Aug 16

Why Is My Hair Getting Worse After Telogen Effluvium?

When you are shedding hair, you often hope that once the hair stops falling out so dramatically, the nightmare is going to be over.  Since telogen effluvium is thought to be only temporary, most people expect their hair to start looking better once the shedding begins to slow down.  Unfortunately, this is not always what happens.  Sometimes, you get the slow down that you’d been hoping for, but you notice no improvement in the appearance of your hair.

Someone might say: “I honestly thought that it was not possible for my hair to actually look worse after my telogen effluvium was over.  I thought that this is when I would start to see it looking better.  I shed non-stop for four months.  It is finally starting to slow down.  I think that the worst is over – at least as far as shedding goes.  But the worst is definitely here was far as my hair is concerned.  It’s limp.  The texture is flyaway and it’s very dry.  It’s very hard to control, but if I put it in a ponytail, the tail is so thin and it just pulls more hair out anyway.  This is the worst that my hair has looked.  I thought that things were supposed to be getting better.”

It can take a while to see a noticeable difference in the way your hairs looks after recovery.  Here is why:   Losing all that hair is going to take a toll on your volume.  There is no way around that, really.  There are certainly styling techniques that you can use to make the most of the volume you have.  But you won’t get your original volume back  until your hair grows in.  It only grows about a half inch per month, so this takes time.

As far as the texture, telogen effluvium resets your hair cycle to the resting phase, which means that many follicles are not getting actively nourished.  As a result, your hair can look dull and be dry.  Once the TE is over, the follicles will eventually go back to the growing phase where they’re getting nourished, but they don’t all go back at once (in the same way that they didn’t fall out all at once.)  Once this reset happens for all of the affected follicles, your texture should eventually return to normal.

You might also want to make sure that you don’t have any miniaturization.  This means that the diameter of your hair has become smaller either because of androgens or inflammation.  When your hair mininaturizes, it takes many more hair strands to cover a smaller area.  Thin hair can be harder to tame than course hair.  And when your hair miniaturizes, it will provide less coverage and volume.  Now, miniaturization isn’t certain with telogen effluvium.  In fact in most cases, it’s said that the follicles are not affected.  However, in severe or prolonged cases, people have reported miniaturization.  I had a slight case of it after a severe bout of TE.  I could tell because when I plucked hairs on a certain section of my head, they would be very thin with no real substance.  If you moved them, they would float like a feather, whereas normal hairs on my head were much more coarse and would not float.  This can be addressed by combating inflammation in some cases.

The bottom line is that unfortunately, improvement isn’t immediate.  You have to wait for regrowth to take hold and for all of the follicles to reset.  Plus you have to combat any inflammation that may have popped up.  However, the good news is that once these things are done and with some patience, you should eventually get hair that is greatly improved.

If it helps for reassurance, my hair looked very rough after one bout of chronic telogen effluvium with some miniaturization.  However, time has now passed and I pretty much have my normal hair back.  It didn’t happen as fast as I might have liked, but once I understood all that was at play, it did happen. You can read more on my blog at http://stop-hair-loss-in-women.com/

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Aug 08

Is It True That Hair Loss Doesn’t Have To be Permanent?

I sometimes hear from people who are dealing with their first bout of aggressive or severe hair loss.  Many are understandably quite afraid.  They’ve never experienced this before and it’s very scary to see so much of your hair falling out all at once.  Some reach out to family, friends, and the medical profession for reassurance and are often told that their hair loss is probably temporary.

Someone might say: “is it true that hair loss doesn’t have to be permanent?  My hair started shedding about six weeks ago and it is very dramatic.  Sometimes, I feel like I will go bald.  I asked my family doctor about this and he says that sometimes, hormonal changes or diet issues can cause hair loss which doesn’t have to be permanent.  Is he right?  I’m thinking about seeing a dermatologist about this because it is so much hair that is coming out.”

I’m not a doctor, but I’ve been through a few rounds of very aggressive telogen effluvium and have done a lot of research on this.  I’d encourage you to see a dermatologist as it might put your mind at ease.  But it is true that many types of hair loss are not permanent.  Telogen effluvium is a condition where your hair temporarily sheds, and as your doctor told you, any changes to the body like fluctuating hormones, (or a dietary or medical change) can cause your body to attempt to store its strength and reserves.  When your body does this, it sees hair as something that is not mandatory or necessary.  So your hair cycles switch from growing to resting, and more hair sheds out as a result.  Eventually, once your body stabilizes again or the trigger is removed, the normal hair cycle will resume and your hair will stop shedding.  This process was only temporary and there usually has been no change or damage to your hair follicles. Only your hair cycle changed and it will reset, so there is no reason for telogen effluvium to be permanent, although some people do take a while to recover.

There’s another hair loss condition called alopecia areata which is an autoimmune disorder which causes the hair to fall out.  Recovery from this condition varies; however, because the follicles remain alive and active for this condition, it also doesn’t have to be permanent in some cases.

The most common type of hair loss is androgen-driven loss or androgenic alopecia (AGA.)  This is more commonly known as male patterned baldness, although women can and do suffer from it as well.  In this condition, the follicles ARE affected because they get smaller (or miniaturized) over time,  As a result, the hair gradually becomes more and more thin / fine with total baldness in the affected area happening eventually in some cases.  AGA can be permanent if you ignore it and do not attempt to treat it.  That said, there are many effective treatments today.  That is especially true if you treat it early before the follicles are severely damaged.    So I would say that AGA can certainly be permanent in some cases.  But in others, it can be slowed substantially or even reversed.

That is why I agree that hair loss does not need to be permanent.  But it is always a good idea to treat any form as soon as is possible.  In the case of telogen effluvium, you can make sure that you’ve addressed and removed the trigger and can encourage regrowth.  If you have alopecia areata, you can find a very good dermatologist who can treat you.  And even with AGA, if you seek early treatment, you can usually avoid hair loss that is permanent or severe.

As I said, I had very severe telogen effluvium that resulted in some miniaturization, but thankfully, it was definitely not permanent. You can read more on my blog at http://stop-hair-loss-in-women.com/

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Jun 28

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 http://stop-hair-loss-in-women.com/

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Jun 27

How Can I Tell If I Have AGA Or TE?

By: Ava Alderman:  I sometimes hear from people who are really anxious to know if they have telogen effluvium (TE) or androgenic alopecia (AGA.)  One reason that this is important is that sometimes, TE resolves on its own, while AGA needs treatment in order to get a good result.  So, most people strongly hope that they have shedding that will resolve rather than hair loss which is likely permanent with out treatment.  This distinction can be difficult to make because both of these conditions have hair loss as the main symptom.  However, there are some distinctions worth noting which can lead to some questions worth asking yourself, which I will discuss below.

Do You Have A Trigger That Started The Whole Thing?:  Often, when you have TE, there will be a trigger that you can pretty easily pinpoint.  Anything that causes your body to store it’s reserves due to stress can be a trigger.  Common examples are starting or starting new medicines, severe dieting, physical illness, giving birth, or even using new styling products.  Keep in mind that the trigger should have occurred around 2 -3 months before the shedding started, so you may have to think back into the past.  But typically, if you have shedding that will resolve, you can look back examine your life style or your habits and figure out what started this whole process.

Is Your Longer Regrowth Miniaturized?:  Miniaturized hair is often noticeable when you have AGA.  You may notice that your regrowth is coming in quite thin and has a flyaway or peach fuzz texture.  Now, with this said, it can be common for all regrowth to be a little bit thin when it begins to grow.  So if your regrowth is still less than a couple of inches long, this probably isn’t the best sample to choose.  Instead, I advise examining one of your mature spent hairs (that has already shed out) and then identifying a regrowth hair that has clearly been around for a couple of months.  If you compare the texture of the two hairs, they should be somewhat similar.  But if you notice that the new hair is significantly more thin and texture, then this is something you may want to keep an eye on.  Although I have heard of cases of miniaturization with chronic cases of telogen effluvium, it is more common with AGA.

Do You See Any Indications Of Excess Androgens?:  People with AGA will often have other symptoms like an oily, itchy scalp, or even facial skin that is a bit shiny due to the excess oils.  Also, if you look at your scalp under bright lights try to take notice as to whether you see a sheen at the follicles which would be indicate or excess oils which is sometimes indicative of an androgen issue.  This isn’t to say that people with an effluvium don’t also have issues with their scalp or skin, but it is more likely with AGA.  And often, people will androgen driven loss have also dealt with excess oil on other areas of their body.

The Bottom Line:  Sometimes, it comes down to whether you want to wait to see if the loss resolves on its own or if you want to have a specialists look at it.  It can be a challenge to find someone who will take you seriously and who is willing to actually test rather than just make assumptions and to offer reassurances that are hard to take when you are still shedding.  But it is worth it to keep looking until you find some relief because I know how difficult this process is.

I know because I went through this myself.  There was a time when I was convinced that I had lasting, permanent hair loss that would never end.  But I kept going back to my triggers and knowing that I was missing something somewhere. After this, I started seeing an improvement. 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 http://stop-hair-loss-in-women.com/

 

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Jun 27

How Should I Style My Hair If I Have Telogen Effluvium?

By: Ava Alderman:  One of the biggest dilemmas that many of us have when struggling with telogen effluvium is how to style and cut our hair.  It is very tempting to just slap your hair in a pony tail all of the time, but then you worry about the extra tugging and pulling causing more hair loss.  Many of us notice that when we don’t keep our shedding hair trimmed, it starts to look stringy pretty quickly.  The all one length, long cut that looked so great when we were not shedding hair can look just awful when you have telogen effluvium.  That’s because the changes in hair texture can mean that your hair doesn’t lay down correctly and the loss in volume can mean that long hair looks limp.

Many of us are tempted to cut our hair off and rock a very short style.  This DOES work for some folks, but you have to be careful if your hair is fine instead of coarse.  In some cases, a layered, short cut will show scalp if the hair does not have enough width to cover it.  You have to evaluate if your hair is coarse enough to cover all of your scalp when cut.  Generally speaking, a shorter layered style will work better for folks with coarse hair or kinky / curly / wavy hair than for folks with fine / straight hair.

For those with fine hair, a bob or blunt cut can work very well.  The bluntness of the ends can make it appear that you have more hair.  Another option is putting some wave or curl in your hair to add volume.  (Tell your stylist that you’re having hair loss if you are getting a perm so that she can be careful not to get as close to your roots and she can try to be as gentle as possible.)

Cheryl Burke’s style in old episodes of “Dancing With The Stars” (the side-swept bang blending into a blunt cut on one side) could help to camouflage a lack of volume, but only if your hair texture lays straight naturally.  You don’t want to choose a style that goes against your texture so that you are required to do a lot of blow drying, curling, or straightening.  You just don’t want to manipulate your hair by styling any more than you have to.

I always regretted it when I cut my hair too short to wear a pony tail.  I never wore my hair up every day when I was shedding because I didn’t want any traction problems.  But there were days when I just did not want to see shedding hair all over my clothes and it was a relief to be able to get my hair up so I just didn’t have to deal with it.  I also found that allowing my hair to dry in an upside down ponytail meant that I had volume when I took it down so that I would not have to manipulate it in order to get volume.

In short, the best style for telogen effluvium works with your hair’s texture and how your hair naturally lays.  You want a style that makes the hair look well kept without needing to manipulate it too much.  And you want a style that can camouflage the loss.  In my case, this was a bob that just brushed my shoulders and worked with my fine, wavy hair.  I could still put it in a ponytail when I wanted to.  And I didn’t need to style it that much in order for it to look okay.

Your best style may be different, but I’ve found it best to keep your hair trimmed when it’s shedding to avoid the stringy look.  If it would be helpful to read some tips for dealing with telogen effluvium,  feel free to check out my blog at http://stop-hair-loss-in-women.com/

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Jun 24

Why Am I Shedding Short Hairs With Telogen Effluvium (TE)?

By: Ava Alderman?  I often hear from people who can’t help but examine the hairs that they are shedding when they believe that they have telogen effluvium (which is commonly referred to as TE.)  Not only do many people count the hairs, but many look very closely at the length and also at the ends to see if they have any bulbs or markings.  They often have questions about what they are saying. I heard from someone who said: “I’ve been noticing that lately, most of the hairs that I am shedding are very short.  Much have blunt ends.  Why could this be happening?  Does this mean the hair that I am regrowing can’t be maintained?”  I will try to answer these questions in the following article.

Shedding Short Hairs Can Mean That You’re Still Cycling Through Different Hair Cycles Of Growth And Regrowth: Many people assume that once their TE is ending or is over, they will just pick up with normal hair cycles and are able to resume their previously healthy hair schedule.  Unfortunately, this isn’t always the case.  Some people go through a few cycles until their hair growth cycles resume to “normal.”  What this means is that your hair is still shedding while you are also regrowing.  Your body or scalp doesn’t distinguish between long or shot hair.  It just continues to shed. And if you’ve gone through TE, you will often have a good deal of short hair growing in.

This doesn’t necessarily mean that your regrowth will never take hold.  Sometimes, it just takes a few more cycles. Or, the trigger that started the shedding in the first place needs to be eliminated.  Ask yourself where you are in the shedding.  Has it been only a few weeks?  A few months?  Shedding short hairs is more common in chronic telogen effluvium (shedding that lasts for six months or longer) because it takes a few months before you start to see regrowth and a few more for it to obtain some length.  So by the time you see short hairs falling out, more than a few months from the beginning of this process has likely passed. If it’s been more than several months, then it might be time to see if something else is at play.

The Possibility Of Continuing Triggers Or Androgenetic Alopecia: Sometimes, the shedding just continues to go on and you’ve seen several cycles of short hairs continuing to fall out.  At that point, if you’re still confident that you’re looking at telogen effluvium, you may want to look the possibility of continuing or multiple triggers.  Sometimes, what caused the original shedding is over but something else has triggered a new one.  Or, other times there is a continuing trigger like a medical issue or a medication that doesn’t agree with you.

The last thing to consider is that you might be looking at androgen driven loss.  It is possible for the loss to start off as telogen effluvium and then turn into something else like androgentic alopecia (which is often referred to AGA.)  It’s not unheard of for androgenetic alopecia to be thought to be telogen effluvium initially.  And, shedding short hairs with AGA is common because people with this condition have a hard time supporting healthy regrowth.  It can help to look at the quality of the shed hairs.  Are they miniaturized? (This means do they look thin and whisky, like peach fuzz.)

The good news is that either of these cases can be addressed by supporting healthy regrowth, minimizing inflammation, and addressing any androgens.  But to answer the question posed, it can be normal to shed short hairs with telogen effluvium.  But if the hairs are miniaturized or if this process goes on for too long, you might want to see if there is something else at play that can be addressed.

I panicked when I saw a bunch of short hairs coming out.  I assumed that 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 loss of short hairs improved dramatically. Once I addressed my triggers, I started seeing normal length 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 http://stop-hair-loss-in-women.com/

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Jun 13

How Much Time Does It Take To Cure Telogen Effluvium

By: Ava Alderman:  I sometimes hear from people who ask me what is the time frame to “cure” telogen effluvium or dramatic hair shedding.  Understandably, people want this “cure” to happen as soon as is possible.  Shedding what seems to be bucket loads of hair is not at all fun.  And you can start to become worried or paranoid that the shedding is going to dramatically change your appearance if it doesn’t stop.

Someone might say something like: “I have a wedding coming up in about nine weeks.  Can I cure my telogen effluvium before that?  I don’t want my hair to be falling all over my dress and I don’t want it to be thin in the wedding pictures.  So how would I go about curing it?”

Most experts will tell you that really, there isn’t a “cure” for telogen effluvium except for time.  Because technically, the shedding is happening because something has happened to the body (an illness, medications or diet, etc.) that causes some of the hair follicles to reset themselves.  So hair that was growing before suddenly begins to shed instead.  Once all of the hair that makes this switch sheds out and begins to regrow, then your hair should just resume with its normal cycles.  Yes, it may be a little more thin and you may have to be patient as it fills in.  But theoretically, there is no lasting damage to the follicles.  They have simply reset.

Where this gets tricky is that the follicles can be reset gradually.  Every hair that is going to be affected by the telogen effluvium does not shed out at one time.  As you probably already know, it happens over the course of weeks or even months. Experts will tell you that the process can take as long as three months (unless you have chronic telogen effluvium.)

There are also a few more issues that can complicate things.  There is often an inciting trigger that kicks off the telogen effluvium.  Many triggers are one-time events – like giving birth or having surgery.  They resolve by themselves.  But other triggers are ongoing – like hormonal changes, chronic illness, or a trigger that you just can’t be identified.  If the trigger doesn’t disappear, the shedding can sometimes continue.

Also, sometimes the shedding kicks off inflammation, that itself becomes a trigger.  And the stress that the TE causes can raise cortisol, which is a hormonal change, (and also a potential new trigger.)  Fortunately, some people do not experience this type of secondary trigger.  For them, the “cure” for TE is simply time.  They have to wait for all of the affected hair to reset.  For others, there is a need to lessen stress and to tame inflammation. If you are not sure which category you fall into, you can try to cover all of the bases by eating well, keeping stress levels down, combatting scalp inflammation, and asking yourself if you have eliminated the trigger or it is possibly ongoing.   Also, if the hair loss continues on, you want to ask yourself if its possibly another type of hair loss.  But if you are very early into this, it very well could still be telogen effluvium.

I hope that helps.  If you’d like to read about some things that helped me to get through a couple of different bouts of TE, you can check out my blog at http://stop-hair-loss-in-women.com/

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May 30

Is My Scalp Tingling A Sign Of Regrowing Or Of More Hair Falling Out?

By: Ava Alderman:  I get a lot of correspondence from people with hair loss who are experiencing discomfort with their scalp.  Specifically, their scalp might be tight and painful.  It might feel tingly or have a “pins and needles” sort of sensation.  It may even be red and irritated.  Many people assume that this is part of the hair loss process.  But then when the sensation continues on, they start to question this assumption.  They may read that hair begins regrowing as soon as it falls out, so they may start to speculate that perhaps it is the regrowth process that is causing the discomfort and the tingling feeling.

Someone might ask: “my scalp has been bothering me for months now.  It started shortly after my hair started falling out from telogen effluvium.  I’ve never had dandruff, so I have never been someone who has to scratch my scalp or pick at it.  But ever since my hair started falling out, my scalp has itched, burned, and generally just made me aware of its presence.  If it is not slightly painful, it is sort of tingly.  I figured the hairs that were falling out might have been causing the discomfort. But then I talked to a friend of mine and she said she noticed her scalp tingling like that when she started hair growth vitamins.  So she says that what I am feeling is probably an indication of my hair actually growing and not falling out.  Who is right?”

I actually think that you are both right, at least in my experience. I’ve had telogen effluvium more than once. And every time, I have had scalp symptoms during both hair loss and hair regrowth.  Here is why.  You normally don’t feel it when your hair falls out or regrows because typically, only ten percent (at most) of your hair sheds out at any one time.  But when you have telogen effluvium, that percentage is higher.  A much higher amount of follicles are affected and become active.  This can create some inflammation, which can cause those burning / stinging / itching / tingling symptoms that we are all aware of.  However, those same follicles that were active during the fall also must be active during regrowth.  The follicle lost a hair in the beginning stage but then it must grow a hair in the regrowth stage.  Since there are so many follicles doing this at once, inflammation continues to be a possibility and of course we know that you can feel inflammation on the scalp.

I hope that this helps and answers the question.  Many notice that as the shedding begins to slow, the scalp symptoms get better.  If this isn’t the case or if you just need some relief, dandruff shampoo, scalpacin, and tea tree oil can all provide some temporary relief.  Once the cycle is over and you only have a small amount of follicles being affected by the growth / rest cycle, you should once again no longer be aware of the cycles that are happening with your scalp and you should no longer feel it.

I hope that helps.  If you’d like to read about some things that helped me cope with TE, you can check out my blog at http://stop-hair-loss-in-women.com/

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May 23

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 http://stop-hair-loss-in-women.com/.

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May 19

The Telogen Effluvium Recovery Process: Step By Step:

By: Ava Alderman:  I sometimes hear from people who think (and very much hope) that they are starting to see some improvement in their telogen effluvium or shedding.  There typically comes a point in this process where you get very tired of seeing the hair falling out and dealing with the lack of volume, so you begin to watch your hair and scalp with an eagle eye.  You start to be on the look out for any signs that you might be in recovery.  The problem can come when you don’t know what is a sign of recovery and what is not.  This article is meant to outline the steps that you might see on your road to recovery.

Step One: The Trigger Is Removed:  This type of shedding is caused by stress to your body.  Sometimes, that is an illness.  Other times, it is a change in hormones.  Occasionally, it can be an inflammatory response or an allergic reaction.  So long as the body is no longer under stress, has recovered, or no longer has a reoccurring trigger,  the affected follicles should eventually go from the shedding phase to the growing phase and recovery begins.  Chronic telogen effluvium occurs when the trigger or stressor is ongoing or another trigger (like inflammation) pops up so that the shedding continues.

Step Two:  Regrowth Begins:  Honestly, as soon as a hair is kicked out of its follicle and sheds out, another hair is in line to take its place.  You won’t be able to see that baby hair replacement for a little while, but rest assured that the process starts long before you realize it.  Since hair only grows 1/2 inch per month and can come in lighter colored or very thin, it can take a while before you get a good look at your regrowth, but it is typically there long before you can actually see it.

Any Inflammation Or Miniaturization Present Shows Up:  Ideally, once you start actually being able to see regrowth without too much trouble (which should happen in a couple of months or so,) the shedding will have started to taper off some.  If the shedding is still going full force with no sign of letting up, it’s probably not a bad idea to examine your scalp for signs of inflammation.  Sometimes, if you have a red, pink, itchy, tingly or painful scalp, you might have inflammation exacerbating the shedding.   The inflammation can be treated, so it makes sense to be on the look out for it.

Another thing you want to look for is miniaturization.  Regrowth hair can look kind of thin and pale when it is first growing.  But once it gains a little length, it should start to look normal.  If you have obvious miniaturization, it makes sense to evaluate for androgen – driven hair loss or AGA.  Now, prolonged and chronic telogen effluvium can cause some mild inflammation (at least in my experience,) but it’s important to be conscious of this because the earlier that miniaturization and the androgens are treated, the better the results are going to be.

Not everyone has inflammation or miniaturization.  Many people do not.   But it’s smart to watch for both because the earlier they are addressed, the better the result.

The Volume Begins To Fill In As Follicles Are In The Growing Phase Again And Hair Gains Length:  As the majority of your hair is back in the growing phase for a while, the strands that are regrowing should start to gain some length.  When many strands gain this length at once, that is when you start to get a gain in volume.  It is when your hair should start looking more full.  And since most of your follicles are getting nourished again, the hair should regain it’s health and sheen. Telogen effluvium hair can look dull, fly away, and dry.  But once you are in recovery for a while, your hair should regain it’s health and look shiny and manageable again.

This process doesn’t always come as fast as we would like.  But as long as the trigger is removed and inflammation / miniaturization are kept at bay, you should eventually get your hair back.  By definition, telogen effluvium is a pause – not a permanent loss.  The hair that is lost grows back. And since the follicles should not be permanently affected, you should theoretically eventually end up with the hair you started with.

Of course, if you have too many cycles of telegen effluvium (which turns into CTE) or you struggle with your trigger, then this process can take longer and be more drastic than any of us would like.

I did have some chronic telogen effluvium.  But that was before I knew how important combating the inflammation truly was.  Once I understood this and embraced preventatives, things got much better.  There’s more about my experience on my blog at http://stop-hair-loss-in-women.com/

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