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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