White Bulb on Hair Follicle – A Sign of Hair Loss?

While the loss of hair with a white bulb attached can be a normal occurrence, there may be reason to worry if the loss of such hair is excessive.

This can be an indicator of telogen effluvium or pattern baldness and, without treatment, can worsen.

What is the White Bulb?

The one thing that scares people about the presence of a white bulb is its confusion with the root. After all, hair grows from the root, so no root means no more hair growth.

The bulb is not the root itself. Instead, it is the part of the hair strand that is the closest to the root throughout the growth cycle.

When a bulb is present on the end of a hair strand, it means the hair was lost at the root. This is indicative of a telogen phase hair, and it does not mean Male-Pattern Baldness (MPB) or other types of hair loss (such as alopecia areata) in and of itself (1, 2).

It also does not mean that further hair growth cannot occur (as loss of telogen hair does happen naturally during the hair growth cycle).

All hair lost at the root will contain a bulb. It may be small or large, white or pigmented. The bulb is always present when it comes from the source (that is, the follicle).

A hair without a bulb, then, means the hair was lost prior to the root. This is caused by premature breakage, typically a result of tension or physical stress. A few things that can lead to hair breakage include:

• Stretching (caused by tight hairstyles or wet styling)
• Protein deficiency
• Vitamin/mineral deficiency
• Overexposure to sun
• Heat styling
• Dyes/perms

Through the strengthening of your hair, you can easily avoid premature breakage. There are also ways to combat excess hair loss when it occurs at the root.

The Hair Cycle

There are four main phases of the cycle of hair growth (3). These include:

1. Anagen. The phase of active growth lasts anywhere from two to six years. At this point in the cycle, rapid cell development is occurring. This results in the formation of the lower portion of the follicle, known as a bulb.
2. Catagen. As the transition phase, active growth ceases and the hair follicle is pushed from the papilla. This lasts from a few days to a few weeks.
3. Telogen. The resting phase when very minimal cell activity takes place. At this point, a new anagen hair is forming under the surface and will soon push the telogen hair (along with the white bulb) completely from its follicle.
4. Exogen. The stage in which telogen hairs are shed and newly-formed anagen hairs push through the follicle. During this stage, 50 – 100 hairs are lost per day.

The hair follicles throughout the scalp are at different points in the cycle. The majority (70 to 85 percent) of hair follicles are in anagen phase at any given time, while another five to 15 percent are in telogen phase.

This means shedding should be fairly consistent throughout the year (unless, of course, you suffer from hair loss).

White Bulb and Hair Loss – Are They Connected?

An increase in hair loss containing a white bulb may be alarming, but it is not necessarily indicative of a larger problem. Other signs can more accurately indicate a problem. These include:

• Excess shedding (as seen on a pillow or in the shower drain)
• Hairline recession (especially near the temples)
• Itchy, flaky scalp
• Thin, wispy hair

Genetic predisposition is another possible indicator of a serious problem. Men and women with a family history of hair loss should err on the side of caution and pre-treat the condition if they experience any of the signs of hair loss listed above.

Telogen Effluvium

Telogen effluvium is a condition characterized by hair loss during the telogen phase. The name means “telogen outflow.” The cause of the outflow varies, but the result is the same. When too many hairs on the scalp enter telogen prematurely, the active growth ceases. This results in diffuse (all around) thinning.

Some known causes of telogen effluvium are:

• Hormonal changes (pregnancy, birth, medication, illness)
• Shock (injury, surgery, anesthesia)
• Stress (acute or chronic)
• Diet deficiencies (acute or chronic)

An increase in hair loss with a white bulb present on the end of the hair strand may be indicative of telogen effluvium. The condition is usually short-lived and the issue will often resolve within months of the trigger being resolved.

How to Stop Thinning and Hair Loss

There are some things you can do to put an end to hair loss.

Change Your Diet

Proper nutrition and mineral support are just as important for hair as it is any other organ. A diet lacking in necessary vitamins and minerals can lead to acute (or even chronic) hair loss.

Telogen effluvium triggered by diet deficiencies can be reversed.

The first step is to pinpoint your body’s nutritional needs. This varies from person to person (depending on gender, weight, BMI, age, and other such factors) but can be determined with the help of a trained medical professional such as a dietitian.

Second, you need the dedication to perform an entire diet overhaul. This can be difficult for some, but it is an absolutely essential step if you are looking to put an end to hair thinning and loss.

There are some food groups more likely to cause problems than others. They include:

• Dairy: This food group can cause delayed allergic reactions and can be difficult to digest after pasteurization. This means consumption can lead to systemic inflammation and digestive imbalance.
• Carbonated drinks: High in sugar and acid-forming, carbonated beverages add no nutritional value to your diet.
• Sugary cereals: Foods that are high on the glycemic index, such as sugary cereals and grains, lead to spikes in blood sugar. Over time, this can trigger insulin resistance (which may be linked to early-onset Androgenetic Alopecia) (4).
• Greasy foods: A diet high in greasy foods can clog the pores and hair follicles.

With these foods removed from your daily rotation, it is time to add in filling and nutrient-dense choices. Some of the best additions to your diet include foods that are:

• High fiber
• Probiotic
• Low glycemic
• Plant-based

With these foods added to your diet, you can ensure that your body (and your hair) is getting the nutrients it needs. This will help to improve overall health and contribute to stronger, more stable hair.

Take a Breather

As stress is a major cause of telogen hair loss, one of the best things to put an end to it is taking part in stress-relieving activities.

One such activity is controlled breathing.

Through calm and intentional breaths, you can lower cortisol levels and increase oxygen intake. This will decrease free radical activity (which can lead to further signs of aging, including hair loss and wrinkles) and improve the growth of healthy hair.

Other forms of stress relief exist as well. These include meditation, yoga or tai chi, massage, and many more. Choose to manage your stress and include self care.

Stimulate the Scalp

The above two techniques are beneficial for long-term health and hair growth. If you want to take a more direct route to stop hair fall, consider scalp stimulation.

Scalp stimulation is physical manipulation of the scalp that occurs in various forms. The most popular include massage, scalp exercises, and microneedling.

Various parts of the hair follicle play a role in hair growth. One of the most important structures is the dermal papilla.

The dermal papilla is the structure at the base of the hair follicle which connects the follicle to blood vessels. These blood vessels deliver oxygen and nutrients, so a strong connection is critical.

Scalp stimulation can naturally increase blood flow to the follicles and ensure adequate oxygen and nutrient levels.

An additional benefit to scalp stimulation, and to microneedling in particular, is cell proliferation (5).

According to a study performed by Dhurat et. al., microneedling can stimulate hair growth in men with AGA (6). This has even been shown to be successful in men who had previously failed to respond to other hair loss treatments (7). The procedure does involve a needle entering the skin and has the same risks as a tattoo. Please research your practitioner for training and certification in your state, and ensure that sterile disposable needles are used.

While you won’t see immediate results, you can use scalp stimulation in conjunction with the other methods mentioned above for a more thorough approach.

The Bottom Line

The loss of hair containing a bulb is a completely natural occurrence. In fact, such hairs can be shed anywhere from 50 to 100 times per day. However, a problem occurs when more hair than that is shed.

Whether through AGA, telogen effluvium, or alopecia areata, an increase in hair loss with a white bulb attached can be treated. This will involve a multi-step approach like the one outlined above.