Telogen Effluvium or Androgenetic Alopecia?

[A_Username]

Okay, so for the past few weeks I've noticed thinning in my part and now have noticed thinning in the back of my head that I only was able to see after expecting myself with a webcam. The "feel" of it also seems different.

Now for some background: in January I got a horrible stomach flu, or that's what they diagnosed it as anyway; 105 degree fever, lots of vomiting, diarrhea and lots of pain for a couple of days and then I got sinus, upper respiratory tract and strep throat infections, and had residual effects in my GI tract for the months to follow, but all that's already being looked into.

I saw a dermatologist about the hair loss and he tells me he thinks it's telogen effluvium but he wasn't positive and told me there's no way to test it. He told me to start using T-Gel and gave me a prescription for cormax and tells me to come back in a couple weeks. I'm not too comfortable with the idea of sitting on my *** and waiting for more hair to fall out that might not come back. Unfortunetlly, after calling about six other clinics, the soonest I can get for a second opinion isn't until after my follow up with this doctor.

Now the things that concern me is that, when he looked me over, he didn't examine terribly thoroughly. He glanced over the part for like three seconds and that was the end of the examination, and he couldn't really tell me why he thought it was stress related besides knowing that I had been sick. Also, I can't say I've noticed much, if any, increase in shedding, which would be a typical symptom, right? Also, the loss seems kind of localized to me, which is atypical from my understanding. My only consolation right now is that I think I can see some regrowth at the hairline.

Thankfully, so far, it's not that overt to a casual observer. I have/had a very thick head of hair, but Christ do I want to keep it that way. I'm 18, and as far as family history goes, my father has a bald spot in the back of his head, and one of my uncles is bald, and that's about all I know. I don't know when their hair loss began either.

Now here's what it looks like(please excuse the shitty quality, it's the best I could get):

Regrowth? Kind of hard to tell from these photos :\

And around the top/back of my head

And here where it seems kind of diffuse

And here's what it looked like a couple years ago (please excuse the contrast, it was taken in a bathroom with a lot of bright lights)

I'm wondering if anyone could give me their opinion on what they think it is, and if they have any suggestions on what I should ask my dermatologist about. I'd like to find out what's causing the thinning as soon as possible and get it treated, and any help is appreciated. Thanks

 

[Johnny24601]

re:

It appears you have lost the majority of your hair in the areas where one deems "pattern baldness" i.e. the front and crown. Therefore, I believe you have male pattern baldness. No need to worry about a few months because you will not lose much ground over such a small time period. What is more important is you find a treatment which you are comfortable with (some people are only comfortable with doing nothing and yet others throw the kitchen sink at their male pattern baldness). So before you rush into anything make sure you do a lot of research and figure out what you want to do, typically factors to consider are potential side effects, cost (especially long term), effectiveness and hassle.
Perhaps I am wrong, but I would be very very surprised.

 

[A_Username]

Ugh, well, from what I've read I guess I'll go on propecia and rogaine assuming I don't have a bad reaction to it, if that's the case. I'm hanging onto the hope it's just telogen effluvium, but I guess I'll see with the upcoming appointments since I need a prescription for the propecia anyway.

By the way, is there really no test that could verify or atleast hint towards the cause of the hair loss? And if there is regrowth without treatment, is that indicative of it not being male pattern baldness? Thanks for the help

 

[DammitLetMeIn]

Yo, I have/had/having/experincing telogen effluvium.

Check the sides of your head, they should be less dense than normal. I'e there should be spaces of scalp visible if you lift your hair slightly. This might depend upon how far into your Telogen Effluvium you are.

It does attack "male pattern baldness" areas as well. I think there may be more telogen hairs in these areas or something, I don't know why.

 

[A_Username]

Yo, I have telogen effluvium.

Check the sides of your head, they should be less dense than normal.

It does attack "male pattern baldness" areas as well. I think there may be more telogen hairs in these areas or something, I don't know why.

My dermatologist did remark that the thinning seemed to be going that way... Thanks for suggesting that

 

[DammitLetMeIn]

My dermatologist did remark that the thinning seemed to be going that way... Thanks for suggesting that

Also hair might be fair easy to pull out in those male pattern baldness areas...

 

[beaner]

Your crown looks exactly like mine did years ago when I first noticed my thinning. Start now or you'll end up with a big 'ol bald spot like me. If you did have a Telogen Effluvium, that could also trigger your male pattern baldness if your prone to it.

 

[retropunk]

Did you look into the medication you were taking while you were sick in January?

I would probably stay away from a corticosteroid. This could further perpetuate your hair loss.

If you want a second opinion, go to a hair surgeon. Another dermatologist will probably say the same thing, "I do not know. Here's some steroids." The hair surgeon will probably check your hair for miniaturization for free. However, miniaturization is not the definite 'all go' for balding as some hairs can just never come back.

You could try taking some MSM. It's not proven to really help new hair growth, but a lot of people on here say it's helped their scalp and/or body hair grow faster.

 

[blondeguy]

By the way, is there really no test that could verify or atleast hint towards the cause of the hair loss? And if there is regrowth without treatment, is that indicative of it not being male pattern baldness? Thanks for the help

All that I know of is that you can have your scalp mapped for miniaturization to determine if hair is thinning.

 

[A_Username]

Did you look into the medication you were taking while you were sick in January?

First, I took cipro for a few days and tylenol, then I was taken off cipro and put on avelox and mucinex D. Then I had a colonscopy and an upper GI endoscopy done. I was given a single dose of percocett once and given a prescription, but I never took any more. I took dicyclomine for a day or two. Between the illness, the drugs, the stress and all the tests, it's probably quite possible that I could be experiencing Telogen Effluvium. But I'm not positive if it is. And since male pattern baldness runs in my family a little, I want to be on the lookout. I certainly hope it's not both

 

[Johnny24601]

re:

It is clear that you have decreased density in the typical male pattern baldness areas. Since Telogen Effluvium is a medical condition not associated with male pattern baldness, then why would you shed in the typical male pattern baldness areas? BTW, is there any history of male pattern baldness in your family going back the last few generations? Have you looked at older pictures to see if your hairline has moved in the past few years?
To answer your other question, men with male pattern baldness (meds or no meds) experience shedding periods, in fact all men do. Often times the shedding coincides with seasonal changes. Because the follicles in the male pattern baldness area are damaged and shrinking, the hair typically cycles at a faster rate then the rest of your head, so you quickly will lose hair and then the new hair growing back may appear to be regrowth but it is more of a replacement for the hair that was recently lost.
1) It is all too common for men with male pattern baldness to hold out hope and blame Telogen Effluvium for their loss
2) Even if you are losing hair over other areas of your head (which I am not sure that you are) the typical male pattern baldness areas are clearly thinner then the rest of your head
3) Derms are idiotic and seem to not care about men who are concerned about their hairloss.

 

[antonio666]

I agree derms are a useless bunch,i went to see one 9 months ago to see if i was thinning,at that point had receded about 10 mm from teenage hairline,she asked if my dad was bald,i said no ,very quick look at my head and concluded it was moving to a mature hairline,no thinning present and 90 pounds to be told information that cost me vital months that i will never get back

 

[DammitLetMeIn]

Did you look into the medication you were taking while you were sick in January?

First, I took cipro for a few days and tylenol, then I was taken off cipro and put on avelox and mucinex D. Then I had a colonscopy and an upper GI endoscopy done. I was given a single dose of percocett once and given a prescription, but I never took any more. I took dicyclomine for a day or two. Between the illness, the drugs, the stress and all the tests, it's probably quite possible that I could be experiencing Telogen Effluvium. But I'm not positive if it is. And since male pattern baldness runs in my family a little, I want to be on the lookout. I certainly hope it's not both

I'd give it until Christmas to see signs of regrowth.

 

[DammitLetMeIn]

Re: re:

It is clear that you have decreased density in the typical male pattern baldness areas. Since Telogen Effluvium is a medical condition not associated with male pattern baldness, then why would you shed in the typical male pattern baldness areas? .

Why does 'medical condition' even have relevance here? The human body is not predictable like that. Hair can indeed be shed in the male pattern baldness areas when it is telogen effluvium.

http://www.themorbidme.com/2006/03/telogen_effluvi.html

Because the follicles in the male pattern baldness area are damaged and shrinking, the hair typically cycles at a faster rate then the rest of your head, so you quickly will lose hair and then the new hair growing back may appear to be regrowth but it is more of a replacement for the hair that was recently lost..

What are you saying here? If hair regrows then its regrown. Its only if it regrows miniaturized that there is a problem.

1) It is all too common for men with male pattern baldness to hold out hope and blame Telogen Effluvium for their loss

This guy has a legitimate reason. i.e. the illness.

2) Even if you are losing hair over other areas of your head (which I am not sure that you are) the typical male pattern baldness areas are clearly thinner then the rest of your head

they tend to fall out first.

I don't know if has T/E or male pattern baldness, but at least give him accurate facts.

 

[Johnny24601]

re:

Dammit,
Look you are not seeing the total picture and I am not explaining things as clear as I should:
According to those photos, the man has thinning in the typical pattern baldness areas. Could this thinning result from Telogen Effluvium....partially. You see the underlining thinning resulting from male pattern baldness must have already been present prior to Telogen Effluvium, otherwise all of his head (and not just the pattern baldness areas) would look relatively the same or at least he would most likely have spotty loss somewhere other then the pattern baldness areas and I don't see that in the photos. This guy either has Telogen Effluvium AND male pattern baldness or just male pattern baldness...IMO of course. A diagnosis of Telogen Effluvium ONLY, does not account for the additional thinning in the pattern baldness areas as Telogen Effluvium should effect more of the entire head. Also, Telogen Effluvium typically does not attack the entire hairline (with uniformity) unlike in this guy's case. Perhaps he has experienced Telogen Effluvium and hair has fallen out all over his head but it is just more noticable in the pattern baldness areas because um he has male pattern baldness. If you have Telogen Effluvium and you notice that hair has fallen out of the pattern baldness areas first, it is because those pattern areas were already thinned out and the additional loss is just noticed in the pattern areas first. To my knowledge Telogen Effluvium loss should not be so targeted in the male pattern baldness areas such as this case, unless of course male pattern baldness already exists.
The term medical condition was meaningless, the point is that Telogen Effluvium and male pattern baldness are totally separate. One can have male pattern baldness and experince Telogen Effluvium and thus notice thinning in the pattern areas first, but the reality is that male pattern baldness most likely exists for this to happen. Though I would say Telogen Effluvium is a medical condition and male pattern baldness is a genetic condition, but there is room for debate on those labels.
When the hair follicle has been damaged by DHT, it is shrunken AND hair cycles tend to diminish in length because the damaged follicle cannot support the hair as long as in the past. That is why SOME people mistake regrowth for simple hair cycles.
I have read nothing that states that Telogen Effluvium is typically so concentrated on the male pattern baldness areas. It makes no sense because Telogen Effluvium is related to hair cycles and the only way it could be closely attached to the pattern baldness area is because those follicles are on a diferent cycle BECAUSE OF male pattern baldness.
I did not even really present any facts, but I stand by every word I have said and do not think you provide any evidence contrary to these facts, though I would certainly appreciate it if you did.

 

[DammitLetMeIn]

According to those photos, the man has thinning in the typical pattern baldness areas. Could this thinning result from Telogen Effluvium....partially. You see the underlining thinning resulting from male pattern baldness must have already been present prior to Telogen Effluvium, otherwise all of his head (and not just the pattern baldness areas) would look relatively the same.

This isn't true, the top of the head has a greater percentage telogen hairs than the sides and the back.

or at least he would most likely have spotty loss somewhere other then the pattern baldness areas and I don't see that in the photos.

That may still be to come. Illness was in January. Telogen Effluvium happens 4 months later and persists for months.

This guy either has Telogen Effluvium AND male pattern baldness or just male pattern baldness...IMO of course..

Not necessarily. His hair may grow back fully, is this still male pattern baldness?

A diagnosis of Telogen Effluvium ONLY, does not account for the additional thinning in the pattern baldness areas as Telogen Effluvium should effect more of the entire head. ..

This may yet still to be recognized.

Also, Telogen Effluvium typically does not attack the entire hairline (with uniformity) unlike in this guy's case. Perhaps he has experienced Telogen Effluvium and hair has fallen out all over his head but it is just more noticable in the pattern baldness areas because um he has male pattern baldness..

It could simply be that he has more telogen hairs in these areas.

If you have Telogen Effluvium and you notice that hair has fallen out of the pattern baldness areas first, it is because those pattern areas were already thinned out and the additional loss is just noticed in the pattern areas first. .

Hair FALLS OUT. It doesn't thin with Telogen Effluvium. If these hairs have fallen out first then it is because they are in the telogen phase or the body saw fit to reject them first to protect the rest of the body.

To my knowledge Telogen Effluvium loss should not be so targeted in the male pattern baldness areas such as this case, unless of course male pattern baldness already exists.

To 'your knowledge'. I disagree. Some areas of the head have a higher telogen turnover rate.

The term medical condition was meaningless, the point is that Telogen Effluvium and male pattern baldness are totally separate. One can have male pattern baldness and experince Telogen Effluvium and thus notice thinning in the pattern areas first, but the reality is that male pattern baldness most likely exists for this to happen.

With Telogen Effluvium the body rids itself of hair to retain nutrients for its inner organs.

I'm not sure why it attacks the 'pattern' areas but if it grows back fully then this cannot be called male pattern baldness imo.

When the hair follicle has been damaged by DHT, it is shrunken AND hair cycles tend to diminish in length because the damaged follicle cannot support the hair as long as in the past. That is why SOME people mistake regrowth for simple hair cycles..

But if it regrows fully and non-minitaturized, then whats your point?

I have read nothing that states that Telogen Effluvium is typically so concentrated on the male pattern baldness areas..

I have. and I provided a photo to prove it.

It makes no sense because Telogen Effluvium is related to hair cycles and the only way it could be closely attached to the pattern baldness area is because those follicles are on a diferent cycle BECAUSE OF male pattern baldness..

They don't have to be on a different hair cycle because of male pattern baldness. All of our hairs are on a different hair cycle otherwise all our hair would fall out at one time - this is not the case.

I don't know why it falls out in pattern areas first perhaps these are the least useful areas for the body to retain hair,I don't know.

My Telogen Effluvium went like this:

Lost hair from temples first and over the top area of head - straight away - no waiting for 3 months to pass.

Then 3 months later - massive shed - most heavily on pattern areas but also from the sides.

Within one month hair initially lost from the temples had begun to regrow and has now regrown fully.

The rest of the hair is now filling in daily non-miniaturized. So there you have it.

go check out mickey's story in the succes forum. he had similar trouble.

 

[Johnny24601]

re:

I find it highly unlikely that this guy is ONLY experience Telogen Effluvium and yet his loss is exclusively targeted to pattern baldness areas. It just doesn't add up. Not to mention that hairs on his hairline appear to be thinning a bit which someone with male pattern baldness would not have. Again, it is my opinion that this man has male pattern baldness or male pattern baldness combined with Telogen Effluvium.
Telogen Effluvium typically does effect the top of the head more, but it does not focus on the male pattern baldness areas EXCLUSIVELY like in this case, nothing I have read says so (unless one already has male pattern baldness). Sides are typically effected as well just not to the same degree. Could we see more loss later, potentially but the evidence (IMO) based on the fact that his frontal loss is basically symmetrical (not typical of Telogen Effluvium) and his loss is so targeted to pattern loss, I stand by my opinion.
It stands to reason that he should visit a Doctor and monitor any further loss. I never said go out and treat your male pattern baldness. Again, he should look at photos prior to his January sickness, if they show loss then he has male pattern baldness. Of course he could have STILL suffered from Telogen Effluvium even if he does have male pattern baldness, but at least he can narrow things down.
Stop trying to use your own case to represent all people with Telogen Effluvium.
BTW, do you have male pattern baldness?

 

[DammitLetMeIn]

I find it highly unlikely that this guy is ONLY experience Telogen Effluvium and yet his loss is exclusively targeted to pattern baldness areas. It just doesn't add up. Not to mention that hairs on his hairline appear to be thinning a bit which someone with male pattern baldness would not have. Again, it is my opinion that this man has male pattern baldness or male pattern baldness combined with Telogen Effluvium.
Telogen Effluvium typically does effect the top of the head more, but it does not focus on the male pattern baldness areas EXCLUSIVELY like in this case, nothing I have read says so (unless one already has male pattern baldness). Sides are typically effected as well just not to the same degree. Could we see more loss later, potentially but the evidence (IMO) based on the fact that his frontal loss is basically symmetrical (not typical of Telogen Effluvium) and his loss is so targeted to pattern loss, I stand by my opinion.

You can stand by it all you like, but it doesn't make it true. All you have said, is opinion, evidence reason etc. But the facts are that Telogen Effluvium is poorly understood and you don't actually know the answer.

It stands to reason that he should visit a Doctor and monitor any further loss. I never said go out and treat your male pattern baldness. Again, he should look at photos prior to his January sickness, if they show loss then he has male pattern baldness. Of course he could have STILL suffered from Telogen Effluvium even if he does have male pattern baldness, but at least he can narrow things down.

I agree with this paragraph.

Stop trying to use your own case to represent all people with Telogen Effluvium.
BTW, do you have male pattern baldness?

I am not trying to do that. All I'm saying is that is not as rigid as the literature may make it seem. Mickey's story on this website is a good example, the website I've provided and my own case are all good examples.

And no, I don't have male pattern baldness. Any loss I have suffered in male pattern baldness areas during Telogen Effluvium has fully regrown. I am now waiting on the non-male pattern baldness areas to fully regrow, which thankfully, they are doing. Surely it was clear from my last post that I have/had Telogen Effluvium.

 

[Johnny24601]

re:

The guy is thinning exclusively in male pattern baldness areas, his hair line appears to have thinned and his hairline loss is symmetrical just like male pattern baldness and not Telogen Effluvium. He asked for an opinion I provided it with evidence. What the hell else do you want? Am I 100% sure, no and I said this many times. What is your point man. You seem like the Telogen Effluvium Nazi!
To the contrary the literature is not rigid, everything I have read has said Telogen Effluvium is complicated and can come about as a result of a number of factors and the symptoms can vary, though there are somethings that are more common in all Telogen Effluvium patients. I am trying to figure out why you have assaulted my opinion, which was based on evidence and was a direct answer to someone asking for opinions? Why is that you could just have said Telogen Effluvium can be complicated? I think you are too emotional over Telogen Effluvium because of your own experience, that is why your approach to this discussion has sucked...IMO of course.
I never told this guy to run out and get on meds. I expressed an opinion based on evidence and presented facts about Telogen Effluvium and male pattern baldness. Again, I stand by all I have said.

 

[Guest]

Looks like classical male pattern baldness to me. Get on treatments! Good Luck!