How Do I Know If I Have Telogen Effluvium or Androgenetic Alopecia?

Both telogen effluvium and androgenetic alopecia cause you to lose hair. The reasons and patterns for hair loss are different with each condition. A doctor can tell which one you have and how to manage it. 

Many people find that they are losing more hair than usual at times. In some cases, the situation is temporary, and hair will grow back on its own. In other cases, the hair loss is permanent. 

What is telogen effluvium?

Hair grows in two stages. During the anagen phase, hair is actively growing. This goes on for two to four years, then it enters the telogen, or resting, phase. Several months after this, the hair naturally sheds. Usually, about 85% of hair is in the anagen phase and about 15% is in the telogen phase. 

With telogen effluvium, something triggers more hair to enter the telogen phase at one time and you notice increased hair loss and thinning hair.

What is androgenetic alopecia?

Androgenetic alopecia is also called male- or female-pattern hair loss. It can begin any time after puberty, though it usually starts later in life. It tends to run in families.

Androgenetic alopecia is a shortening of your hair’s anagen (growing) phase due to genetics. Your hair will take longer to grow back after shedding. Androgenetic alopecia is typically permanent.

Both conditions cause hair loss. The pattern of missing hair is different with each one. Only one of these conditions causes permanent hair loss.

Symptoms of telogen effluvium 

With telogen effluvium, you might notice more hair than usual coming out when you wash or brush your hair. You may find more hair on your pillowcase. The appearance of your hair might change and look thinner all over your head.

Symptoms of androgenetic alopecia 

Androgenetic alopecia varies in men and women. They each have a characteristic pattern of hair loss: 

• Male pattern hair loss: Hair loss starts above the temples. The whole hairline recedes into an "M" shape. Hair at the top of the head also thins. Sometimes, total baldness occurs. 
• Female pattern hair loss: Women lose hair along the line of the part first. Hair around the top of the head gets thinner as well. Women's hairlines aren't usually affected and they seldom go completely bald.

Telogen effluvium and androgenetic alopecia have different causes. Your doctor can explain which one you have. 

Causes of telogen effluvium

Usually, telogen effluvium happens due to a triggering event. Some of the triggers for telogen effluvium include: 

• Surgery
• Major physical trauma
• Psychological stress
• Extreme weight loss or change in diet
• Abrupt hormonal changes, such as during pregnancy or menopause
• Severe infection or other illness
• Iron deficiency
• Hypothyroidism or hyperthyroidism
• Some medications

Because the hairs don't begin to shed until two to four months after the trigger, you may not connect the hair loss to the event that caused it.

Causes of androgenetic alopecia 

The underlying cause of androgenetic alopecia is your body's response to androgens, a type of sex hormone. There is a genetic component to the condition. You can usually identify family members who have had the same kind of hair loss.

A doctor can help you figure out if your hair loss is due to telogen effluvium or androgenetic alopecia. A simple examination is usually enough to determine the cause of your hair loss. 

Diagnosis for telogen effluvium 

Your doctor will want to hear about how much hair you are losing and when the hair loss started. They may ask for pictures of your hair before you noticed the loss so he can compare that to how you look now. 

Your doctor might examine your scalp and see how much hair comes out from gently pulling on it. He will look for short, new hairs that are coming in to replace the extra hair fall. Sometimes a biopsy can show more hairs in the telogen phase than is normal.

They will probably ask about other symptoms you have to rule out conditions like thyroid problems.

Diagnosis for androgenetic alopecia 

Your doctor can look at your hair and scalp to see the pattern of your hair loss. If you have family members with similar hair loss, you should let your doctor know. 

They will also ask you about your health history and any medications you are taking to rule out other reasons for your hair loss.

Not all hair loss is permanent. If you do have thinning that doesn't get better, there are some treatments for hair loss. 

Treatments for telogen effluvium 

In most cases, telogen effluvium is temporary. The hair loss will continue for about six months, then taper off. New growth will begin as soon as each hair falls out. After some time, you will be able to see the new hairs growing in and your hair will return to its previous volume.

Treatments for androgenetic alopecia

There is no cure for androgenetic alopecia, but there are treatments to minimize hair loss. Some options include:

• Minoxidil (Rogaine): Minoxidil is available in over-the-counter and prescription strengths. You apply it directly to your scalp and hair can begin growing back after six months of regular use. 
• Anti-androgens: Some women respond well to medicines that block androgen production. These medicines can slow hair loss. 
• Hair transplant: This is a surgical procedure where a doctor moves hair follicles from one area of your body to another.