Hair Shedding is Part of Androgenetic Alopecia

Equating Hair Shedding to a Diagnosis a Telogen Effluvium is Incorrect

One of the biggest mistakes that practitioners make and one of the biggest mistakes that patients make is a failure to recognize that androgenetic alopecia causes increased hair shedding.

How many people ask me “How should I treat my telogen effluvium- I’ve been shedding for 2 years and every blood tests is perfect!” What supplement should I buy? I’ve bought them all! What shampoo should I buy to stop my shedding?

My reply over and over is the same: Be sure to see a specialist as you may have androgenetic alopecia. Other causes should be ruled out too.

Is it this simple?

Yes, almost.

Once acute TE triggers like stress, low iron, thyroid problems, medications and weight loss have been ruled out, a bit more detective work is needed. Chronic shedding does not equate to chronic telogen effluvium despite the tightly held view.

Of course, there are chronic shedding conditions like chronic telogen effluvium. But most women under 30 do not have chronic telogen effluvium as the cause of their chronic shedding despite what they think or their specialists think. Is it possible to have CTE under 35? Sure, anything is possible. But it’s pretty rare. Diffuse alopecia areata, scarring alopecia, TE and AGA are all right there staring at you.

One of the greatest gifts you can give to yourself as a hair loss practitioner is to realize that shedding does not equal telogen effluvium. Stop that thinking as soon as you can and you will change the course of many more patient’s hair.

The 2017 Martinez Velasco paper is among my favourite papers. Using a shedding scale from 1 (low shedding) to 9 (high shedding) women without hair loss rated their daily shedding at 2.3. Women with androgenetic alopecia rated their daily shedding at 7.3.

Hair shedding is very much a part of androgenetic alopecia.

The paper is available free online and any search engine can retrieve it.

Reference

María Abril Martínez-Velasco et al. The Hair Shedding Visual Scale: A Quick Tool to Assess Hair Loss in Women. Dermatol Ther (Heidelb). 2017 Mar.