Androgenetic alopecia and telogen effluvium

Androgenetic alopecia progressively miniaturises genetically susceptible follicles. Telogen effluvium shifts more hairs than expected into the resting and shedding phase, often after a physical stressor, medical change, or nutritional problem. The second process can make previously subtle patterned thinning more noticeable.

Androgenetic alopecia commonly presents with slowly reduced density at the temples, frontal scalp, central part, or crown, depending on the person. Telogen effluvium more often presents with increased shedding from across the scalp, noticed in the shower, brush, or hands. Neither description alone proves the diagnosis.

Timing offers another clue. A clinician may ask about illness, fever, surgery, childbirth, restrictive eating, weight change, severe stress, or a new or stopped medicine before shedding began. Scalp examination can identify variation in shaft thickness, active shedding, inflammation, breakage, and the presence of short regrowing hairs.

Seek an assessment rather than assuming every shed hair comes from patterned loss. Prepare a timeline of when shedding changed, recent health events, eating changes, menstrual or pregnancy history where relevant, and all medicines and supplements. Blood tests are selected from the history and examination rather than ordered identically for everyone.

Management separates the two components: identify and correct a telogen trigger when possible, while deciding whether androgenetic alopecia also needs ongoing treatment. Eat a balanced diet and handle hair gently, but avoid high-dose supplements without a documented need because excess intake can cause harm or confuse test results.

Get examined if shedding is abrupt, substantial, persistent, or associated with smooth patches, scalp pain, burning, redness, heavy scale, sores, or broken hairs. Prompt assessment is also sensible when loss accompanies fatigue, weakness, unexplained weight change, menstrual change, or symptoms of systemic illness.

Urgent help is appropriate for breathing difficulty, facial swelling, faintness, or a widespread blistering rash after a treatment. Otherwise, bring worsening photographs and your symptom timeline to the clinician so changes in pattern and density can be judged consistently.

Ask whether the examination shows miniaturisation, active diffuse shedding, or both; which possible triggers fit the timing; and whether targeted tests are appropriate. Discuss which part of the loss may recover, whether patterned-loss treatment should begin or continue, and how adverse effects and progress will be monitored.