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