Chronic Telogen Effluvium Or Female Pattern Hair Loss

[Kate93]

Hi guys. I'm looking for some opinions on my hair loss.

It started 3 years ago out of nowhere.
I remember on the day I used a new shampoo and when I came to brush my hair it was all tangled and tight, and as I brushed it about 300 hairs came out, but only on the left side. I binned the shampoo thinking that was the cause, but since then its just been constantly shedding at least 300 to 400 hairs a day, and my eyebrows go patchy too.

I finally went to the doctor and had my bloods done in January this year and the only thing that came back wrong was a Vitamin D deficiency (it was 8). I asked the doctor if that was the reason for my hair loss and she was adamant that it was, but after reading online I'm not convinced. I've been on 3, 200 IU of vit D since January and I have noticed a bit of regrowth and the shedding slowed to "normal" levels, but I've got this niggling feeling that it's female pattern hair loss.

I've put some pics of my parting and the sides of my hair to see what you guys think. It looks similar to the pics I've seen on Google of FPHL but initially the shedding seemed to fit chronic telogen effluvium more. I should add I've lost at least 60 percent of my hair, possibly more. (I had my hair highlighted to try and hide my scalp a bit, hence the difference in the pictures.)
I know obviously no one here can diagnose it, but I would really appreciate some opinions or just someone to talk to. Thanks for reading

 

[Kate93]

Hi Kate,

Honnestly I could not tell you for sure. The fact you don't seem to be thinning in the front part makes me think it might not be FHLP. But it could be a diffuse form. Only a derm could tell you (when they can!!).
I am actually in a somewhat similar case although my pattern is very clearly the Xmas tree shape + sides. I have been thinning for years without noticing or really worrying. After an hormonal change on my body occured I started losing a ton and that's when it appeared clearly. Since then I have had several Telogen Effluvium due to trying meds (start-stops). Any hormonal imbalance triggers it. Have you had hormonal imbalance ? Took any meds? Changed your pill?
I also had very low vit d (6) and low ferritin. Supplementing helps but only hormonal treatment helped (but I had to discontinue) calming down the shedding. If you can link the shedding with a birth control pill switch then it can indicate Androgenetic Alopecia.

Thanks so much for replying, I really appreciate it

I've never been on the pill or had to take any medication before, so I'm sure its not that. I'm wondering if trying the pill might actually help, or is that a bad idea?

I first thought chronic Telogen Effluvium because I had a few things happening around the time that could have triggered it, mainly stress. my dad was really ill for a while and they suspected he had cancer, so I was panicking about that (thankfully it wasn't). Then shortly after he had to have a brain operation so it was literally stress after stress. I remember I wasn't sleeping very well at the time.

I was considering using minoxidil but there's that much loss I'd probably use a bottle in a week

Sorry about your AA btw. That's my biggest fear. I know I'll really struggle to cope if I'm diagnosed with it because it feels so final, if that makes sense?

 

[Kate93]

Your welcome Kate.
Sadly that makes sense. When the derm told me I had Androgenetic Alopecia I cried, told my parents crazy things... I am still very fragile and depressed-obsessed about it, but the forum helps to cope. (a bit)
I am really happy for your dad btw. Try to go to a derm specialised in hair loss and get a scalp biopsy done and hormonal +thyroïde blood work done. You could have to consult an endocrinologue for the last one. Then you will act. There is also the site her alopecia providing data, regimen, success stories and support whether it's Androgenetic Alopecia or CTE.

Ah I'm sorry to hear that I can completely relate. Hope you have support in real life too.

Thanks for the advice. Looks like I'm going to have to bite the bullet and get back to the docs to get them to dig a bit deeper then.

I hope everything works out for you pasbrilliantebrunette. Take care

 

[Nano123]

As Pas has said, you don't have the clear Christmas tree pattern but it could be diffuse FPHL, I think you could use a scalp biopsy, it checks the ratio between terminal "healthy hairs" and vellus or miniaturizing hairs. The main difference between CTE and FPHL is that CTE has very little miniaturization in comparison to FPHL.

I couldn't get a scalp biopsy done but I noticed that a big portion of my shed hairs are shorter than my hair length and thinner, to the point that I shed very tiny hairs and fuzzy hairs + the fact that my dad has crown thinning and the start of a receding hair line so it kind of confirms it. You can look back at your family history of hair loss and provide it to your derm as it would help in diagnosing your case, I hope your hair loss turns out to be CTE.

 

[Kate93]

As Pas has said, you don't have the clear Christmas tree pattern but it could be diffuse FPHL, I think you could use a scalp biopsy, it checks the ratio between terminal "healthy hairs" and vellus or miniaturizing hairs. The main difference between CTE and FPHL is that CTE has very little miniaturization in comparison to FPHL.

I couldn't get a scalp biopsy done but I noticed that a big portion of my shed hairs are shorter than my hair length and thinner, to the point that I shed very tiny hairs and fuzzy hairs + the fact that my dad has crown thinning and the start of a receding hair line so it kind of confirms it. You can look back at your family history of hair loss and provide it to your derm as it would help in diagnosing your case, I hope your hair loss turns out to be CTE.

Hey, thanks for the reply, I've only just noticed it

Yes, I really do want a scalp biopsy, but I'd need my doctor to refer me to a derm first, and I'm not sure she will because she says the vitamin D deficiency is the cause, but I genuinely don't believe it is.

At the moment I'm mainly shedding full length hairs with the white bulbs at the end (don't know if the bulbs have any relevance), and a few hairs mixed in that are about half the length of the rest. That could be broken hairs because it snaps so easily, or previous regrowth shedding I guess.

I've put some pics of the regrowth I've got at the front. That little fringe thing I've got going on is all new hair. I can see regrowth everywhere if I comb my hair in the opposite direction and it's quite dark and decent thickness but there's still a lot of scalp showing, so I don't want to get too excited. This is the first regrowth I've noticed in 3 years though.

My dad has male pattern baldness, the horseshoe pattern I think it's called? And my mum and nan have very fine hair naturally but no pattern loss. My brother's just turned 21 and he's starting to recede at the temples and thinning above the ears , roughly the same age as me when my loss started, so I'm kind of nervous it is down to crappy genes and nothing can be done about it.

Anyway, sorry for the ramble

 

[Nano123]

Hey, thanks for the reply, I've only just noticed it

Yes, I really do want a scalp biopsy, but I'd need my doctor to refer me to a derm first, and I'm not sure she will because she says the vitamin D deficiency is the cause, but I genuinely don't believe it is.

At the moment I'm mainly shedding full length hairs with the white bulbs at the end (don't know if the bulbs have any relevance), and a few hairs mixed in that are about half the length of the rest. That could be broken hairs because it snaps so easily, or previous regrowth shedding I guess.

I've put some pics of the regrowth I've got at the front. That little fringe thing I've got going on is all new hair. I can see regrowth everywhere if I comb my hair in the opposite direction and it's quite dark and decent thickness but there's still a lot of scalp showing, so I don't want to get too excited. This is the first regrowth I've noticed in 3 years though.

My dad has male pattern baldness, the horseshoe pattern I think it's called? And my mum and nan have very fine hair naturally but no pattern loss. My brother's just turned 21 and he's starting to recede at the temples and thinning above the ears , roughly the same age as me when my loss started, so I'm kind of nervous it is down to crappy genes and nothing can be done about it.

Anyway, sorry for the ramble

The regrowth looks very good, resolve the vitamin D thing first and then see what happens, if you notice miniaturization or hair loss doesn't correct itself after the vitamin D levels are back on track then try to get a biopsy done

 

[Nano123]

and by the way your hair looks very good as it is now so if you chase the problem now and even just maintain what you have it'd be pretty good, I wish you the best of luck dear xo

 

[Hope for hope]

Hi Kate 93, I'm 33 and have similar diffuse hair loss like yours for about 6 months now. My hair has gotten so thin from the bouts of diffuse shedding that you some of my scalp too. I've gone through about 2-3 bouts of hair loss since May2017 triggered from the flu and stress I think. I was on the pill as well- trinessa and recently switched back to ortho tri cyclen lo since I never had issues with that and was on it for 8 years prior to the trinessa, I was on trinessa for about a year when my shed started. I was also on Wellbutrin for a year and stopped when my shed started in May and it continued so I'm sure it wasn't the Wellbutrin.
I had all tests done and my iron was low-27- in July and was put on iron pills 27mg twice daily and it's now at 88 (yay) but my vitamin D is on the low side of the normal range so I just started Vitamin D supplements. I mostly shed long hairs with the white bulb at the end and currently shed about 15-30 hairs a day now and have lots growth along the hairline and some throughout the top of my scalp. My hairloss is all over my scalp.
I've been through so many ups and downs with this hair loss that I don't even know what's normal anymore. Shedding 15-30 hairs a day seems normal but to someone that's suffered about 2/3 hair loss, any hair loss is hard to see. I have to admit I've gotten so depressed since my last shed in September and praying that it was my last shed. I was told in August that I had telogen enfluvium by my derm and I want to go back again soon for another check up to make sure it's not more than that. It's hard to not stress about stressing about hair loss if that makes sense and I'm trying other things like reading and exercising to keep my mind from worrying.
Can anyone relate to this? Ive heard it's possible to prolong Telogen Effluvium by chronic stress and hormonal changes so I'm hoping I'm doing more good than harm right now. I just started Viviscal vitamins today and will keep you updated on that. I just hope for the day that my hair fullness comes back. I had a head full of super dark thick hair that even after straightening it, it was still full and thick everyday and I never once noticed one strand of hair shedding. I pray for those days to come back.

 

[Kate93]

Hey, so I thought I'd come back with a little update just in case anyone sees this and has similar hair loss.

I finally got to see a derm a couple of days ago. She had a quick look at my head, armpits and pubic hair and said it's most likely genetic because I have no density and my bloods are fine. She sent me to have a blood test for hormones and said the results will most likely come back okay from that too

I was expecting her to look for miniaturization or regrowth but she didn't, so I'm guessing it must be glaringly obvious to her that its FPHL. She told me to use Plantur39 caffeine shampoo, which seems to be a preventative more than anything else (if it even works) so I thinks it's 4 years too late to be using it, but hey ho.

I've got to go back next month, so hopefully then she'll look at my hair more in depth and prescribe spironolactone or something. I just hate feeling like I'm sitting back doing nothing about it.

Oh, and if anyone finds this thread through Google or whatever who has diffuse hair loss ,don't do what I did and presume it can't be FPHL because it's diffuse or because you're too young. It can be, and it's an aggressive little b**ch. Please get help straight away whilst you still have a chance to preserve what you have.

 

[Roxxy]

I am checking to see how Kate93 is doing. Did your doctor definitely diagnose FPHL?

I'm especially curious about the fact she made a conclusion looking at your body hair in addition to scalp. I have almost no arm pit hair left, but my dermatologist didn't seem to care.

 

[Kate93]

I am checking to see how Kate93 is doing. Did your doctor definitely diagnose FPHL?

I'm especially curious about the fact she made a conclusion looking at your body hair in addition to scalp. I have almost no arm pit hair left, but my dermatologist didn't seem to care.

Hello Roxxy I have my follow up appointment on April 13th, so hopefully I'll have a definitive answer then.

To be honest, I wasn't expecting the derm to check my armpit or pubic hair. She didn't say WHY she was checking but I assumed it was to rule out other forms of Alopecia or disorders? I'm not sure if FPHL causes body hair loss? I've read so any conflicting articles on it. my armpit hair is okay but my pubic hair has thinned out diffusely (didn't tell her that until after she'd looked lol) along with my eyebrows (though the left one filled back in and my right one is very sparse )

Regarding my head hair loss, she just "fluffed" through my hair a little with her fingers and lingered at my temples. No close ups or any tests. She said due to the low density it is "most likely" FPHL. The density is so bad that whenever I touch my hair I feel my head first But then 4 years of non stop shedding would affect density regardless of the condition causing it, surely? I hope she does more at my next appointment because after the last one I left with more questions than answers.

Sorry that your derm seems uninterested. It's frustrating isn't it? Are you losing head hair too?

 

[Jhair123]

I’ve been dealing with this too, and now think it is Telogen Effluvium for sure. One thing I’ve found is that maintaining a positive attitude is really important when dealing with this, which can be so hard when loosing hair. I found this video and it helped me understand my situation and stay positive. Maybe it can help some other people too:

 

[Danzee]

Hi @Kate93

Can you please let us know the update? Hope you are fine now.