Shedding is a normal part of the hair growth cycle, but ‘losing’ hair can still cause anxiety in people with a susceptibility to balding or a current hair loss condition.
One particular aspect that can raise alarm is the presence of a white bulb on the hair strand.
Fortunately, this is a natural part of the hair growth cycle, and it indicates telogen phase shedding. But in some people, it can also be a sign of telogen effluvium or another condition.
By failing to treat hair loss at its earliest stages – i.e. when you first notice an increase in shedding – you can create a situation where hairline recession and balding become more difficult to treat.
This is true whether the white bulb is present on the end of the hair strand or not.
In this article, you’ll learn about the various parts of the hair follicle and the different stages of the hair growth cycle. You’ll then learn exactly what it means when fallen hairs contain the white bulb.
Finally, you’ll learn what you can do to combat hair fall and create the ideal scalp environment for healthy hair growth.
The Hair Follicle: An Introduction
The hair follicle is an organ found throughout the body, except on the soles of the feet and palms of the hands. It’s found in the dermal layer of mammalian skin, and it contains various structures within it (1).
At the very bottom of the follicle is the bulb which contains three distinct parts. They are:
- The papilla: The bottommost part of the bulb, the papilla connects to the follicle root and is where nutrients, oxygen, and energy are delivered from the blood vessels.
- The germinal matrix: The second layer within the bulb, the matrix is where cells divide to produce new hair.
- The root sheath: The inner and outer root sheaths protect the newly-produced hair strand, as well as support the structure as it grows (2).
These structures within the bulb play a significant role in hair growth.
The Hair Cycle
To better understand the structure of the hair, it’s important to understand the hair growth cycle. This will provide you with a better idea of how each part of the follicle works.
The hair growth cycle contains three phases (3):
- Anagen – The active phase of growth, which lasts between three to five years. This is when the cells within the germinal matrix divide rapidly and a strand is produced within the follicle.
- Catagen – The transitional phase, which lasts just 10 weeks on average. At this time, the base of the follicle constricts to detach the the upper part of the bulb from the lower part (the papilla and germinal matrix).
- Telogen – The rest phase, which lasts a few weeks to a few months. This is when the upper part of the bulb will fully detach from the follicle and shed from the scalp.
This cycle will continue throughout the life of the person or until the hair follicle dies, which may happen as the result of a condition such as AGA.
The White Bulb – What Is It?
The base of the hair follicle – known as the bulb – contains three main structures: the papilla, the germinal matrix, and the root sheath. And although it’s a bit misleading, this bulb is slightly different from the bulb that’s shed.
As the diagram shows, the hair’s bulb contains an indent at the very bottom. This is where the papilla rests.
And both the papilla and the germinal matrix are needed for the proliferation of new hair.
So, the bulb that you see at the end of a fallen hair strand only contains root sheath and the base of the hair strand found within it.
Is the White Bulb a Sign of Permanent Hair Loss?
As mentioned previously, there’s always a percentage of hair follicles in the last phase of the hair cycle – the telogen phase. This means that shedding is always happening and, in and of itself, does not indicate a long term hair loss problem.
However, when you notice an increase in the numbers of shed telogen hairs, you might want to talk to a doctor as there is a possibility of it being Telogen Efflvium (4).
Telogen effluvium is a type of hair loss that literally means “outflow of telogen hairs.” The most common signs are an increase in the number of hairs shed with a white bulb and noticeable thinning on the scalp.
TE isn’t a condition in the same way as AGA and AA. It’s often temporary, and the loss of telogen hairs doesn’t mean that permanent balding is imminent.
There is still little known about the condition, or why some individuals are more susceptible to it than others.
What is known, though, are the most likely causes of TE (4). These include:
- Hormone changes (e.g. pregnancy, menopause, birth control)
- Shock (e.g. injury, surgery)
- Nutrient deficiencies
The good news is that most of the causes are temporary and, therefore, so are the effects of TE.
What Does It Mean to Lose Hair Without a Bulb?
If the white bulb’s presence is indicative of telogen effluvium, what does it mean when the bulb isn’t there?
This is a more complicated answer, as the causes of hair loss in this case can vary widely.
When a hair strand that has fallen from your head does not contain a bulb at the end, it simply means the hair was lost prior to the root. This is caused by mechanical tension on the hair strand, which is most common in cases of:
- Nutrient deficiency
- Protein deficiency
- Overexposure to the sun
- Heat styling
- Perms/hair dyes/overprocessing
Without the presence of the bulb at the base of the hair shaft, you may also notice splitting of the hair strand. This further indicates tension or damage from events mentioned in the above list.
Other Potential Causes of Hair Thinning and Balding
Whether the white bulb is present at the end of the hair strand or not, it’s important to remember that there are many potential causes of thinning and balding. While some of these are temporary, there are others that can lead to permanent hair loss if not handled effectively.
As the most common cause of hair loss, Androgenetic Alopecia (AGA) is a problem for millions of men and women worldwide (6).
There are three pathophysiological features present in men and women with AGA. They are (6):
- An alteration in hair cycle development
- Follicular miniaturization
If left to progress on its own, this will lead to the development of the tell-tale M-shaped balding pattern as seen in men, or diffuse thinning as seen in women.
And while there is much research on the topic – including pathology and potential treatments – there is still much that is unknown about AGA and who is at risk of developing the condition.
In general, researchers agree that various factors contribute to it. Genetics may contribute to as much as 80% of predisposition, though androgens (i.e. hormones), lifestyle, and environment can also tip the scales (7).
So, is AGA treatable?
There are FDA-approved medications such as finasteride and minoxidil that may be used to delay the onset of symptoms. Another ‘treatment’ option is hair transplantation, which ultimately just covers up the problem.
Unfortunately, there is no known way to cure the condition and other treatment methods – including the use of naturally-derived ingredients and manual stimulation of the scalp – are often employed as a way to reduce symptoms and slow the progression.
Alopecia Areata (AA) is an autoimmune condition characterized by non-permanent, patchy balding spots on the head (8). Biopsies of affected patches of skin show:
“a lymphocytic infiltrate in and around the bulb or the lower part of the hair follicle in anagen (hair growth) phase.”
This simply means that there is an immune facet to the condition, though the exact cause is unknown.
One possible connection to the immune theory is the fact that AA is associated with several concurrent diseases, including autoimmune disorders such as hypo/hyperthyroid, vitiligo, psoriasis, lupus, and inflammatory bowel disease (9).
Unfortunately, there is no one treatment option that has shown to be consistently effective in treating AA patients. A variety of possible future options exist, though, including JAK inhibitors and stem cells (10, 11).
Also known as scarring alopecia, cicatrical alopecia is a less common form of hair loss characterized by destruction of the hair follicle and the formation of scar tissues over affected areas of the scalp (12).
Cicatrical alopecia is actually a grouping of similar disorders, all of which lead to permanent hair loss (13).
While the exact cause of this condition is unknown, there are numerous theories surrounding its etiology (14).
The most common theory posits that an abnormal immune response is the culprit, though some researchers believe that the sebaceous gland may also play a role (15). However, support for the sebaceous gland theory has only been seen in mice models and is not believed to be viable in humans.
But whatever the cause, the outcome is the same: permanent and disfiguring hair loss on the scalp.
There are quite a few treatment options available to sufferers of scarring alopecia, but their efficacy depends on many factors. Oral steroids seem to provide the best results, but such drugs come with their own side effects (16).
While not common in the majority of developed countries, nutritional deficiencies can be present in adults and children alike. They may be triggered by poor nutritional intake, a pre-existing condition, or a sign of a more serious underlying medical condition such as Celiac or Chron’s (17).
The most common deficiencies among the United States population include iron and vitamins B6, D, C, and B12 (18).
The effects of these deficiencies, especially if left untreated for a long period of time, can be far reaching.
One way in which deficiencies may contribute to hair loss include a slowing down of the hair growth process. This is seen in iron deficient patients (particularly women), and the cause is believed to be a limiting of DNA synthesis which is required for hair cell proliferation (19).
Anther example is of vitamin D deficiency, which may be caused by inadequate sun exposure or fat malabsorption (20). This vitamin is believed to play a role in hair follicle cycling and, as such, a deficiency can lead to incomplete cycling and poor growth (21).
Physical and Emotional Stress
As mentioned previously, stress can trigger a form of hair loss known as telogen effluvium. This is the type of hair loss most often associated with a white bulb.
But did you know that both physical and emotional stress can trigger hair loss in the follicles in a similar fashion?
While physical and emotional stressors are considered to be quite different, they actually share numerous physiological reactions within the body (22). This simply means that no matter what type of stress you’re experiencing, your body will perceive it to be the same.
And when all is said and done, the outcome is the same: inflammation (23).
A 2017 study looked to understand the effects of stress on cytokine balance and hair parameters in healthy humans (24).
33 female college students were analyzed during a stress examination period, in which 18 participants were taking the exam and 15 were not.
They were analyzed at three point throughout the study, at 12 weeks apart, and the assessments included:
- Self-reported distress and coping strategies (Perceived Stress Questionnaire [PSQ], Trier Inventory for the Assessment of Chronic Stress [TICS]), COPE),
- Cytokines in supernatants of stimulated peripheral blood mononucleocytes (PBMCs)
- Trichogram (hair cycle and pigmentation analysis)
The results of the study showed that exam students experienced higher levels of cytokines – pro-inflammatory substances – than their non-exam counterparts (25). These higher cytokine levels were also associated with higher levels of hair loss as more follicles remained in telogen phase during this stressful period.
This strongly indicates that anything perceived by the human body as stress, can trigger inflammation and even put you at risk of increased hair shedding.
How to Stop Excess Hair Fall
Whether you’re dealing with a temporary form of hair loss such as telogen effluvium, or a more permanent condition, you still want to do all you can to slow hair fall.
Optimize Your Nutrition
The Standard American Diet (SAD) is full of sugars, fats, and high-glycemic foods. This can have long-term effects on your health, but it may also have an immediate impact.
One way it can do so is by promoting nutrient deficiencies.
A health-promoting diet is one that meets your daily macro- and micronutrient needs (26). And, while it can be overwhelming at first to create a diet plan that fits these needs, success is all about the little changes you begin making today.
You can begin to slowly introduce more colorful, nutrient-dense foods into your diet. The easiest place to start is with fruits and vegetables, which can be added as a snack or packed into a delicious morning smoothie.
Another aspect to consider is a high-fat, high-glycemic diet contributes to poor function of the sebaceous glands (27). These are located adjacent to the follicle, so any dysfunction can trigger inflammation and increase hair fall.
The foods that are most responsible for this and other negative health effects include (28):
- Red meat
- Animal-based oils
- Simple starches (potatoes, rice, bread)
- Sugary foods (candy, cakes)
- Carbonated beverages
The initial transition phase from a high-fat, high-glycemic diet to a healthier one can be difficult. However, by ensuring you receive the nutrients you need, your body will soon adjust and be even healthier.
While there are different causes of telogen effluvium, they all have one thing in common: stress.
Illness, nutrient deficiencies, shock, and hormone changes can trigger automatic responses in the nervous system (22). This leads to the release of hormones, including epinephrine and norepinephrine, which then causes emotional and physical symptoms of stress.
You may not be able to prevent illness or shock, but you can work to reduce the impact that it has on your emotional and physiological health.
Meditation is one coping mechanism.
Study: The Effects of Mindfulness Meditation on Hope and Stress (2016)
One particular study, published in 2016, monitored the effects of mindfulness meditation on a community sample (N = 46) (29).
The participants were split into two groups, with one group (n = 23) performing meditation regularly and the other group (n = 23) abstaining from meditation.
The results of the small-scale study showed that “the meditation group exhibited significantly higher hope and lower stress than the comparison group.”
While not completely convincing, there are further studies to back the claim that meditation can reduce stress levels naturally.
Study: Mindfulness-Based Stress Reduction as a Stress Management Intervention for Healthy Individuals (2014)
A previous study, published in 2014, reviewed research articles from between January 2009 to January 2014 to determine “whether mindfulness-based stress reduction is a potentially viable method for managing stress (30).”
Seventeen articles were included in the review, in which 16 of them showed “positive changes in psychological or physiological outcomes related to anxiety and/or stress.”
This indicates that mindfulness-based stress reduction techniques, including meditation and deep breathing, can be helpful in reducing stress levels and managing stress/anxiety.
Use Natural Shampoos and Hair Products
It may come as no surprise that the hair care products you use on a regular basis – shampoo, conditioner, hairspray, and serum – can have a significant impact on the health of your scalp and hair.
The majority of these products contain harsh ingredients, including preservatives and waxes. And while these may promote the longevity of the products themselves, they don’t do much good for your hair.
Natural shampoos are those that contain naturally-derived ingredients without preservatives, alcohols, and sulfates.
They instead contain ingredients aimed at improving the health of your scalp and supporting healthy, strong hair growth. This is especially important for anyone with pre-existing hair loss conditions, or for those with a genetic predisposition to developing them.
The white bulb at the end of a fallen hair strand can initially raise alarm. However, its presence is not immediately indicative of future thinning and balding.
Instead, the presence of a white bulb on the strand can indicate a simple case of telogen phase shedding, or the onset of telogen effluvium as caused by physical and emotional stressors.
Neither of these are anything to worry about and, in the case of TE, the problem will resolve naturally over time.
However, it’s still a good idea to be wary of the signs of more serious hair loss and what you can do to combat the problem.
That’s where lifestyle and dietary changes can make a big difference.
With just a few simple changes to your current routine – including a healthier diet and stress management techniques – you can take hair growth into your own hands.