Videodermoscopy of the scalp in a patient with a combination of androgenetic alopecia (AGA) and chronic telogen effluvium (CTE). There is a slight variation in the caliber (diameter) of follicles that can be appreciated but it is subtle. The patient however is troubled by massive amounts of shedding despite the fact that her density is not getting worse over the years. This is typical of CTE.
Chronic telogen effluvium is frustrating for patients because they experience unpredictable shedding. It seems to improve only to worsen again. New products are bought and tried some of which seem to help for a short while only to lose hair again. The reality is that most of these products had no effect and the improvements and worsenings are just what CTE “does.” Many patients with CTE are told they look fine by doctors, friends, spouses, hairstylists but few actually appreciate just how much hair the patient has really lost. Many patients with CTE start out with extremely thick hair and even with a massive reduction in density they still look like they have alot of hair. CTE may slow or eventually stop but it can take a very long time for some to do so (10 + years) and some do not. Most patients with CTE do not have AGA and because of this shedding does not lead to a change in density over time. Most patients are surprised to learn that their density is not worse in subsequent visits to the clinic because of all the shedding they have experienced. Treatments for CTE include minoxidil (topical or oral), laser, biotin, hair and nail supplements, lysine. Rarely other treatments are considered. #chronictelogeneffluvium
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