Nov 23

I’m Not Seeing Any Regrowth After My Telogen Effluvium. Why?

By Ava Alderman: I sometimes hear from people who are extremely discouraged that they aren’t seeing much hair regrowth after shedding has affected the appearance of their hair.

Common comments are things like: “I am pretty sure that I have telogen effluvium. I gave birth about six months ago and a couple of months after that, my hair started falling out. I have been shedding for about three months. My hair has gotten very thin as a result. I keep looking for regrowth but I am not seeing any. Does this mean that I don’t have telogen effluvium? Or that my hair isn’t going to grow back normally? When will I start seeing my hair growing back?”

Before I answer, I have to tell you that I am not a specialist or medical professional. The opinions that I’m going to share are based on my own experience with this type of hair loss. I have to say that what this woman was describing did sound like telogen effluvium, mostly because childbirth is a very common trigger. Also, when you are pregnant, the increased hormones give you a wonderful, thick head of hair where sometimes you end up with more hair than started with. As a result, post pregnancy telogen effluvium can be particularly bad with an awful lot of hair loss.

When a certain percentage of your hair goes into the shedding phase and you have started with more hair than usual, then your shedding can be a bit worse than what would typically be expected. But, with this type of hair loss, the follicles aren’t being affected by androgens so you should be able to regrow normal hair. And, once a strand of hair is shed out, it begins to grow back immediately. Many people assume that the regrowth is going to come all at once. Generally speaking, it doesn’t. It comes back at the rate that it fell out. So the hairs that shed out early on in the process are going to grow back first.

You should have stands of hair constantly coming in as they were constantly falling out. Now, the reason that you may not be seeing regrowth is that those hairs are thin and tiny. It takes the hair an entire month to grow a half inch. And hair that short in length and fine in diameter can be very hard to see coming in. You can help this process by doing a couple of things. Try pulling your regular strands straight back. Then see if there are any tiny, baby hairs sticking straight up. If your hair is dark colored, try spraying some dry shampoo or pouring some white powder in at your part line.  This will allow you to see those white small hairs coming through.

Also, you can lift up your bangs, pull them straight back, and then see if there is regrowth pushing forward. So what happens if you try all of those things and you are still coming up short? I would say to give it a bit of time. Perhaps your hair grows a little more slowly. If this doesn’t work, then you might want to consider that your follicles are being affected by inflammation or androgens. Or, perhaps you have another type of hair loss. But this scenario did sound like telogen effluvium and she wasn’t seeing any patterned or patchy loss, which was a good sign.

I will admit that I used a lot of dry shampoo to see my regrowth.  I began kind of obsessed about it for a while.  Try not to worry too much.  If you have light colored hair, it can be challenging to see the regrowth, especially at first.  If it helps, you can read about my gradual recovery on my blog at

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Nov 21

Can Stress Cause Hair Miniaturization?

By: Ava Alderman: I sometimes hear from people who are horrified to notice that not only has their hair been shedding, but it is now starting to become miniaturized and thin. If you have found this article, you probably already know that when hair miniaturizes, it becomes thin, fly away, and it may even be lighter-colored.  Because of these changes to the hair, places on your scalp that are growing miniaturized hair may present as thinning areas or as bald spots.

No one wants this, so naturally people begin to research the cause.  Because hopefully, if you can understand the cause, then you can take action to prevent or treat it.  One concern that people sometimes have is that of stress.  It’s normal to feel some psychological distress when you see these types of changes in your hair.  And you can start to wonder if this may be the cause of the miniaturization.

Someone might ask: “I honestly am not sure why I am seeing hair miniaturization.  I am a woman.  I don’t have any one in my family who is balding or thinning.  But there is no denying that certain areas are definitely thinning.  And when I isolate those hairs and look at them closely, they are pathetically sickly-looking.  They are clearly miniaturized.  I have no idea what could be causing this. The only thing that I can identify is severe stress.  I’ve been having a difficult time at work and it is relentless.  So I stress out about that, but I also stress out about my hair.  It’s so hard to watch it fall out and transform into old-man hair and yet I don’t feel that I have any control. I am a still young. Could the stress be causing the miniaturization?”

The Most Common Causes Of Hair Miniaturization: I’m not a doctor, but from my own experience, I can tell you that many doctors believe that what causes hair miniaturization is androgenetic alopecia.  And what causes that condition are things like genetics, aging, and a sensitivity to DHT (dihydrotestosterone.)  Since it appears that you don’t have genetics or aging as issues, you may have a sensitivity to DHT.  And yes, women produce this hormone.

Since I mentioned DHT, I have also found in some of my research that stress can cause a rise in cortisol.  And a rise in cortisol can also contribute to a rise in DHT.  Again, I am not a doctor.  But it would make sense that a rise in DHT would increase the sensitivity and potentially give way to androgenetic alopecia or the symptoms associated with it.  I am just a lay person, but this makes sense to me.

So that is one way that stress might affect your hair loss.  Another way is that severe stress is thought the contribute to telogen effluvium.  I am not sure if you’re been shedding a very large number of hairs.  But if so, that could be one indication of telogen effluvium.  And prolonged shedding because of telogen effluvium can sometimes cause miniaturization.

So in my non-professional opinion, yes, there are cases where stress can contribute to a rise in DHT or it can be a contributing factor to telogen effluvium, which in some severe cases can lead to miniaturization.

Regardless, it makes sense to get serious about reducing your stress.  It’s not good for your health, your well being, or your hair.  Of course, most of us have no control over what happens in our jobs.  But what we can do is learn to manage your stress.  We can learn to decompress.  We can try meditation, yoga, mindfulness, and all of those other things that give us some relief.  We can tell ourselves that at the end of the day, very few things will matter five years from now.  If something won’t truly impact your life greatly in five years, it is best just to let it go.

I know how stressful losing your hair is.  This turned my life upside down for a while.  So I totally sympathize.  But allowing myself to get upset did me no good. I sometimes had to force myself to focus my attention elsewhere.  Once my hair loss stabilized, I could look back and see that all that time I spent being upset really didn’t serve any purpose but to make things worse.  Looking back, I have come to believe that you want to control what you can.  You want to pursue treatments and research causes.  You certainly want to educate yourself.  But you don’t want to place your sole focus on something that may well resolve.  You don’t’want to let it take over your life.  You can read more about learning to deal with this on my blog at

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Nov 19

Why Does It Take So Long For Hair To Regrow After Telogen Effluvium?

By: Ava Alderman:  I often hear from people who are becoming extremely impatient while they are waiting for their hair to recover and regrow after they’ve suffered from telogen effluvium.  Often, they aren’t seeing progress nearly as quickly as they would like and they find this very discouraging.

I heard from someone who said “my hair started shedding about five months ago.  About six weeks ago, the amount of hair loss began to lessen.  I am still shedding much more than is normal for me, but it is much better than it was.  However, I am not noticing much regrowth.  My hair hasn’t even begun to look any better.  Sometimes, I see tiny regrowth hairs at my part line but they don’t seem to be growing all that much.  Why does it take so long to see some improvement?  I thought I would get some relief after the shedding let up, but I was obviously wrong.”

Believe me when I say that I understand your frustration.  I remember a time when I used to spray my hair with dry shampoo so that the white color would allow me to see (and measure) my regrowth.  So I know that you are probably looking for some progress every single day and that you sometimes feel disappointed.  I hope to offer you some encouragement (and some perspective) in the following article.

Understand That Even Normal, Healthy Regrowth Only Grows A Half Inch Per Month:

If you were to look at a half of an inch on a ruler, you’d see that it’s a very small amount.  Well, this is how much your hair regrows after an entire month.  So it’s entirely possible that only six weeks after you saw an improvement in shedding, you are still only seeing very short baby hairs growing in.  This is normal.  After another month, you will have added another half inch to the length of those hairs.  So as you can see, it takes more than a few months for the hair to get long enough to where it makes much of a difference or becomes noticeable.

And if you are a woman with long hair, it can take up to a year (or more if your hair is really long) before you are able to replace the length and volume of the strands that you lost.  I know that this is a long and frustrating process, but it doesn’t mean that you are behind or that you are doing anything wrong.  It’s just the way that the process works.

Additional Shedding Can Slow The Process Even More:

Sometimes, even when we see some improvement in our telogen effluvium, we continue to shed.  That’s why you will sometimes see short strands in your shower drain and on your clothing.  When this happens, obviously you are having to start all over, gaining only a half inch over the course of a month once the hair begins to grow in all over again.  So, know that if you are still losing more hair than what is usual for you, then you may also be losing some of your regrowth which can slow this process a little more.

Make Sure That You Are Supporting A Healthy Scalp And Paying Attention To Nutrition: 

Admittedly, this is a process that you can’t necessarily completely change.  But there are some things that you can do to make sure that your body and your scalp have what they need to support healthy regrowth.  Make sure that you aren’t doing anything that can create additional trigger that might bring on more shedding.  Also, make sure that you aren’t on any severe diets.  Ensure that your nutritional needs are met because if your body doesn’t get proper nutrition, the first place that you will see this is in your hair. Also, take very good care of your scalp.  You want to combat any inflammation that might impede your regrowth.  (And inflammation is common after periods of high shedding.)

People often ask me if there is any supplements they can take to make their hair grow more quickly or thickly.  It’s my experience that some of these products actually caused more hair loss in my case.  I found that for me, I could tolerate a general daily supplement for women, but I could not tolerate anything that had very high amounts of any ingredients.  That is only my experience but I don’t think that it is one that is uncommon.  I find that just making sure that you have good nutrition and the healthiest scalp possible is usually the best thing that you can do.  Because sometimes when you become too aggressive, you do more harm than good and you bring on a new trigger.

I found that focusing on caring for my hair’s health without focusing on its daily progress helped me.  I just decided to make my hair as shiny, voluminous, and as healthy as possible.  And I think that in the process, I was also able to support healthy regrowth.  I look back on those days with gratitude that they are over.  But I wish I hadn’t worried as much as I did because I think this made it worse.  If it helps, you can read my story at

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Nov 17

Does Hair Miniaturization Always Lead To Eventual Baldness?

By: Ava Alderman: I often hear from people with hair loss conditions like androgenic alopecia and telogen effluvium who can’t help but notice that their hair is getting thinner and thinner over a period of time.  Sometimes, they also notice that the hair that is growing in is much more thin and fine than the hair that it was replacing.

This process is called hair miniaturization and it happens because the hair follicle is being attacked by androgens which makes it more difficult for that follicle to support normal hair growth and to regrow normal hair.  So with each cycle of shedding and regrowth within that follicle, the hair that grows back becomes more and more thin each time and offers less and less coverage.  The fear of course is that eventually the hair won’t come back at all and that baldness will occur.

I heard from someone who said: “my hair has started miniaturizing.  I tried to deny it for a long time but at this point, it’s obvious.  My hair loss started after I went off of contraceptives.  I was trying to become pregnant.  This kicked off what I think was a bout of telogen effluvium.  But honestly, it never really stopped. The drastic shedding eventually slowed after some months, but my hair has never really been the same.  It never retained it’s previous volume.  It is much more thin in texture and it is limp and lifeless.  It is also a lighter color.  I think what happened is that my telogen effluvium eventually gave way to androgenetic alopecia which is why my hair is thinning so badly now.  My question is whether this is going to lead to total baldness? Should I be shopping for a topper or wig now?” I will try to address these concerns in the following article.

You Can Treat And Try To Negate The Miniaturization: People often assume that there is nothing that they can do to treat androgen driven hair loss.  That assumption isn’t always true.  The idea is to lessen the androgens and to minimize the sensitivity of the follicle.  There are various ways to go about this but the most common treatments are prescribed medications and over the counter supplements and topicals that are applied to the scalp.

Some people will try a few things, not have much success, and then assume that nothing is going to work.  Sometimes, you have to methodically try a couple of different things until you find something that really helps.  With that said, you want to make sure that you are giving the treatment enough time to work.

Typically Only Certain Areas Of Your Scalp Is Going To Show Miniaturization (Especially If You Are Female:)  People often assume that androgenic alopecia will eventually mean total baldness.  This isn’t necessarily the case.  Many people typically thin in certain high androgen areas like the part line, the crown, and the temples.  Some will have more diffuse or all over thinning but this rarely leads to total baldness, particularly in women.  Granted, many men today will shave their heads when they start to thin, but this is often a choice rather than a necessity.

Sometimes, What You Assume Is Androgenic Alopecia Is Something Else: There are times when chronic telogen effluvium can cause miniaturization.  However, when you find and eliminate the trigger, sometimes the shedding, and then the miniaturization, will stop.  Admittedly, it’s estimated that well over ninety percent of all hair loss in androgen driven, but there are occasions when telogen effluvium has the appearance of something else.

I’m certainly not a doctor or specialist, but I can tell you that going off of birth control pills will often bring about both telogen effluvium and an androgenic response.  Your body sees this as almost similar to giving birth (which can cause shedding.)  And, constraceptives often lessen androgens.  So when you stop them, you might find that you have a sensitivity to the sudden increase.

But to answer the question posed, miniaturization certainly does not always lead to baldness.  There are treatments that can work and often, your entire head isn’t affected.

I know much of this from what I went through.  For a long time, I didn’t know if I had chronic telogen effluvium or androgenic alopecia. I looked at my shedding triggers, my iron, my thyroid, my adrenals, my hormones, and my scalp’s health. It was a long, hard, frustrating journey but thankfully I didn’t give up. You can read that story on my blog at

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Nov 02

Does Every Hair Need To Shed Out Before New Hair Grows With Telogen Effluvium?

By: Ava Alderman:  If you are suffering through a bout of telogen effluvium, I can say with a reasonable degree of confidence that you are probably thinking about (if not obsessing over) your regrowth.  It’s easy to see why.  Everyone wants to focus on the light at the end of the tunnel rather than on the potentially difficult road ahead of you.

When I was suffering with chronic telogen effluvium (CTE,) the biggest question I had was how much longer the whole process was going to take.  Because at least if you know that you have the regrowth to look forward to, then in theory, the shedding becomes somewhat more tolerable.  I used to try to train myself to see spent hairs as the stimulus to regrowth.  It’s true, if you think about it. Because it’s the regrowth hair that is pushing out the old hair.  So as painful as it is to see that hair on the floor or in your brush, (assuming you don’t have miniaturization or some other inflammatory process,) there is theoretically a healthy hair on its way.

Even with knowing this, it’s very hard not to be impatient about regrowth.  Some people think that you have to lose most of the hair on your hair before regrowth can actually happen. For example, someone might ask: “my doctor said that the shedding with TE is making way for a new cycle of hair regrowth to start.  I kind of understand that, but I’m afraid that he means that ALL of my hairs need to fall out before regrowth can truly begin.  If this is the case, I don’t know where I am in the process.  I mean, I’ve lost a lot of hair, to be sure.  But I’m certain that I haven’t lost all of it – or even close to it.  Is my assumption true? Does everything have to come out before regrowth starts?  I get that I won’t go bald because hair is regrowing all of the time, but I hate to even think that I’m early in this process.”

I’m certainly not a doctor, but nothing says that all of your hair comes out with TE before regrowth starts.  It’s true that more hair than normal goes into the shedding phase all at once with TE, but not ALL of it does.  And it is certainly not all of it all at once.  I’ve had more than a few bouts of TE and in all cases, I don’t think that anywhere near all of my hair fell out, even gradually.  Sure, it did feel like it at times.  But think about it.  The average person’s head has 100,000 – 150,000 follicles.  When I was at the height of my shedding, I was shedding an average of around 200 hairs per day.  At that rate, I would have had to shed for about 600 days for all of the hair to be shed out.  Luckily, I did not shed for anywhere NEAR this long or this dramatically.

So no, the hair doesn’t have to all come out for regrowth to start.  In fact, it’s very likely that it won’t even come close to that.  Not only that, but the hair that you are seeing coming out (although it’s a larger fraction than usual) comes out gradually and over a period of time – just like it does normally when your hair isn’t shedding.

You lose some hair every day even in normal times because the hairs are all growing, resting, and shedding at different times.  The hairs on your head are all different ages and in different parts of their life cycle.  This doesn’t completely change in TE.  What does change is that more of them go into shedding mode in order to store the body’s reserves.  But “more” doesn’t mean “all.”  Your hair starts to regrow as soon as the follicle that housed it sheds the original hair.  You don’t have to wait to meet any quota before regrowth starts.  Now, some people lose a bigger percentage than others, but here’s no quota.  I hope this makes you feel a little better. If he helps, you can read my story of getting over hair loss on my blog at

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Oct 27

Does Hair Miniaturization Always Mean Androgenic Alopecia (AGA)?

By: Ava Alderman: I sometimes hear from people who can no longer deny that they are seeing miniaturized hairs when they look in the mirror or when they inspect their brush or shower grain. What I mean by this is that they are noticing that some hair on their scalp is much more thin in texture than the rest. Sometimes, miniaturized hair like this is refereed to as “peach fuzz” or “baby fine hair.”

Often, you see miniaturized hairs in high androgen areas on the scalp like on the top of your head, at the temples, and at the crown. Women in particular can get miniaturization in the bang area also. Many people panic when they see miniaturized hairs because they worry that this means that they have AGA (androgenic alopecia, which is often described as male patterned baldness.) Since androgenic alopecia is considered by many to be a long term problem rather than a short term issue (like seasonal shedding or telogen effluvium,) most people become very upset when they realize that they are seeing miniaturized hairs.

I heard from someone who asked: “does miniaturized hairs always mean that you have androgenic alopecia or AGA? When my hair loss started, my dermatologist said that telogen effluvium was the most likely diagnosis because I had gone off of my birth control pills. However, it has now been eight months of shedding with no signs of improvement and now I am seeing miniaturization. My dermatologist says this is indicative of AGA. This was not what I wanted to hear and part of me doubts this. Because I don’t have any hereditary baldness in my family.” I will try to address these concerns as best as I can in the following article.  However, I am certainly not a doctor or specialist and I highly recommend addressing any remaining questions to your health care provider.

Miniaturization Can Be Indicative Of AGA, But There Are Other Conditions That Can Cause Hair To Be Miniaturized: In the above case, there were indicators that could be indicative of androgenic alopecia or telogen effluvium. Going off of birth control pills is a common trigger for TE. However, birth control pills can also act as an anti androgen and going off of them can sometimes give rise to androgenic alopecia that was going to present itself at some point in the the future.

With that said, although AGA is the most common reason that you will see miniaturization, it is not the only reason. Many people report seeing at least some or small amounts of finer textured hairs with chronic telogen effluvium, as was the case with me. I’ve also heard of miniaturization occurring with some autoimmune hair loss.

So to answer the question posed, it’s my opinion that miniaturization does not always mean androgenic alopecia, although many will jump to this conclusion because AGA is the most common reason that you will see these baby fine hairs.

And it is important to remember that in all of the above scenarios, this condition can be reversed.  Many people assume that peach fuzz can never become normal hair again, but I disagree with this assumption.  That’s not to say it’s an easy process.  In order to grow regular diameter hairs again,  you must either remove the trigger (in the cases of CTE and autoimmune hair loss) or protect the follicle from the androgens (as with AGA.) And sometimes, you must do both.

I panicked when I saw the hair at my temples becoming miniaturized.  I was sure this meant that I had androgenic alopecia.  Looking back now, I still believe that I had chronic telogen effluvium.  I suspect this because over time, the temple area improved dramatically.   And I didn’t see any other areas that were affected.  Once I addressed my CTE,  I started seeing normal textured hair growing in again.  But, it was a long, hard, frustrating journey, especially in the beginning. If it helps, you can read the whole  story on my blog at

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Oct 20

Shouldn’t I Be Able To Literally Feel The Regrowth With Telogen Effluvium? What If I Don’t?

By: Ava Alderman: I hear from a lot of folks who are suffering from shedding and hair loss and who are extremely tuned into their regrowth.  They find themselves constantly looking – and feeling – for it.  Many have come to learn or believe that you can literally feel your regrowth as it’s happening.

This makes sense when you think about it.  Because many of us can definitely feel a difference in our scalp when we’re actively shedding.  Many people notice pain, tightness, or itching when so much hair is falling out at once.

Taking this idea even further, many understandably say that they can also “feel” the regrowth.  Many describe this as a tingling sensation. I can confirm that when I was regrowing hair during my first bout with TE, I DID notice a tingling sensation – at least at first.  However, as some time passed, I stopped being able to feel anything different.  And with my second bout of TE, I really did not notice much of a difference.  And I regrew hair both times.

I can certainly understand wanting to feel progress.  But I don’t want anyone to think that they aren’t regrowing hair if they’re not itching or tingling.  I’ve literally heard people say things like: “I feel nothing.  I see nothing.  I feel like I’m going to go bald since I’m not regrowing any hair.”

The thing is, unless you have a severe androgen issue with miniaturization or a severe autoimmune or inflammatory condition, there should not be any reason why you can’t regrow hair with telogen effluvium.  In fact, as soon as a hair follicle expels a hair, most of the time, it is literally being pushed out by the hair shaft behind it – which is regrowing in its place.

Granted, this can be hard to see at first.  Often, the hairs are thin and light-colored.   But as they grow, they thicken and darken.  Whether or not you feel them may depend upon many factors, but in my non-expert opinion, the quality and quantity of the regrowth  does not correspond with how much tingling or discomfort you feel.

I’ve known people who’ve struggled with the constant tingling who were very dissatisfied with their regrowth and those who felt absolutely nothing who ended up gaining a normal amount of volume with little discomfort involved.

In summary SOME people do feel the regrowth SOME of the time.  But if you don’t feel it (or you feel it sometimes and not at others) this doesn’t necessarily mean that you are not regrowing hair.  We don’t necessarily feel all of our bodily functions as they happen.  But that doesn’t mean that they are not happening.

Try to worry more about what you see than about what you feel.  White colored dry shampoo will often help you see your regrowth. And if you think that your regrowth is insufficient, ask yourself if there could be inflammation or miniaturization involved.  My progress improved greatly once I understood this. You can read more about my own bouts of TE and recovery on my blog at

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Oct 18

I Feel So Ugly Because Of My Telogen Effluvium. Tips That Might Help.

By: Ava Alderman: It’s very normal to be overly self conscious when you are struggling with hair loss or with shedding from conditions like telogen effluvium.  I know from experience that you are often worried that everyone is looking at you and wondering what is going on with your hair.  You might imagine that people are staring at thin areas or are noticing your experimentation with different styles and camouflage.  Some people are better able to deal with this than others.  Some take it all in stride, while others experience quite a bit of distress over it.

In fact, some people will become so affected by this process that they will feel bad about their appearance and consider themselves ugly.  Needless to say, this makes a bad situation worse.

Someone might say: “I have always been pretty comfortable with my appearance until now. I’m honestly not a vain person.  I would be perfectly content with looking merely normal.  I have always had pretty hair.  I used to get compliments on it.  But then I got telogen effluvium when I switched birth control pills.  My doctor assured me that the shedding would stop in weeks. But months went by.  He told me that three months was the mean duration of telogen effluvium.  I am at four months.  And although my shedding is sometimes better, I’m still losing more hair than normal and my hair looks absolutely awful.  It used to be shiny and now it is dry and dull.  Because I couldn’t take the long hairs anymore, I cut it short. Well, I look totally awful with short hair.  And the short length just showcases how thin my hair is.  At least before I could put in a ponytail. Now it is too short for that.  I always worry about bald spots.  I always think that people are starring at it.  I feel that it’s more noticeable than before.  And I never thought that this would be possible.  And now, for the first time in my life, I feel ugly.  I don’t want to go out nearly as much.  I don’t participate in life nearly as much.  Because I don’t have the confidence that I once had.  How do I get that confidence back?  Because I am very tired of living like this.”

I am so sorry that you are going through this.  I have been where you are.  I know how you feel.  And I am going to share some things that helped me to get through it.  First of all, telogen effluvium eventually ends.  Now, some of us get the chronic variety which means that it does not always end as soon as we want it to.  But if we are able to look on the bright side, we can realize that at least telogen effluvium means that our follicles should not be damaged — so that when we get over this, we should be able to go right back to producing the healthy hair we have always had.  Yes, it may take a while and that stinks.  But it should also happen eventually.

I know that you are self conscious about your short hair.  (I didn’t like my short hair experiment, either.)  Try to grow it out in a blunt bob.  I found that to be the best cut for making your hair look more thick.  I also want you to be aware that sometimes, when we go through something as traumatic as this, we lose perspective a bit.  I could not stop complaining about how hideous my hair was when I had CTE and yet, when I look back at pictures from that time, it is not as bad as I remembered.  Does my hair look different?  Yes.  Is it more thin?  Absolutely.  But it is not so bad that people were going to recoil in horror as I remembered it. And I think it’s possible that the same is true here.  We have a tendency to think the worst.

I found it helpful to make the most of what I could.  I played up my eyes. I worked out and developed ripped arms, which I enjoyed showing off.  I played up my fit body and best features and tried to take the attention off of my hair.  There are also colored powders just for hair to cover any bald spots.

And make no mistake.  There are MANY beautiful women who have short hair.  Think Halle Berry.  Or Courtney Cox when her hair was short.  Many of us tend to identify strongly with our hair.  So when it is taken away, we struggle.  But there is more to us than that.  I know you have other attributes that you can play up while you’re waiting for your hair to grow back.  And with TE, it SHOULD grow back. Always remember that.  It isn’t gone forever.  You just have to make the best of the waiting game while you’re dealing with it.

I know that it’s not easy.  But focus on what you can – encouraging healthy regrowth and discouraging inflammation.  I look back now at the all the time and turmoil I wasted on my hair.  Those were months that I will never get back.  My hair is back to a relatively normal situation now, but all the worry and distress didn’t do one thing to make it end any sooner.  In fact, it probably delayed it.  You can read more about my own recovery on my blog at

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Oct 06

What Causes Your Scalp To Itch With Shedding Or Telogen Effluvium? Is This DHT?

By: Ava Alderman:  I hear from a good amount of people who are not only shedding hair, but who are also having scalp issues.  Many of them notice a tight, itchy scalp and they do not understand why.  Some of them have never had dandruff or any itching before.  So they can correlate the scalp problem as occurring shortly after the hair shedding started.  They know that the two must be connected, but they don’t know why.

Someone might say: “ever since my hair started shedding badly, my scalp has itched.  I don’t notice any flaking, so I don’t think that it is dandruff.  But it’s really bad.  It’s hard not to notice it all of the time.  Scratching really doesn’t make it any better.  I try not to be obvious with the scratching, but last night my husband asked me if I had fleas. He was only joking, but this means that the scratching is obviously noticeable. Why is this happening?  I’ve read that your scalp can itch with hair loss from DHT.  Is that what is it is? My doctor thinks that I have telogen effluvium.”

In cases of telogen effluvium, the most common cause for the itch (at least in my experience and observation) is inflammation and irritation.  Except for when you’re experiencing telogen effluvium or a severe summer shed, it’s just not normal for so many of your hair follicles to go into shedding mode all at once.  Normally, you may have less than ten percent of hair in this mode.  So when the hair sheds out during a normal cycle, you don’t notice it much or feel any discomfort in your scalp.  But when this is magnified by five times or more (as is the case with TE,) than you most definitely do notice it and you can sometimes see evidence of it on your scalp, which can become irritated and inflamed.

Another reason for the itching is regrowth.  Since you probably have many more follicles growing hair than normal, this can create some tightness, tingling, or itching as the hair begins to fill in.

The inflammation and tightness can often be helped with a little tea tree oil or the commercially available product scalpacin (at least it gave relief in my experience.)  And frankly, even if dandruff is not a problem and never has been, many people with TE get some relief using dandruff shampoo simply because it kicks back inflammation.

As far as DHT goes, if you truly have TE, DHT really should not be the cause of your itching.  However, there is another type of hair loss (androgenetic alopecia) where DHT is most definitely an issue. The scalp becomes overly sensitive to this androgen and the follicles shrink as a result – causing hair loss, and eventually, miniaturization.  This process can cause itching and discomfort also.

But people with TE typically don’t have hair loss caused by androgen sensitivity.  Their hair loss and shedding is caused by stress or change to the body or illness.  It’s important to understand the difference between the two and to differentiate which type you have.  AGA and miniaturization can be addressed if treated early.  But since TE doesn’t permanently affect the follicles and doesn’t include the DHT sensitivity, it’s more likely that the itching isn’t from DHT if you are dealing with telogen effluvium.  It’s most likely from inflammation, irritation, or regrowth. Sometimes, you can have all three going at once, which can be a challenge.  It took me a while to get a handle on my inflammation, but I had CTE (chronic telogen effluvium.)  I often wonder if I would not have developed the chronic variety if I had gotten the inflammation under control earlier.  But I did not know then what I know now. You can read more on my blog at

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