Telogen Effluvium or Androgenetic Alopecia: Which do I have?

Do I have AGA or TE?

Androgenetic alopecia and telogen effluvium are both common diagnoses in women. They can look very similar in some cases which makes the proper differentiation just a bit more challenging. Not a day goes by the someone doesn’t say to me “Dr. Donovan, I just need your help to figure out if I have TE or AGA.” 

To this, I typically reply “What you meant to say I’m guessing is Dr. Donovan, I just need your help to figure out if I have TE or AGA or I have both of these or I have something else altogether.”

Many times, in return, I just receive a stare.

What could be causing my increased shedding?

You see, there are 7 possibilities that exist when a female patient notices she’s shedding more than normal:

1) the patient’s shedding is from TE as the sole diagnosis 

2) the patient’s shedding is from AGA as the sole diagnosis 

3) the patient’s shedding is from both AGA and TE

4) the patient’s shedding is from TE plus another diagnosis besides AGA 

5) the patient’s shedding is from AGA plus another diagnosis besides TE

6 )the patient’s shedding is from AGA plus TE plus another diagnosis  

7) the patient’s shedding is from neither AGA or TE but rather has a hair loss condition like scarring alopecia or alopecia areata the looks identical sometimes to TE.

Conclusion

The question about TE vs AGA is a good one. But one does themselves a great amount of harm by being so closed minded as to think they are choosing between the two. There are seven possibilities! A careful review of the patient’s history, together with an examination of their scalp and review of blood tests will help determine which of these seven possibilities are the real answer.