Chronic telogen effluvium vs Genetic hair loss - Easily confused !

CTE vs AGA - easily confused but different conditions

CTE and AGA are often easily confused. Labs normal in both. Family history of hair loss similar in both. Hair check similar in both. Biopsy often unhelpful unless done properly (meaning transverse sections and measurement of terminal to vellus ratios).

CTE takes time to figure out. Info on family history of AGA is not useful at all in diagnosing AGA in women.  AGA doesn't start in the 50s in women. All in all, you'd need a careful examination. CTE is the most challenging of diagnoses.



1. CTE leads to fluctuations in shedding with shorter breaks

2. Women often once had thick hair (very thick)

3. Miniaturization not typical

4. Onset is sudden

5. Scalp sensations (tingling, burning) often present

6. Pretty normal looking scalp exam or maybe significant temple recession in some

7. Labs normal

8. Some days 50 hairs lost; some days 350-400

9. After 6-8 months, tends to reach a balance between shedding and growing and patients look similar month after month (despite massive shedding!!!)

10.           Biopsy done with horizontal sections show terminal to vellus ratios above 8:1 (whereas less than 4:1 for AGA)

11.           Central part width not typically widened in CTE



I understand how tough it is to get a diagnosis of CTE vs AGA. But they are very different conditions.

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

Share This