Do I have chronic telogen effluvium (CTE) ?

What is CTE?

Hair shedding problems are among the most challenging of the hair disorders. They can be challenging to diagnose. Patients with shedding problems are the most frustrated of all patients with hair loss looking for a diagnosis because they receive so many different opinions. 

Both my friend and mom think it's stress.

One dermatologist said it's genetic hair loss another said low iron

My naturopath said it's a thyroid problem even though my TSH is normal


Chronic telogen effluvium (CTE) is a real and true hair shedding problem

CTE is a true hair loss problem. IT's not a diagnosis that women get when all other diagnoses have been exhausted. Patients with CTE often look like they have tremendous amounts of hair.  Patients with CTE who tell their friends they are going to see a hair specialist, will immediately hear "why would you do that ? .... your hair is great." Patients with CTE often start out with tremendous amounts of hair (and often joke that hair stylists once complained that they had too much hair). Patients with CTE have good days and bad. Good weeks and bad weeks. Some weeks they lose 50 hairs a day and some days 400 hairs per day. Surprisingly (despite this loss), these patients never go bald. They reach a new plateau of hair density and maintain that for years.  Patients with CTE are usually 35-70. They may have scalp symptoms like scalp "pins and needles" or "burning" or "tingling" - this often confuses things tremendously! It's unusual to have TE at younger ages. 

Do I have CTE or AGA?

A common question form patients is "Do I have CTE or AGA?" Of course the only way to confidently figure that out is to have a full examination. But patients who walk into the office with 1) concerns about tremendously increased daily shedding all over the scalp AND 2) look like they have a lot of hair and 3) have normal blood test results are the typical patient with CTE. Usually the scalp is NOT showing in patients with CTE.  The patient who walks into the office with hair thinning to a degree that the scalp IS showing is more likely to have AGA. Usually women with AGA have hair loss more concentrated in the front and middle of the scalp. Patients with CTE have hair loss all over. 


Treatments for CTE

Treating CTE requires patience. There is no cure but there are treatments than can help. These include 

1. Minoxidil (Rogaine)

2. Low level laser therapy (LLLT)

3. Platelet rich plasma (PRP)

4. Supplements (vitamins, biotin, VIVISCAL, Priorin)

5. Lysine


The precise 'starting treatment' depends on a number of factors. 

Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887

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