If you’ve started to notice the early signs of hair loss, it’s easy to wonder what’s causing you to shed hair.
Telogen effluvium and androgenetic alopecia are two common forms of hair loss. One causes temporary hair shedding that’s usually triggered by a specific event, while the other produces permanent hair loss that usually develops in a specific pattern.
While both forms of hair loss can look similar at first, their effects on your hair follicles are quite different. The good news is that both telogen effluvium and androgenetic alopecia are treatable with the right combination of habits and, if necessary, medication.
Below, we’ve explained what telogen effluvium is, as well as the effects that it can have on your hair’s thickness, density and general appearance. We’ve also explained what androgenetic alopecia is, as well as what you may notice if you have this common type of hair loss.
Finally, we’ve covered the differences between telogen effluvium and androgenetic alopecia, as well as your options for treating both forms of hair loss and maintaining a full, thick head of hair at any age.
What is Telogen Effluvium?
Telogen effluvium is a form of temporary hair loss that occurs when your hairs prematurely enter the telogen phase of the hair growth cycle. Your hair constantly grows, rests and sheds as part of a multi-phase cycle. In a healthy person’s scalp, about 85 percent of all hairs are in the anagen phase of this cycle at any one time, during which the hairs grow to their full length over the course of several years.
Approximately 15 percent of hairs are in the telogen phase — a resting phase during which each hair stops actively growing and prepares to shed. Hairs that enter the telogen phase eventually fall out, only to be replaced by new hairs in the anagen phase. This guide to the hair growth process explains this process, which affects all hairs on your body, in more detail.
Telogen effluvium is triggered by sudden, severe stress on your body, which can affect your hair follicles and cause them to prematurely enter into the telogen phase. A variety of factors can trigger telogen effluvium, including illnesses that cause fever, infections, severe trauma, surgery, fluctuations in your levels of certain hormones, medications and dietary issues such as iron deficiency, low protein intake or heavy metal ingestion.
Even severe stress can trigger hair loss from telogen effluvium, causing you to shed hair when you’re going through a difficult time in your life. These events can suddenly move your hair follicles into the telogen phase, causing 70 percent or more of your hairs to stop actively growing. These hairs may rest for one to six months, then shed en masse, causing your hair to appear thin and lacking in coverage.
Telogen effluvium can have a major effect on your hair density, but it isn’t permanent. Once the causative factor has been identified, it’s typically possible to restore your normal hair growth by making certain changes to your lifestyle, habits and general health.
What is Androgenetic Alopecia?
Androgenetic alopecia is a form of permanent hair loss that’s caused by the effects of androgen hormones (male intimacy hormones) on your hair follicles. When androgenetic alopecia affects men, it’s referred to as male pattern baldness. This type of hair loss can also develop in women (referred to as female pattern hair loss), although it’s less common and usually less noticeable.
Androgenetic alopecia is caused by a mix of genetic factors and the effects of a hormone called dihydrotestosterone, or DHT. DHT causes androgenetic alopecia by attaching to androgen receptors in your scalp. This can start a process called follicular miniaturization, in which your hair follicles become progressively smaller and spend less time in the anagen phase of the hair cycle.
Over time, your hair follicles can become so damaged that they’re no longer able to grow hairs that penetrate through your epidermis — the outermost layer of your skin.
Androgenetic alopecia usually starts near your frontal hairline, resulting in the classic receding hairline that many guys first spot in their 20s, 30s or 40s. Over time, it may affect almost your entire scalp, leaving behind a horseshoe-shaped pattern of hair.
Androgenetic Alopecia vs. Telogen Effluvium: Key Differences
Androgenetic alopecia and telogen effluvium are both common types of hair loss, although they have several key differences.
The first key difference is that androgenetic alopecia is a permanent form of hair loss, whereas telogen effluvium is a temporary type of alopecia. Put simply, hair that’s lost from androgenetic alopecia usually won’t grow back, whereas telogen effluvium shedding will eventually stop.
The second difference is that androgenetic alopecia and telogen effluvium typically cause very different types of hair loss, at least from an aesthetic perspective.
With androgenetic alopecia, it’s normal to notice some recession around your temples or other parts of your hairline, usually followed by a bald patch near the crown of your scalp. Because there’s a genetic component to androgenetic alopecia, the precise pattern of hair loss can vary from one person to another. Dermatologists and other medical professionals often use the Norwood scale to assess the severity of androgen-related genetic hair loss.
With telogen effluvium, it’s more common to experience diffuse hair loss that affects your entire scalp fairly evenly, with your hairline intact and a reduced hair count producing a generally “thin” look to your hair.
The third difference is that androgenetic alopecia usually develops gradually over the course of years or decades, whereas telogen effluvium can often occur suddenly. If you have androgenetic alopecia, you may notice your hairline slowly getting higher when you look at old photos of yourself and compare them to recent ones. Or, you might notice that some techniques for styling hair don’t provide the same frontal coverage that they previously did.
Telogen effluvium can come on much more suddenly. After a triggering event, your hair may go into a resting state for several months, only to suddenly fall out en masse a few months later as the proportion of anagen follicles goes back to normal.
The fourth difference is that although androgenetic alopecia can affect men of all ages, it’s most common (and usually most severe) in middle-aged and older men. As many as 50 percent of men are affected by age 50, with up to 80 percent affected by 70 years of age.
In comparison, telogen effluvium occurs in people of all ages, without a clear increase as people grow older. However, it’s more common in women than in men due to the severe, often sudden changes in hormone levels that can occur during and after pregnancy.
Similarities Between Scalp Telogen Effluvium and Androgenetic Alopecia
Although they have different causes and can produce different symptoms, telogen effluvium and androgenetic alopecia also have several similarities:
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Both conditions can cause hair shedding. Because telogen effluvium and androgenic alopecia are both forms of hair loss, they can both cause hair shedding beyond the usual 50 to 100 hairs you shed per day.
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Both types of hair loss can cause thinning. Androgenetic alopecia generally begins at your hairline or crown, but it can also result in diffuse alopecia that makes the hair across your entire scalp appear thin and lacking in coverage.
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Both forms of hair loss are treatable. Although losing hair from androgenetic alopecia or telogen effluvium can be frustrating, it doesn’t need to be permanent. Treatments are available for both forms of hair loss — a topic we’ve discussed more below.
Other Types of Hair Loss
Although androgenetic alopecia and telogen effluvium account for the majority of hair loss cases in men, they aren’t the only causes of hair loss. Other conditions that may cause permanent hair loss or temporary hair shedding include:
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Traction alopecia. Traction alopecia is a form of permanent hair loss that’s caused by damage to the hair follicles from tight hairstyles. You may be more at risk of this type of hair loss if you wear your hair in styles such as dreadlocks or cornrows.
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Tinea capitis. Tinea capitis is a form of scalp fungal infection that can cause hair loss. When the infection causes severe inflammation of the scalp (referred to as kerion), it may result in permanent damage to your hair follicles.
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Alopecia areata. Alopecia areata is a form of patchy hair loss that’s associated with certain forms of autoimmune disease. It can cause round patches of hair loss and exclamation mark hair strands — hairs with narrowed hair roots and other growth defects.
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Alopecia totalis. Alopecia totalis is a rare form of alopecia areata that causes widespread hair loss on your scalp, likely due to an autoimmune condition.
How to Treat Telogen Effluvium
Telogen effluvium is treatable. Usually, the treatment process involves identifying the underlying cause of the hair shedding, then taking steps to treat the medical condition and stop further hair loss from occurring.
If your healthcare provider suspects you have telogen effluvium, they may perform a hair pull test to check for signs of excess hair shedding. This test involves gently tugging on your hairs to see if a large number of loose hairs are shed at once. If you have a positive hair pull test result, your healthcare provider may perform a scalp biopsy to identify the underlying cause of your hair loss.
Most of the time, telogen effluvium hair loss stops once the underlying problem is treated. You may need to take medication, correct a dietary imbalance or make changes to your lifestyle in order to limit stress in order to prevent shedding.
How to Treat Androgenetic Alopecia
Androgenetic alopecia is treatable with medication and surgery. Because this type of hair loss is permanent, it’s important to take action and consider treatment options as soon as possible after you notice the symptoms of hair loss developing.
Medications for Androgenetic Alopecia
Currently, the FDA has approved two medications as hair loss treatments: the prescription oral medication finasteride and the over-the-counter topical medication minoxidil.
Finasteride works by preventing your body from converting testosterone into DHT, the hormone that damages your hair follicles. This reduction in your DHT levels can slow down, stop or even reverse the effects of androgenetic alopecia on your hairline and scalp. Numerous studies have found that finasteride works well as a hair loss treatment. In one, more than 90 percent of men with androgenetic loss of hair who took finasteride for 10 years showed signs of improvement in hair growth.
A separate study published in the Journal of the American Academy of Dermatology found that men with androgenetic alopecia who used finasteride over the course of two years experienced slower progression of hair loss and increased hair growth.
Minoxidil works by moving your hair follicles into the anagen phase, or growth phase, of the hair growth cycle. It also stimulates blood circulation to hair follicles, which may trigger growth and supply your hair with extra nutrients.
Like finasteride, minoxidil is supported by a lot of scientific research. In fact, a study published in the journal Dermatologic Therapy found that it’s particularly effective when it’s used at the same time as finasteride. In the study, researchers found that 94.1 percent of men with androgenetic hair loss who used both finasteride and minoxidil showed improvements over the course of 12 months, compared to 80.5 percent for finasteride on its own and 59 percent for minoxidil alone.
Hair Transplant Surgery
Hair transplantation is a surgical procedure that involves extracting hair follicles from the back and sides of the scalp (areas that are resistant to the effects of DHT), then moving them to the hairline, crown and other areas affected by male pattern baldness.
Getting a hair transplant may be an option worth considering if you have a receding hairline or other specific areas of hair loss that you’d like to address. This type of procedure can range in price from $4,000 to $15,000 or more based on the number of hairs to be grafted. There are several different kinds of hair transplants: Stem Cell Hair Transplant, NeoGraft Hair Transplants, FUT Hair Transplant, FUE Transplant, and if you are looking for non-surgical hair replacement, there’s a guide for you, too.
This guide to the cost of hair transplant surgery goes into more detail about how hair restoration surgery works, current techniques, pricing for this type of procedure and more.
Learn More About Treating Hair Loss
Both telogen effluvium and androgenetic alopecia can cause you to shed hair. However, telogen effluvium usually involves temporary, diffuse hair loss, while androgenetic alopecia is permanent and typically develops as a receding hairline or bald patch.
If you’re starting to lose hair and want to seek expert help, you can take action by talking to your primary care provider, scheduling an appointment with a dermatologist in your area or using a range of easy, FDA-approved hair loss medications.
Interested in learning more about your options before you start? This guide to finasteride for hair loss goes into more detail about how the most effective prescription medication for androgenetic alopecia works, as well as potential side effects that you should be aware of.
This article originally appeared on Hims.com and was syndicated by MediaFeed.org.
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7 Common Causes of Hair Loss for Men (& How to Treat Them)
What probably comes to mind when you think of hair loss, or alopecia, is an older man with a receding hairline and a bald spot on the top of his head. But from male pattern baldness to hair loss caused by autoimmune conditions, vitamin deficiencies, or stress, hair loss comes in many patterns and affect men of all ages.
You might be thinking, “Why is my hair thinning?” or “Why is my hair falling out?” More importantly, you might be wondering if your hair falling out is permanent or if there’s something you can do to treat it.
Some forms of hair loss can actually be reversed, and the sooner you start, the better the outcome.
So let’s dive into all things hair loss — its symptoms, causes, treatments, and more.
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Classically, symptoms of hair loss in men include a receding hairline (particularly over the temples, creating a characteristic “M” shape) and signs of balding at the top of the head, referred to as the crown.
But, as we mentioned, this only represents one of many types of hair loss (more on these below).
Hair loss can be sudden or gradual. In can come in waves or happen in stages. It can be permanent or temporary. In some cases, hair loss might not be a complete loss of hair. Instead, the hairs get thinner, shorter and lighter.
It’s not a one-size-fits-all situation, and it comes with many potential signs and symptoms. Some of the common ones include:
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Hair loss on different parts of the head or body
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Thinning hair
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Patchy hair loss
In some cases, hair loss can also include:
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Itching
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Irritation
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Redness
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Scaling
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Oozing
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Pain
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Burning
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Tenderness
If your hair loss is related to a medical condition or vitamin deficiency, you could also experience:
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Skin changes
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Nail changes
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Other symptoms
Lastly, depending on how you feel about your hair loss, you may have symptoms such as:
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Stress
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Distress
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Low self-esteem or confidence
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Depression
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As you can guess, each type of hair loss has its own causes.
Broadly speaking, the different types of hair loss can be broken down into two categories: non-scarring alopecia and scarring alopecia (also called cicatricial alopecia).
With non-scarring alopecia, hair follicles are preserved, meaning hair loss is potentially reversible. With scarring alopecia, hair follicles are irreversibly damaged, leading to permanent hair loss.
Of the two, non-scarring alopecia is the more common. Let’s take a look at each common cause of hair loss.
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Male pattern hair loss — also called androgenetic alopecia or androgenic alopecia — is a progressive type of hair loss. It’s mostly influenced by genetics, meaning the genes you get from your parents determine if you develop this type of hair loss.
In the case of male pattern hair loss, in susceptible men, a hormone called dihydrotestosterone (or DHT), which is a derivative of testosterone, causes hair follicles to undergo a process called follicular miniaturization.
Follicular miniaturization is what it sounds like — hair follicles get smaller, and the hairs they produce get thinner and lighter. Technically speaking, hairs transform from terminal hairs (the longer, darker hairs like the ones typically found on the scalp) to vellus hairs (the tinier hairs on the rest of the body).
As the hair follicle shrinks, it also loses attachment to the arrector pili muscles under the skin that help hold it in place.
This whole process takes time. If you start addressing male pattern hair loss early on, hair loss can be delayed or even stopped completely. In some cases, it can even be reversed and you can regrow hair. But if the process is allowed to go on for too long, hair follicles can reach a point of no return.
In women, this form of hereditary hair loss is called female pattern hair loss.
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Telogen effluvium is a type of hair loss that occurs when hair falls out rapidly.
It’s caused by stress (such as by experiencing a trauma) or a sudden change to the body, such as being in an accident, getting surgery, weight loss, having a change in your hormones (like during menopause, in women), childbirth, having an illness or starting a new medication.
This type of hair loss is usually temporary.
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Alopecia areata is a type of hair loss that results in patches of complete hair loss. It’s an autoimmune hair loss disease, so it’s caused by the body’s immune system attacking your own hair follicles.
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Traction alopecia is a type of hair loss that can occur from certain hairstyles. When hair is pulled too tight repeatedly or for a prolonged period (like in tight braids or ponytails), it can result in areas of hair loss where the hair is being strained. While certain hairstyles can cause traction alopecia, wearing a hat is not considered a cause of hair loss.
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Some vitamin deficiencies, such as a biotin deficiency and iron deficiency, can lead to hair loss or unhealthy hair.
(Related: 12 Best Vitamins for Hair Growth)
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Trichotillomania, also called hair-pulling disorder, is a mental health condition in which a person habitually and compulsively pulls out their own hair. The hair can be pulled directly from the scalp, but can also include other parts of the body including the eyebrows, arms, legs, and elsewhere.
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Other medical conditions can cause hair loss, such as psoriasis, syphilis, thyroid disease or a fungal infection like ringworm (tinea capitis). Depending on the medical condition and severity, these may also be scarring alopecias.
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Hair loss can sometimes be a side effect of medication. If you suspect this is the case, talk to your healthcare provider — don’t stop taking any medication without their guidance. Other medical interventions can also cause hair loss, such as chemotherapy, which is associated with anagen effluvium.
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There are many different kinds of scarring alopecia. In these cases, hair follicles are damaged by inflammation. Types include but aren’t limited to frontal fibrosing alopecia, lichen planopilaris, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis and central centrifugal cicatricial alopecia.
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Just like there are many types of hair loss, there are also many different risk factors.
Chief among them is your genes. Having a history of hair loss on either side of the family — your mother’s or your father’s — can increase your risk of experiencing hair loss.
Other risk factors include:
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Advanced age
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Poor diet
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Having a medical condition that can cause or contribute to hair loss
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Taking a medication that can cause hair loss as a side effect
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Stress
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Certain hairstyles that pull on the hair
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A sudden change, such as something major happening physically or emotionally
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According to the American Academy of Dermatology, losing 50 to 100 hairs a day is normal. So, if you’re waking up with just a few hairs on your pillow or you see some hairs stuck in your comb after using it, there usually isn’t cause for concern — this is normal hair shedding.
However, if you notice a sudden change in how much hair you’re losing, feel like your hairline has changed or your hair feels thinner when you run your hands through it, it can be time to talk to a healthcare provider.
In some cases, you might not be the first person to notice hair falling out. A friend might tell you that the hair at the top of your head looks thinner, or after looking at an old photo of you, a friend might say it looks like your forehead has gotten larger. These can also be signs that your body is changing, and a conversation with a healthcare professional is a good idea.
You should also contact a provider if your symptoms are sudden or if you’re experiencing other symptoms along with your hair loss, like irritation, redness, flaking, skin and nail changes and more.
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To diagnose hair loss, a medical professional will typically start by asking you about your symptoms and taking a medical history.
They may ask things like:
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How long you’ve been experiencing hair loss
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If you have hair loss in your family
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If you recently started taking any new medications or supplements.
Next, a healthcare provider might do a physical exam in which they pay close attention to your hair, skin and nails.
During this physical exam, they’ll look for signs of what could be causing your hair loss and other skin conditions you might have. There are also specific tests they might do, like the pull test. The pull test involves pulling several hairs at once to see how many come out.
In some cases — like if you have very classic male pattern hair loss — additional testing might not be necessary.
In others, your healthcare provider may run additional tests — like a scalp biopsy, blood tests or microscopic hair exams — to help figure out what might be causing your hair loss.
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The specific medical treatment for your hair loss will depend on the type of hair loss you have.
For many, medication is the right approach for treating hair loss. And there are lots of treatment options to choose from. The two most common medications used for treating male pattern hair loss in men are finasteride and minoxidil. They can be used separately or together. So let’s take a closer look at each of these.
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Finasteride is a type of prescription medication known as a 5-alpha-reductase inhibitor. Remember DHT, the hormone that can lead to follicular miniaturization and male pattern hair loss? Well, 5-alpha reductase inhibitors like finasteride prevent the conversion of testosterone to DHT.
Finasteride is available as a generic medication or as the brand name Propecia, which is FDA-approved to treat male pattern hair loss. It’s also available in a higher dose as a generic and as the brand name Proscar.
Proscar is FDA-approved to treat the symptoms of benign prostatic hyperplasia (BPH), which is an enlarged prostate.
There’s another 5-alpha-reductase inhibitor called dutasteride that’s also FDA-approved to treat the symptoms of BPH, but is sometimes used off-label to treat hair loss in men.
Propecia, or generic finasteride, is a pill intended to be taken daily. It is also sometimes found in compounded medications — alone or combined with other active ingredients — and in a topical form that can be applied directly to the scalp.
Some men may prefer this form of finasteride because it reduces the risk of experiencing unwanted finasteride side effects, such as intimacy side effects (including decreased libido and ED).
(Related: Finasteride for Hair Loss: Side Effects, Dosage & More)
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Minoxidil is the active ingredient found in the brand name Rogaine. It is a topical medication that is available over the counter, and it comes in different strengths — 2% and 5% — and in various forms — as a topical solution or foam.
Researchers aren’t entirely sure of how minoxidil works, but it’s thought that it increases blood flow to hair follicles and could prolong the anagen phase (growth phase of the hair growth cycle) of a hair.
Recently, there has also been a lot of buzz about oral minoxidil. Oral minoxidil is an FDA-approved blood pressure medication, but research shows it can effectively be used off-label to treat hair loss.
Like all medications, both finasteride and minoxidil can cause side effects. They also aren’t appropriate for everyone and could interact with other medications you’re taking. Keep your healthcare provider up to date with all of your medications and medical conditions.
(Related: How Much Does Rogaine (Minoxidil) Cost?)
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While finasteride and minoxidil are the most common medications used for hair loss and the only ones specifically FDA-approved for male pattern hair loss, other interventions can also be effective. The exact treatment depends on the type of hair loss you are experiencing — some of these treatments can be effective for male pattern hair loss, while others are better for other hair loss types.
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Ketoconazole, an antifungal medication, has some activity against 5-alpha-reductase (similar to how finasteride works).
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Spironolactone, another blood pressure medication, can be used to treat hair loss in women because of its effects on hormones.
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Low-level laser therapy (LLLT) uses a laser, typically over several treatment sessions, to stimulate hair growth.
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Platelet-rich plasma (PRP) involves injections of your own blood components to prevent hair loss and promote new growth.
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Other injections, such as corticosteroids, can be given as a potential treatment.
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Supplements like biotin (vitamin B7), vitamin E, saw palmetto and more. Research on the efficacy of supplements for hair loss is generally weak or mixed, so we still need to learn more before these can be considered hair loss “treatments.”
In general, medications and treatments to treat hair loss and promote hair growth can take time to work — typically several months. In some cases, it can also appear that things are getting worse before they get better.
And if all of this doesn’t work for you, surgery can be an option, too. Different types of hair transplantation surgery include follicular unit transplantation (FUT) and follicular unit extraction (FUE). To learn more about whether hair transplant surgery is right for you, talk to a healthcare provider.
Lastly, let’s not forget about hair tattoos, wigs and toupees. Is it your natural hair? No. But can it be just as stylish? Yes!
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Hair loss is a BIG topic. It affects many people. There are many different types. There are many different causes. There are many different treatments. It seems like it would be easiest just to avoid hair loss in the first place. So, is that possible? Can you prevent hair loss?
Unfortunately, preventing hair loss altogether just isn’t in the cards for some people. Nearly everyone’s hair will thin with age and, for a large part of the population, genetics determines what you get to keep on your head.
But that doesn’t mean there isn’t anything you can do. If you’re concerned about hair loss, try to:
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Eat a healthy, balanced diet
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Manage stress
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Use hair care products that aren’t damaging to your hair and scalp
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Avoid hairstyles that tightly pull on your hair
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Cut back on unhealthy habits, like smoking
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Treat other health conditions you might have
And if you notice your hair is falling out and want to do something about it, schedule an appointment with a healthcare provider. For some kinds of hair loss, the sooner you intervene, the better — and you could not only prevent further hair loss but potentially even regrow some new hair.
You can go to your primary care provider or a dermatologist, or you can connect with a healthcare provider online from the comfort of your own home and start addressing hair loss today.
When it’s that easy, why wait? A fuller head of hair — if you want it — might be just around the corner.
This article originally appeared on Hims.com and was syndicated by MediaFeed.org.
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Featured Image Credit: Victor Manuel Mulero Ramirez/istockphoto.
