- General

How to Differentiate Telogen Effluvium (TE) From AGA (Androgenic Alopecia)

I get a lot of questions about how to tell if your hair loss is caused by TE (telogen effluvium) or AGA (androgenic alopecia.) People are very interested in making this distinction, with many hoping that they have TE instead. I believe that this is because TE is considered only temporary by most while AGA is seen as more hopeless or permanent. (This perception isn’t always correct though. Androgenic alopecia can be successfully treated and telogen effluvium can turn into the chronic kind which has no end in sight.)

Although there are a few general guidelines which do help to indicate which kind of hair loss you may have, know that there are exceptions to every rule. I will discuss this more in the following article.

How Much Hair Loss Do You Have?: Is It Shedding Or Thinning?: Generally speaking, folks with TE shed while people with AGA thin or have less strands per day coming out. Shedding is pretty hard to ignore and if you are experiencing it, you probably don’t have to ask in order to classify it because there is simply hair every where. If you run your fingers through it, you’ll come away with several spent strands. If you comb or brush your hair, there will be a lot of strands on your brush. And when you wash it, you can’t ignore it’s presence in the drain. With that said, there are very aggressive forms of androgen driven hair loss that presents itself like TE, but this is a bit more rare.

People with genetic or androgen driven loss may well be losing a problematic or troubling amount of hair but it often doesn’t reach the high levels of shedding each day. You may well notice more hair than what is normal coming out, but you may not be at the level where there are spent strands all over you all of the time.

Is Your Hair Loss Patterned And Occurring At Vulnerable Areas On Your Head?: Hair loss that is driven by AGA is often thought to come out and be noticeable in certain areas. These are the crown, the temples, the front hair line, and the top by the part line. These areas are thought to be more susceptible to DHT. However, I would argue that these areas are also the most sparse on your head and that’s why you can see TE type loss happen in these areas. Because you have less hair there to begin with, after a massive shed, these areas are going to be the hardest hit and the most noticeable. Still, if your hair loss is more patterned than diffuse, this is one more reason to suspect AGA.

What Does Your Regrowth Look Like?: The common perception about regrowth is that if it is miniaturized or coming in sickly, thin or fine then you must suspect androgenic alopecia because miniaturization indicates that the regrowth is being affected by a sensitivity to DHT or androgens. It’s also a common perception that a person experiencing TE is going to have much healthier regrowth. This is often the case, but again there are exceptions. People with chronic shedding (CTE) can sometimes have miniaturized hair. And, folks with shedding due to medical issues like thyroid or adrenal problems can have trouble with regrowth too. So it can be the wrong call to automatically think AGA if you’re seeing thin regrowth.

Similar Treatments: I understand the psychological need to diagnose what type of loss you have, but most of the time, the first line of treatment is going to be the same whether you make the distinction or not. You’ll still need to reduce inflammation and support and stimulate healthy regrowth. Notice that I omitted DHT blockers from my description. That’s because I don’t believe that they are the first line of defense. They have the potential to change and alter hormones which will often make the shedding or hair loss worse. One of the best ways to stop the shedding or loss is by creating a stable environment with out a lot of change. People who are hormonally vulnerable will often shed with each change in the body so you have to be careful with internal treatments. I always advocate trying the least invasive treatment first and working up from there.