Telogen Effluvium or Androgenetic Alopecia ... Or Both?

Biopsy Suggested AGA and a bit of TE: Which one is causing my hair loss?

I’ve selected this question below for this week’s question of the week. It allows us to the review some key concepts related to the diagnosis of hair loss

QUESTION

My biopsy came back showing that I have androgenetic alopecia with bit of telogen effluvium. My terminal to vellus ratio was 1.8: 1 and there were 16 % telogen hairs. I’m wondering if I have both diagnoses, which one is causing my hair loss.

ANSWER

Thanks for the question.

It’s likely that they both are. However, most of your hair loss is from the AGA. I would need to see your scalp to give you a precise breakdown but it’s likely the AGA is the main cause given that the T:V is well under 4:1.

But both of these contribute!

Suppose you ran a 20 mile run and also carried groceries up 40 flights of stairs because the elevator was broken. Why are your legs sore? Well mostly from the 20 mile run but some of your leg soreness is due to the climb up the stairs. If you didn’t have to do the stairs you might be 6 % less sore but you’d still be sore.

If someone has a little bit of telogen effluvium and mostly androgenetic hair loss they’ll get a bit of hair back if they address their telogen effluvium but really they need to address the androgenetic component.

Hope this helps.