Telogen Effluvium vs Androgenetic Alopecia: Understanding the Difference
Two prevalent forms of hair loss are Telogen Effluvium and Androgenetic Alopecia.
While their symptoms may have some similarities, they are fundamentally distinct conditions with different causes and outcomes.
Understanding the differences between these conditions can help individuals seek appropriate treatment and manage their hair loss effectively.
In this article, we’ll be shedding light on the distinctions between Telogen Effluvium and Androgenetic Alopecia.
Quick Overview
Here is a quick overview to give a clear picture of Telogen Effluvium vs Androgenetic Alopecia.
| Androgenetic Alopecia | Telogen Effluvium | |
|---|---|---|
| Definition | Androgenetic Alopecia causes permanent hair loss. | Telogen Effluvium causes temporary hair loss. |
| Gradual vs. sudden | Hair loss happens gradually | Hair loss happens over a short period of time |
| Most Affected people | Males | Females |
| When it happens | In the age of 20s, 30s, and 40s | In age 30 to 60 |
| Causes | High fever, childbirth, severe infections, psychological stress.major surgery, hyper or hypothyroidism, discontinuing of the usage of birth control pills, a fat diet with non-proteins, medications like retinoids, beta-blockers, depression drugs, and non-steroidal anti-inflammatory drugs(NSAIDs) | High fever, childbirth, severe infections, psychological stress.major surgery, hyper or hypothyroidism, discontinuing of the usage of birth control pills, a fat diet with non-proteins, medications like retinoids, beta-blockers, depression drugs, and non-steroidal anti-inflammatory drugs(NSAIDs) |
| Signs and Symptoms | Gradual thinning of hair on top of the head circular or patchy bald spots, sudden loss of hair, full body hair loss, and patches of scaling that usually spread over the scalp | Gradual thinning of hair on top of the head, circular or patchy bald spots, sudden loss of hair, full body hair loss, and patches of scaling that usually spread over the scalp |
| Treatment | Medications(Finasteride, Minoxidil, and other medications like Spironolactone or oral Dutasteride), Hair transplant surgery, and laser therapy | Over-the-counter Minoxidil, multivitamins and supplements (iron biotin), and styling techniques such as (hairstyles, wigs, and hair weave) |
Telogen Effluvium
It is a temporary hair loss condition characterized by excessive hair shedding from the scalp.
It occurs when many hair follicles enter the Telogen phase prematurely.
During the Telogen phase or the resting phase of the hair growth cycle, the hair stops growing and eventually falls out.
Normally, about 85-90% of the hair on the scalp is in the Anagen phase, the active growth phase, while the remaining 10-15% is in the Telogen phase.
However, during Telogen Effluvium, a higher percentage of hair follicles shift into the telogen phase simultaneously, leading to increased hair shedding.
Androgenetic Alopecia
Androgenetic Alopecia is a complex and multifactorial form of hair loss.
It happens because of the influence of Androgens, which are male sex hormones in both men and women.
Certain hair follicles in individuals with a genetic predisposition to Androgenetic Alopecia are more sensitive to the effects of Androgens, specifically Dihydrotestosterone (DHT).
DHT binds to Androgen receptors to hair follicles, leading to follicular miniaturization.
As a result, affected hair follicles become smaller and produce thinner, shorter hairs with each growth cycle.
Over time, these miniaturized hairs cannot grow back, leading to progressive hair thinning and, in some cases, baldness.
Nature of hair loss in Telogen Effluvium vs Androgenetic Alopecia
Both of these types of hair conditions involve hair loss.
However, there is a difference between how hair loss occurs and its nature.
Telogen Effluvium is a temporary condition that involves widespread hair shedding across the entire scalp.
Androgenetic Alopecia is a progressive and permanent form of hair loss.
Hair loss is diffuse and not limited to specific areas of the scalp in Telogen Effluvium, while in AGA it follows a specific pattern and typically starts with a receding hairline in men or diffuse thinning in women.
Underlying causes of Teogen Effluvium vs Andrgenetic Alopecia
The underlying causes of Telogen Effluvium and Androgenetic Alopecia are fundamentally different, leading to distinct hair loss patterns in each condition.
Telogen Effluvium is usually triggered by a sudden and significant physiological or emotional stressor. Common triggers include:
- High fever or severe infections
- Childbirth
- Psychological stress
- Major surgery
- Thyroid disorders (hyper or hypothyroidism)
- Discontinuing the usage of birth control pills
- Nutritional deficiencies, especially protein deficiency
- Medications like Retinoids, beta-blockers, antidepressants, and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Androgenetic Alopecia is caused by a combination of genetic factors and the influence of Androgens, particularly Dihydrotestosterone (DHT), a potent male sex hormone derived from Testosterone.
- Genetic predisposition: Androgenetic alopecia has a clear genetic predisposition. Individuals with a family history of pattern baldness are more likely to develop the condition
- Androgen sensitivity: Hair follicles in some scalp regions are more sensitive to Androgen hormones, especially DHT. When DHT binds to Androgen receptors on these susceptible hair follicles, it leads to progressive shrinking of the hair follicles
- Hormone metabolism: Testosterone is converted into DHT by the enzyme 5-alpha reductase. Elevated levels of DHT in the scalp area with susceptible hair follicles contribute to the miniaturization process
Difference in hair regrowth
Hair loss in Telogen Effluvium is a temporary condition as compared to Androgenetic Alopecia where hair loss is permanent.
Once the triggering factor is resolved in TE or the body’s stressors are alleviated, the affected hair follicles will gradually return to their normal growth cycle.
While treatments for Androgenetic Alopecia can slow its progression and promote some degree of hair regrowth, it may not be possible to reverse the extent of hair loss fully.
This regrowth process may take some time and usually occurs within 3-6 months after the initial trigger in Telogen Effluvium.
The main aim of treatments in AGA is to maintain the existing hair, slow down further hair loss, and stimulate the regrowth of miniaturized hairs.
Timeframe
The duration of losing hair is different for both condition.
The hair shedding typically occurs within a few months of the triggering event and can last six months in Telogen Effluvium.
Once the underlying cause is resolved, the hair grows back gradually.
In Androgenetic Alopecia it develops gradually over the years or decades.
The rate and extent of hair loss can vary from person to person, and it tends to be a progressive condition.
Gender and age distribution
Telogen Effluvium and Androgenetic Alopecia, have distinct patterns of occurrence and severity based on gender and age group.
TE can affect both men and women of all ages. It is not specific to any particular age group or gender.
While Androgenetic Alopecia can affect both men and women, it is more common and typically more severe in men.
However, the risk of developing chronic Telogen Effluvium without a detectable cause is higher for women and falls within 30 to 60 years.
Androgenetic Alopecia often begins in the late teens or early adulthood for men, whereas women may experience it during Perimenopause or Menopause.
Diagnosis of Telogen Effluvium vs. Androgenetic Alopecia
To detect Telogen Effluvium, your healthcare provider might conduct the following test:
Pull Test
A “pull test” is conducted, during which the healthcare provider gently pulls a small clump of 40 to 60 hairs between their fingers to assess hair shedding.
If Telogen Effluvium is present, at least four to six hairs may be pulled from the scalp with white bulbs at the roots.
Dietary cause
The healthcare provider may be able to identify a dietary cause or a specific stressor or illness that could have led to Telogen Effluvium.
For Androgenetic Alopecia, the following test may be performed:
Dermoscopy
Dermoscopy or biopsy can aid in diagnosing androgenetic alopecia by revealing miniaturized hair and brown perihilar casts.
Psychiatric screening
A quick psychiatric screen for depressive symptoms and other psychiatric disorders may be relevant for all hair loss patients visiting a dermatologist.
Common diagnostic approaches and tests
Apart from the tests mentioned above and methods, there are some common tests for both conditions.
Physical examination of the scalp
Both conditions thoroughly examine the scalp to assess hair loss patterns and characteristics.
Medical/clinical history
Telogen Effluvium assessment includes inquiries about recent infections, surgeries, or illnesses within the past three months.
They also look at significant physical or emotional stressors. These factors may help identify triggers for sudden hair shedding.
The Androgenetic Alopecia assessment includes details about the patient’s family history of hair loss or pattern baldness, general health, and any chronic medical conditions.
These factors are important in diagnosing this genetic form of hair loss.
Blood tests
Both conditions may require blood tests to help in the diagnosis.
A blood test in Telogen Effluvium is conducted if it is suspected that the hair loss is because of an underlying condition.
These tests can include thyroid studies, complete blood count (CBC), screening for iron deficiency, and screening for syphilis in Androgenetic Alopecia.
Treatment
The treatment approaches for Telogen Effluvium and Androgenetic Alopecia, aim to address the underlying causes and promote hair regrowth.
Various treatments can support healthy hair growth.
- While Telogen Effluvium usually resolves on its own without treatment, but Androgenetic Alopecia requires treatment
- Medications like Minoxidil (Rogaine) and Finasteride may be used to promote hair growth and are FDA-approved
- Multivitamins with iron and biotin supplements can support healthy hair in Telogen Effluvium
- A hair transplant is a viable option in AGA and can restore hair in affected areas
- Spironolactone (for women) can block Androgen effects on hair follicles in Androgenetic Alopecia
- If desired, styling techniques, wigs, or hair weaves may conceal hair loss for both types
- Red light or laser therapy (LLLT) may be used for hair loss IN Androgenetic Alopecia
Conclusion
Telogen Effluvium and Androgenetic Alopecia are distinct hair loss conditions with unique characteristics and underlying causes.
While both conditions involve hair loss, they differ significantly in their nature, regrowth potential, and underlying mechanisms.
Telogen Effluvium is a temporary condition characterized by widespread hair shedding due to triggering events or stressors.
It often resolves once the underlying cause is addressed, and treatments like minoxidil and multivitamins can support hair regrowth.
On the other hand, Androgenetic Alopecia is a progressive and permanent form of hair loss, primarily influenced by genetics and the impact of Androgens.
While topical Minoxidil, oral Finasteride, and hair transplants can slow its progression and stimulate some hair regrowth, the condition requires ongoing management.
A comprehensive medical history, physical examination, and diagnostic tests are crucial in accurately diagnosing these conditions and tailoring treatment plans to individual needs.
