Dec 06

Can An IUD Cause Telogen Effluvium?

I sometimes hear from people who purposely avoided using prescription oral contraceptives as a form of birth control because they did not want to potential side effects.  Instead, they used an IUD, but some still suffered from side effects like hair loss.  You might hear someone say, “I know that birth control pills cause hair loss, so I purposely avoided using them.  Instead, I opted for an IUD.  About 3 months later, I am shedding hair horrifically.  When I google this, it sounds like telogen effluvium.  But I’m not taking anything internally so I thought I’d be safe.  Do IUDs cause telogen effluvium or hair shedding?  Because my hair loss is extremely bad.”

I’m not a doctor, but if you google this topic, you’ll see tons of posts by women who suspect telogen effluvium from IUDs. I think that this is because, like anything which can suddenly change your hormones or change what is going on inside of your body, this type of birth control has the potential to cause telogen effluvium which changes in your hair cycles.  There appear to be a decent number of women who have experienced hair loss with IUD’s, but every one is different.  Any medication or any CHANGE that alters your hormone levels can potentially cause telogen effluvium in some people.  I know that it’s assumed that avoiding internal medications makes you more safe, but it’s not always medications that cause TE.  Diets, stress, and even a harsh exercise regimen has been known to kick it off.

Unfortunately, some people are more sensitive than others to changes in the body.  When I was dealing with hair loss, I would sometimes take vitamins and supplements to try and help my hair.  There were times when some of these items would actually kick off a new trigger and make my hair loss worse.  This is probably because the supplements were having an affect on my hormones. I learned to be very, very careful about making any changes to my diet, supplement regimen, exercise routine, and stress.

I would ask myself if there were any other possible triggers other than the IUD and then approach your doctor about your concerns.  He or she would be familiar with potential side effects and could advise you on your best course of action.  If you are experiencing telogen effluvium, you’ll need to wait for your hair cycles to reset and you can support regrowth by eating well and watching out for scalp inflammation.  Again, I’ve not had personal experience with an IUD, but it’s my understanding that anything that can change your hormones or any change that fools your body into thinking that it is under stress can cause telogen effluvium.

I definitely had some shedding when I changed my birth control methods.  But I’m so prone to shedding, that almost any change can set me off.  Over time, I’ve learned to control it a little better and for the most part, I now have normal cycles.  If it helps, there’s more on my blog at

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Nov 23

Can Hair Follicles Produce Healthy Hair After Chronic Telogen Effluvium?

By: Ava Alderman:  I sometimes hear from people who have been suffering from telogen effluvium hair loss for so long that it has reached the level where it’s said to be chronic, which is typically defined as longer than six months.  These folks often worry that their hair follicles have been damaged and, as the result, will be unable to produce healthy or normal hairs once again.

Common comments are things like: “I’ve had hair loss for over a year.  During that time, my regrowth was thin and it kept falling out so that it never had the chance to regrow normally.  Now, the shedding seems to have stopped.  But I’m worried about my regrowth.  Will my follicles be able to produce normal and healthy hair again? Or, have they been damaged from this process?  I have an awful feeling that I’m going to regrow thin, sickly, flyaway hairs.”

I’m certainly not a medical expert, but in my own experience and observation, as long as the triggers that kicked off the shedding in the first place have been removed and you have no other scalp or hair loss issues, then normal hair cycles (including regrowth) should eventually resume.   Sometimes, people worry that their scalp or ability to regrow hair has been negatively affected because they see their new hair fall out or they notices that it looks thin early after recovery.  Sometimes, the new hair has to grow a few inches in length before it begins to reach a normal diameter.  Also, it is possible to need a couple of shedding cycles before your normal hair cycles resume.

If your hair is a couple of inches long or you’re still seeing things that worry you for a couple of months after recovery, then there are a couple of other possibilities.  The first is that the original trigger has returned or a new trigger has come up.  If your hair loss is due to medical issues, then it’s possible that they are not completely resolved.  Another possibility is the inflammatory process.  Rapid and drastic hair shedding and regrowth can sometimes cause an inflammation process in your scalp your can affect your regrowth.  If this is the case though, you’ll often see a reddish or pink scalp that feels tight or itches.

If you’ve ruled these things out, ask yourself if it’s possible that the CTE was instead an androgen driven process.  Androgen driven hair loss or AGA is the most common form of hair loss, even for women.  And one of the symptoms of this type of hair loss is a scalp and hair follicles that have problems regrowing and maintaining healthy hair because of the excess androgens (or your body’s reaction to normal androgens.)  So if you’ve given your regrowth plenty of time and you’re still seeing things that make you worry, then it might be a good idea to explore if your hair loss is androgen driven.  Also, some hair loss starts out as an effluvium and eventually turns into androgen driven loss as soon as the person reaches the age where the AGA would have begun in the first place.

So to answer the question posed, it’s my experience that the follicles are not negatively affected by CTE in the long term.  While it’s possible for hair to look different when it is still short and it’s not uncommon to have a few abnormal cycles before normal patterns resume, follicles should behave normally several months after the shedding is over.  If they aren’t, then it’s important to see if there are any other possibilities (like inflammation, medical issues, or androgens) that need to be addressed.

I did have several abnormal cycles after my shedding ended. My regrowth looked like peach fuzz for a while until I got serious about combatting the inflammation and supporting healthy regrowth. My hair might have resumed normally if I had been patient, but I didn’t feel that I could afford to wait after all the damage that was the result of the shedding.   If it it helps, you can read my story at

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Nov 22

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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Nov 22

Scalp Injections With Telogen Effluvium

I sometimes hear from people who have been dealing with severe telogen effluvium for quite some time. Because of this, they are ready to do something drastic to stop the shedding. I’ve been asked about injections into the scalp and whether or not this will help with telogen effluvium.

Before I attempt to answer, I have to stress that I am not a doctor or specialist. I am just a layperson who has gone through this and, because of that, has done a good deal of research. It is my understanding that dermatologists sometimes use cortisone or steroid injections directly into the scalp for autoimmune or scarring conditions like alopecia areata, or for scarring alopecia due to lichen planopilaris. This is usually done in situations where there is an alarming amount of inflammation and the hair loss could be permanent without treatment.

Typically, telogen effluvium does not rise to the extremely high level of inflammation that we are talking about. These injections are typically performed by a dermatologist only when a scalp biopsy has shown an extremely high degree of inflammation that could cause scarring. Yes, sometimes, ongoing and severe telogen effluvium CAN cause inflammation. But this is often a by product of the condition. It is not the initial trigger for the condition. Most often a person with telogen effluvium will be given topical anti inflammatories (or told to use an anti inflammatory shampoo) rather than getting injections. The idea is to try non invasive methods.

I’d certainly encourage anyone with telogen effluvium to see a dermatologist, but I would not push for injections unless my scalp biopsy showed something alarming that made injections medically advisable. This is just based on my personal experience where I was able to kick back TE inflammation using more natural topicals that I could use at home and did not need to inject. Certainly, there are medical conditions of the skin and scalp that are severe and will require medical intervention. Telogen effluvium typically does not fall into that category because it usually ends on its own once the trigger is removed and the inflammation is dealt with. (Typically, the hair cycles reset themselves after these things happen.)  Even androgenetic alopecia is not typically treated with scalp injections. It is usually very specific, severe, and potentially scarring or permanent conditions that require the injections. I do not want to discourage you from seeing a dermatologist. In fact, I encourage that. It’s just that it’s my understanding that most dermatologists only perform scalp injections for specific conditions. But if you have very severe inflammation with your telogen effluvium, a dermatologist might be able to offer you some topical anti inflammatories or even put your might at ease. Also, I do know a few people who were thought to have telogen effluvium, but who later learned that they had something else entirely after a scalp biopsy, so it never hurts to have your scalp checked if your TE is ongoing and severe.

As I alluded to, I had decent success with natural, topical anti inflammatories combined with occasional dandruff shampoo (even though I didn’t have dandruff.) You can read more about what helped my triggers, my regrowth, and my inflammation on my blog at

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Nov 21

Can The No Poo Method Help With Hair Loss?

By: Ava Alderman:  Before I try to answer this question, I want to clarify what “no poo” means as it relates to hair.  Essentially, it means that you are going to commit to washing your hair and scalp with something other than commercially available shampoo, which can contain harsh chemicals that strips your hair and scalp of the natural oils that many people feel are healthy.

People use different substances to get their hair clean without shampoo.  Some just use water.  Others use baking soda.  Or apple cider vinegar.  Or even gentle conditioner, since conditioners have less harsh ingredients with enough of a cleaning agent to get your hair clean.

Many people with curly or wavy hair embrace the “no poo” movement because it allows their curls to not get fried by shampoo.  It makes curls soft and it helps control frizz.

If you are suffering from hair loss, “no poo” may sound very intriguing to you. During the worst parts of my hair loss, I hated washing my hair so much.  It was traumatic every time.  So I tried “no poo.”  And I can tell you what happened for me and for some others who tried this experiment with me.  Initially, it was a relief because less hair was coming out during grooming.  But within a week or two, my hair loss got worse.

And here is my theory as to why. I believe that my hair loss (which was chronic telogen effluvium with some miniaturization thrown in) was always made worse by inflammation.  Not washing it as much didn’t allow the inflammation to get kicked back or under control. In my own case, I found that using an anti-inflammatory shampoo helped me both in terms of hair loss and the pain in my scalp. So when I was no longer using something strong enough to help with inflammation, the loss got worse, at least that’s my theory.

Plus, if you are losing hair due to androgens or DHT, no poo may not allow you as much of an opportunity to at least wash some of those substances off of your scalp.

Now, my experience may not be true of every one.  If your hair loss was due to some sort of allergic reaction to harsh grooming or hair products, then no poo may help.  Baking soda and diluted apple cider vinegar can be pretty gentle to even those who are very sensitive.  So I don’t think it hurts to give it a try and then if you notice worsening hair loss, you can stop.

What I wouldn’t recommend is just not washing at all.  Some people use dry shampoo or come to hope that the hair and scalp is self-cleaning.  In my own experience, it’s not. I think that it’s important to clean your scalp of debris and build up.  You don’t want your follicles getting clogged or blocked.  You want as healthy a scalp as possible so that you can support healthy hair growth.

I know that everyone is different.  But for me, the key was bringing the down the inflammation in numerous ways.  No poo just didn’t allow for that.  You can read more about my experiences on my blog at  Now that my hair loss is under control, I do take breaks from shampoo once or twice a week and wash with conditioner only.  This keeps my hair soft and brings out the natural wave.

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Nov 20

Why Is My Shedding Hair Getting So Tangled?

By: Ava Alderman: As if it’s not bad enough to be dealing with shedding hair, many people going through this notice a change in texture also. This change in texture can go so far that you can find yourself with hair that is now fly away and getting tangled.

Someone might say: “I have always had pretty manageable hair. Before my hair started falling out, it wasn’t that much of a chore to comb it and to make it look nice. But ever since it started falling out, it’s been almost impossible to tame. It doesn’t lay down anymore and it’s becoming very tangled. Why is this? And what can I do about it?”

Hair That Is Resting Instead Of Growing: There are a couple of possibilities for what you are seeing. Often, when your hair is shedding, something has happened to cause some of the hairs to change from the growing cycle to the resting cycle. When this happens, the hair that is in the shedding cycle is no longer actively becoming nourished. There is no longer any point to that because that hair is going to fall out soon anyway.

When this process starts to happen with more hairs than normal (as is the case when you have telogen effluvium) it can produce flyaway hair. When your hair is in a normal growth and shed pattern, there are a small amount of hairs being affected so that it is not noticeable. But when a larger number of hairs shift, there can be a very noticeable change in hair texture. And as the hair is often more raised and not laying down, it’s easier for it to become tangled.

In addition to this, many people notice that they lose more hair when they comb it or use conditioner. So many people do this less, which leads to tangling.

Miniaturized Hair: There is one more possibility that I can think of. If you have a hair condition called androgenctic alopecia (patterned thinning) the hair can eventually become miniaturized or more thin. When this happens, the hair doesn’t lay down correctly because the weight of it has been diminished. This can also lead to tangling.

Gentling Addressing The Tangles: It can be frustrating to deal with the tangling because when your hair is falling out, you have to be very gentle with it. That’s why it can help to use a spray in conditioner to help your comb glide through it very easily. Use a very wide tooth comb so that the hair doesn’t pull. Hold your head at the scalp and only comb right before where the tangle is located. By holding your hair firm and not taking long strokes, you’re only affecting the tangled area and this is a more gentle approach to take.

Once you have the tangles taken care of, you can very gently comb the full length of your hair to keep the tangling from coming back for a while. When you wash your hair, allow it to dry flat. Don’t put it up in a towel because this can make the problem worse. (If you want to use a towel, make sure that the hair is not twisted inside of it.)

Tangling was a problem for me when my hair was shedding.  I would often gather my hair in a ponytail when wet and wrap the towel around it that way so that it could not move or twist (and therefore tangle) during the drying process.  The good news is that once I got my shedding to stop, the tangling stopped also.   You can read more about my experience on my blog at

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Nov 19

How Often Should I Wash My Hair With Telogen Effluvium?

By: Ava Alderman: If you are suffering from severe hair shedding, then you probably know that washing your hair can become a traumatic event. This may sound silly or overly dramatic to people who haven’t been through this. But for those of us who know the reality of having hair all over our clothes and floor, we know that it is no dramatization to say that it can almost seem as if you are losing huge, alarming amounts of hair every time that you wash it.

Understandably then, many of us consider washing it less. We aren’t always happy about this since some of us have additional itching when we’re shedding. But we figure if we can forego a wash or two and save ourselves a lot of spent hairs, then perhaps all of this would be worth it. It’s not uncommon for me to hear comments like: “I used to wash my hair every day. But now that I have telogen effluvium and am shedding, it’s psychologically difficult for me to shed my hair. The drain is nearly clogged with my hair. I have read that you really don’t need to wash your hair that much. In fact, I’ve read some celebrities wash their hair about once per week. Would washing less help me? How often should you be washing your hair with telogen effluvium?”

I’m not a doctor or hair specialist, but I do have an opinion on this based on my own experience and research. I completely understand this. Because when I was shedding, I experimented with washing my hair less. Here is what I found, although I would encourage you to see for yourself. Not washing as often didn’t really save me any hairs, I don’t think. Because what happened is that I just shed so much more on the days that I did wash. So I believe that the average number of hairs per day were probably about the same or maybe even a little more.

Not only that, but my hair itched, my scalp burned, and the overall experience was more painful. I was using an anti-inflammatory shampoo at that time and I believe that going days without this benefit wasn’t helpful to my hair, my scalp, or to me. Also, if your hair loss is in any way due to inflammation or a response to androgens, not washing your hair can make these responses more intense, which can lead to more shedding. Plus, your hair tends to take on a bad texture when its shedding and it can be limp and look oily. Not washing your hair can make the appearance of your hair a little worse, and this can be psychologically damaging as well.

So my answer to the question would be that, to the extent that you are able, I would keep up the hair washing regimen that worked for you before the shedding. If this is too difficult, maybe you could add one additional non-washing day without a huge surge in inflammation or oiliness. When my shedding was at its worst, I would wash with regular shampoo one day and dry shampoo the next. But I would not go for so long that you risk your follicles being affected by debris.

Instead, I would try to wash my hair as gently as I could. But I would also understand that if my hair is in the resting or shedding phase, not washing it isn’t going to save it. Hair that has switched phases is going to fall out at some point soon anyway. And this is true whether you are washing it or not.

One thing that helped me with this process was to allow my hair to mostly dry in a towel.  This kept me from seeing the fall out and helped psychologically.  Also, my hair didn’t pull out as much if I styled it when it was mostly dry. If it helps, you can read more about my experience on my blog at

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Nov 18

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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Nov 17

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

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Nov 13

I Can’t Tell If I Have Miniaturization Or Regrowth. How Do I Tell?

By: Ava Alderman: I sometimes hear from folks who really hope that they are seeing regrowth after a bout of hair loss or shedding. The problem is that they can’t be sure what type of hair they are looking at. They often see wispy, thin, and short hairs that could possibly be either regrowth or hair that has thinned or become miniaturized. Of course, most people hope that they are seeing regrowth, but they can’t be sure.

To that end, you might hear a comment like: “I had a horrible bout of what I believe is telogen effluvium. I lost a lot of weight a couple of months ago and I think that this is what brought on the shedding. It was really bad for a while but it seems to have gotten better. When I pull back my bangs and when I look at the top of my head, I see some tiny little baby hairs that appear to be coming in. My first inclination is that these hairs are regrowth. But, they look a little sickly. They are thinner than the rest of my hair. My father is bald. My brother is thinning. So I suppose it’s not inconceivable that what I am seeing is actually miniaturized hairs. How can I tell which one I’m looking at?”

I agree that it can be difficult. And fear of the unknown can make you begin to worry that you are only seeing what you want to see. Here are a couple of things to look at to help you determine if you are looking at regrowth or miniaturization.

Is The Hair More Thick In Diameter Closer To The Scalp?: Some people are lucky enough to have really robust, and normal looking regrowth. What I mean by this is that even if they are growing in short, baby hairs, those hairs are normal in diameter and they are the normal thickness of a regular hair. But some of us are not so lucky. Many people have commented on my blog that their regrowth came in fine at first but then it thickened up as it grew. I had some areas of my scalp where I noticed this as well. In this case, you might notice that the hair is thicker the closer to the scalp that it is.

Is The End Tapered Or Blunt?: This observation isn’t always going to be applicable. But sometimes, this information is very helpful. Generally speaking, regrowth hair has a tapered end. The reason for this is that you haven’t cut this hair, so it won’t have that blunt, straight across end. Now, if you are looking at miniaturized hair that has been cut, that hair will almost always have a blunt end. But if you are looking at a tapered end, then you are either dealing with regrowth hair or you haven’t cut that hair yet. As I said, this won’t always be applicable, especially if your hair is longer and you don’t cut it regularly. But if the hair is blunt or cut straight across, the chances are good that it’s not regrowth, unless you just got a hair cut and the stylist cut those baby regrowth hairs for some reason.

Do The Feather Test: This isn’t scientific by any means. In fact, I’m not a specialist of any kind. This is just something that I developed myself. This comes from my own observations during my own bout with hair loss. Hopefully, you find it helpful and applicable. I had a couple of areas on my head that were miniaturized and were different from those thin baby hairs that were regrowth. I plucked hairs from both areas of my head and I compared them. Although the regrowth hairs were more thin than my regular hairs, the miniaturized hairs were just so much more light weight. If I took the hair and held it between my fingers and then moved my hand in an upward motion to make the hair fly up, the miniaturized hairs would float down like a feather. They did not have enough weight to make them come down naturally. They would short of hover and float whereas the regrowth hairs would come down more slowly than normal hairs, but they wouldn’t float.

I know that this is probably a weird description. But I found it to be helpful in separating the two types of hairs. I hope that you do as well. I was very upset to determine that I had miniaturized hairs.  But I found a way to support healthy regrowth.  You can read more on my blog at

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