How do I know if my hair loss is from Telogen Effluvium or male pattern baldness?

ithappens

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here's the story i completed a course of accutane back in february of this year. i was on it from august till feb 07 at 40mg a lower dose. anyway, i lost some hair throughout the treatment but it wasn't anymore than a few more hairs in the shower, something that my derm said was consistent with the treatment. anyway, towards the end of the treatment around the last month i noticed a ton and ton of hairs just coming out in the shower and throughout the day. since i ended in february i would say that i've lost close to 50-60% of my hair, i think i even started to shed body hair on my legs as well. anyway, my hair loss was not just on the top of my head in the male pattern baldness areas, but everywhere throughout my scalp and is occuring in a diffuse pattern. When i lift up the top of my head and the sides i look like some kind of chemo patient granted it isn't that noticeable unless i lift it up. Another thing is that the texture of my hair has also changed. I used to have thick straight hair and over the past few months it has become these thin weak curly strands. I mean i have these weird hairs sticking up all over the place on the vertex of my head and even my hair all over has become curlier.

anyway, i went a derm up here at school and he looked at my hair and agreed that accutane had at least something to do with it and gave me all kinds of blood tests and even a couple testosterone tests. He said from the blood and testosterone tests that everything came back normal, and my testosterone levels don't seem to indicate male pattern baldness so he thinks that it is Telogen Effluvium and over the course of the next few months or so my hair should recover and come back. The thing is i am just worried and hope that i am being diagnosed right and all. Can you know if someone has male pattern baldness based on their testosterone tests alone? he gave me two or three testosterone tests, but i'm not sure of the details exactly. also is it normal for people to fully recover from Telogen Effluvium? i'm just sort of at a loss right now and scared cause i still have my hair line and all but hair is just diffusing throughout.
 

ithappens

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oh yea i forgot to mention hairtodaygonetomorrow, the derm i saw did do a hair pull test where he pulled on the hairs in the back vertex of my head and guess what a ton started to come out. like maybe not all once but while i was in his office and after i left it started raining hair in that area of my scalp. is that what you mean by a hair pull test?
 

spinner2

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If it's from accutane then it's Telogen Effluvium. The real question is whether your Telogen Effluvium is going to trigger male pattern baldness.
 

ithappens

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well how do I know if this thing is going to trigger male pattern baldness. I have hair loss all over, granted is worse on the top part of my head. I have always had a thick full set of hair, but granted most people have less hair on the top than the sides so this would seem logical that it would be more harshly affected. How do I tell if this triggers male pattern baldness. My mom's side of the family has some hair loss issues while both my father and brother and me up until the Telogen Effluvium have always had thick full sets of hair. and no male in my family has had to deal with hair loss until they were into their 30s. My dad is pushing 50 and still has a huge thick mane on his head, granted it is a huge white mane now.
 

DammitLetMeIn

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spinner2 said:
If it's from accutane then it's Telogen Effluvium. The real question is whether your Telogen Effluvium is going to trigger male pattern baldness.

yeah, thats always the worry...
 

spinner2

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You aren't gonna know for months. When I had Telogen Effluvium pretty much all the hair thickened up again over the next 8 months, only I had receded slightly. Just keep an eye on it and read here to figure out what you plan to do if you have male pattern baldness.
 

Johnny24601

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re:

male pattern baldness only effects the hairs on the top of your head, this is the key difference.
Clearly you either have Telogen Effluvium, male pattern baldness or both. The first thing you must figure out is whether you had Telogen Effluvium. If the answer is yes, then you have to wait months to let your hair grow back and then you can determine whether you have male pattern baldness as well.
There is plenty of info on Telogen Effluvium on the web. Acne meds are known to effect hair quality. Perhaps you have simply have the early onset of male pattern baldness and the Telogen Effluvium revealed some thinning (from male pattern baldness) that you never noticed. But you need to be sure or at least relatively confident in your diagnosis.
 

ithappens

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male pattern baldness only effects the hairs on the top of your head, this is the key difference.
Clearly you either have Telogen Effluvium, male pattern baldness or both. The first thing you must figure out is whether you had Telogen Effluvium. If the answer is yes, then you have to wait months to let your hair grow back and then you can determine whether you have male pattern baldness as well.
There is plenty of info on Telogen Effluvium on the web. Acne meds are known to effect hair quality. Perhaps you have simply have the early onset of male pattern baldness and the Telogen Effluvium revealed some thinning (from male pattern baldness) that you never noticed. But you need to be sure or at least relatively confident in your diagnosis.

i highly doubt i have both at the moment an i can assure you i'm fairly certain i didn't have male pattern baldness before or at least it hadn't set in yet. 9 months ago I had a thick full set of hair i mean trust me it was more hair than most guys my age at 21 have. anyway, over the past 9 months i've been losing hair due to accutane and then i would way that most of my loss actualy has occure during the past like 4. My derm is very certain that it is Telogen Effluvium and he has seen people recover. And yes i've talked to many Telogen Effluvium patients and Telogen Effluvium affects the whole scalp but tends to hit male pattern baldness areas the hardest because that is generally where guys have less hair to being with. It isn't just random hair loss all over the place exactly like a chemo patient which is what many people think.My hair loss is also all diffuse as in i still have my front hair line intact but i've just had diffuse loss all over. The other thing is my shedding has slowed down over the past week or so so it may actually be Telogen Effluvium i dunno.
 

Johnny24601

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I remain skeptical of the idea that one who suffers from Telogen Effluvium can lose MORE hair in the male pattern baldness areas without um....having male pattern baldness. It assumes that hair density for those without male pattern baldness are less on the top of the head as opposed to the sides and I just have not seen enough evidence to conclude that point of view, but I would love to see it.
Remember male pattern baldness is not the same animal for all individuals. Some men lose hair very slowly over the period of literally decades. I for one am between a Norwood-1 to Norwood-2 and yet when I look back at photos from at least seven years ago I can see some recession.
To me, it makes more sense that Telogen Effluvium sufferers who appear to lose more hair in the male pattern baldness areas do so because they have male pattern baldness (perhaps early stage in many cases) as opposed to Telogen Effluvium somehow effecting the male pattern baldness areas more then the rest of the head. If your body is shutting down hair growth to compensate for other areas it is lacking, then why would it concentrate on hair in the male pattern baldness area unless there was some sort of difference with the follicles in that area. But I want to make it clear that this is my opinion and I have NO evidence to back this up.
I am not trying to scare you or be some sort of conspiracy theorist, just giving my thoughts. If you have exhausted all avenues and conclude that it is strictly Telogen Effluvium, then good luck with getting your hair back. Be patient because I hear it takes time and just keep your hair really short until it grows back.
 

Nathaniel

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I agree with Johnny, but you probably need to wait a few months. If it doesn't go away its definetely male pattern baldness too.
 

DammitLetMeIn

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Re: re:

Johnny24601 said:
I remain skeptical of the idea that one who suffers from Telogen Effluvium can lose MORE hair in the male pattern baldness areas without um....having male pattern baldness.
.

Thats because you're hooked on medical definitions. Look at it like this: when a man loses his hair, certain areas will go first whether its male pattern baldness or Telogen Effluvium. Theres no rule to say this just happens in male pattern baldness only after all male pattern baldness is an attempt to categorize the body.

Johnny24601 said:
It assumes that hair density for those without male pattern baldness are less on the top of the head as opposed to the sides and I just have not seen enough evidence to conclude that point of view, but I would love to see it..

There are more telogen hairs in certain areas I'm led to believe. At the end of the day, certain areas have to go first, so it makes sense that they're the same areas in Telogen Effluvium as in male pattern baldness.

Johnny24601 said:
To me, it makes more sense that Telogen Effluvium sufferers who appear to lose more hair in the male pattern baldness areas do so because they have male pattern baldness (perhaps early stage in many cases) as opposed to Telogen Effluvium somehow effecting the male pattern baldness areas more then the rest of the head. If your body is shutting down hair growth to compensate for other areas it is lacking, then why would it concentrate on hair in the male pattern baldness area unless there was some sort of difference with the follicles in that area..

It affects the male pattern baldness areas more because there is said to be a greater telogen turnover on the top of the head.

I don't know why they're the first areas to go with Telogen Effluvium but they definitely are or perhaps they're just more noticeable.
 

ithappens

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yea i mean i've lost hair all over the male pattern baldness areas and the sides have all thinned out very very much. i mean my sides as well as the male pattern baldness areas have diffuse hair loss, in fact my derm said one of the trademarks of Telogen Effluvium is bitemporal loss so I dunno. If my hair loss has been occuring all over which it has it would only seem logical that as my entire head of hair thins that the top would be the worst affected area compared to the sides because most if not all people have more hair on the sides than the top. i dunno i have to wait and see if it slows up and comes back. my temples are starting to grow back already and it seems to be slowing up so i guess that's good. i'll keep everyone posted
 

DammitLetMeIn

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ithappens said:
yea i mean i've lost hair all over the male pattern baldness areas and the sides have all thinned out very very much. i mean my sides as well as the male pattern baldness areas have diffuse hair loss, in fact my derm said one of the trademarks of Telogen Effluvium is bitemporal loss so I dunno. If my hair loss has been occuring all over which it has it would only seem logical that as my entire head of hair thins that the top would be the worst affected area compared to the sides because most if not all people have more hair on the sides than the top. i dunno i have to wait and see if it slows up and comes back. my temples are starting to grow back already and it seems to be slowing up so i guess that's good. i'll keep everyone posted

This basically happened me too. I don't know how it can be classified as male pattern baldness if it is/has grown back.
 

ithappens

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dammitlee did you're hair grow back? i'm pretty sure i've had a recent bout with Telogen Effluvium for the past few months and it is finally slowing down, and i think i see some regrowth on my temples. anyway it all started like 3-4 months ago for me and is finally slowing down. how long did it take for it to stop? and did the hair ever grow back?
 

DammitLetMeIn

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ithappens said:
dammitlee did you're hair grow back? i'm pretty sure i've had a recent bout with Telogen Effluvium for the past few months and it is finally slowing down, and i think i see some regrowth on my temples. anyway it all started like 3-4 months ago for me and is finally slowing down. how long did it take for it to stop? and did the hair ever grow back?

yeah, the temple hair which I lost has basically grown back and some hair is still growing in what remains to be filled in.The sides of my head lost a lot of hair and have now begun growing back in the same manner as my temples. The area which was hit hardest was the vertex, or at least it appeared to be hit hardest, it too is growing back. I expect this will take the longest.The key thing is to be losing hair in great amounts. I was losing hair in shocking amounts. In fact, I was even losing hair in some areas whilst other areas were growing back. Telogen Effluvium is fkd up.

Telogen Effluvium has lasted for 7 months to date. I still lose hair but nowhere near as much and much more is growing back. I never got a haircut so I've coped pretty well. I can imagine I would've went insane thinking I was balding if I had gotten a shave...
 

Johnny24601

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What you fail to point out is the fact that male pattern baldness does not mean your hair just dissapears over one cycle, as instead it just thins over time. There is an entire spectrum when we talk about the rate of hairloss, as many men go years and years before their loss becomes noticeable to the general public but a close up look would reveal that there is pattern loss. Perhaps a bout of Telogen Effluvium could reveal some small degree of pattern loss that went unnoticed for years. Perhaps not.
When it is stated that the hair grew back after Telogen Effluvium, that does not conclude that male pattern baldness does not exist because most men with male pattern baldness are still growing hair even in the pattern loss areas. If one looked at me, they would most likely not think I had male pattern baldness unless they got up close and studied my head or looked at a progression of photos over years and saw that the top was a bit thinner then the sides. It is very possible that many men in my position would not even notice that they are balding. If I did not know I had male pattern baldness and I got Telogen Effluvium and thus had thinning all over my head, then the top of my head would show the most loss. After the bout of Telogen Effluvium was over and my hair returned to normal, I'd be back at the point I am at now where my hairloss is essentially undetectable. Could I now conclude that I do not have male pattern baldness because my hair grew back? I'm confused?
I am not saying that you are all incorrect, just that there is some doubt in my mind and it is worth it to keep an eye on the situation.
I also would like to see studies that back up your point of view that hair follicles on the sides of the head for men WITHOUT male pattern baldness are different then follicles on the top of the head. I do not deny that this is the case as I think you could be right, I just think that this website is dedicated to proven studies to back up a particular point view if possible. I would do this researching myself but frankly this subject is not important enough to me.
Let's look at a man with male pattern baldness who sufferers from Telogen Effluvium. It is clear that he would show the most thinning in the pattern loss areas. However, I have not seen enough evidence that Telogen Effluvium should have a greater effect on pattern loss areas for men without male pattern baldness, especially on the hairline.
I am not trying to create a problem where there isn't one. Just giving my opinion. I hope that none of you have male pattern baldness.
 

DammitLetMeIn

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Re: re:

Johnny24601 said:
What you fail to point out is the fact that male pattern baldness does not mean your hair just dissapears over one cycle, as instead it just thins over time..

I'm aware of this.

Johnny24601 said:
Perhaps a bout of Telogen Effluvium could reveal some small degree of pattern loss that went unnoticed for years. Perhaps not.

How about you dont actually know, as indicated by the use of 'perhaps'. Speculating is pointless.

Johnny24601 said:
When it is stated that the hair grew back after Telogen Effluvium, that does not conclude that male pattern baldness does not exist because most men with male pattern baldness are still growing hair even in the pattern loss areas.

You're failing to recognize that it has grown back at the same strength and quality as it was previously. How can this be male pattern baldness?

Johnny24601 said:
If I did not know I had male pattern baldness and I got Telogen Effluvium and thus had thinning all over my head, then the top of my head would show the most loss. After the bout of Telogen Effluvium was over and my hair returned to normal, I'd be back at the point I am at now where my hairloss is essentially undetectable. Could I now conclude that I do not have male pattern baldness because my hair grew back? I'm confused?.

Undetectable or non-existent? I had no loss whatsoever prior to this and now my hair is returning to where it was - i.e. a full head of hair with no thinning in any areas.

Johnny24601 said:
I also would like to see studies that back up your point of view that hair follicles on the sides of the head for men WITHOUT male pattern baldness are different then follicles on the top of the head. .

No ones saying they're different. All we're saying is that those areas of the head are affected.

What exactly makes them male pattern baldness areaas apart from the fact they're the first to disappear?

isn't it logical they'd be the first disappear with Telogen Effluvium too?

Johnny24601 said:
I do not deny that this is the case as I think you could be right, I just think that this website is dedicated to proven studies to back up a particular point view if possible. .

I don't need a study. Im not questioning anything, you are. I'm giving you the facts and so is the threadmaker.

Johnny24601 said:
Let's look at a man with male pattern baldness who sufferers from Telogen Effluvium. It is clear that he would show the most thinning in the pattern loss areas. However, I have not seen enough evidence that Telogen Effluvium should have a greater effect on pattern loss areas for men without male pattern baldness, especially on the hairline..

The hair has to go from somewhere. Maybe the body eliminates it from certain areas first, regardless of male pattern baldness.


I don't know what you're trying to say here. If someone loses hair in a Telogen Effluvium and in 'male pattern baldness' areas and it grows back to full strength. Where is the male pattern baldness? There is none.
 
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