May 09

Every Time I Put My Shedding Hair Up, Short Hairs Fall Out

By: Ava Alderman:  It can be a cruel irony.  When you are shedding hair, you put your hair up in order to spare yourself the pain of having to deal with it, but then it can seem as if more hair comes out as a result.  You might also notice a particular type of hair coming out as the result of your hair being put up.

Someone might say: “I have been shedding hair for about eleven weeks.  I feel like it is really aggressive shedding.  I’ve had seasonal types of sheds before.  But this goes beyond that. It started after I went off of birth control pills, so I think that it is telogen effluvium.  To keep the hair from getting all over my clothes and just annoying me, I put it up in a bun or a ponytail and that does help.  This keeps me from having to pick the long hairs off of my clothes.  But unfortunately, I notice all these small, short hairs all over my clothes when I wear my hair up.  Is it the pulling that is bringing the short hairs out?  This is really troubling because those short hairs are probably regrowth hairs.  I like the relief of putting my hair up.  But I don’t want to sacrifice those little hairs. They are the foundation of my hair in the future.”

I’m not sure that putting your hair up is pulling out the hairs.  I think that it is more likely that since they aren’t being caught in the ponytail (since they are not yet long enough,) they are able to fall onto your clothing.  I also think that it’s probable that they are caught up in the same shedding cycle as the rest of your hair.  If shedding goes on for long enough – even the regrowth can get caught in the shedding cycle.  Putting your hair up really doesn’t have anything to do with this.  And once the telogen effluvium and shedding stops, the regrowth should stop shedding and can hopefully grow unimpeded.

I don’t see any reason to stop putting up your hair if it is giving you some relief.  Hair would have to be long to be pulled out anyway and once hair is in the shedding cycle, it’s going to fall out eventually regardless of whether you’ve put it up or not.  It’s just that the ponytail isn’t catching the short hairs to keep them from falling on your clothing.  It feels like you’re sacrificing them, but you really aren’t.  And once they are pushed out, a new hair is theoretically starting to regrow again anyway.  Hopefully, there are no additional underlying triggers or inflammation and the shedding will stop soon.  Once this happens, the regrowth to reach its full potential.

I know that it’s upsetting to see the short regrowth shedding out.  But it’s simply a continuation of the cycle.  As long as you know that you’ve addressed all possible triggers and are addressing inflammation, it can be a waiting game.  You can read about some things that helped me when I had chronic telogen effluvium on my blog at

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May 02

Is There Such A Thing As Telogen Effluvium That Never Stops?

By: Ava Alderman:  I sometimes hear from folks who worry that their telogen effluvium goes far beyond what is normal.  Not only do they feel as if they are shedding more than what is typical, but they feel that they are shedding for much longer than is typical.  In short, they feel that their experience is extreme all of the way around.  And it can start to feel like there is never going to be any relief or any end.

Someone might complain: “it has been seven months since my shedding started and it honestly has not let up for even one day.  It seems as if every day is worse than the day before.  That might sound like an exaggeration, but that is the way that I feel.  Plus as my hair becomes more and more thin, each daily loss gets more and more noticeable and is more and more impactful because I can’t afford to loose that much more.  I was discussing this with one of my friends and she told me that this lady at her gym started shedding after she gave birth to her child and has never stopped. That was years ago.  And this woman is still shedding the same amount.  Is it possible to have telogen effluvium that never ends?”

It’s certainly possible to have reoccurring bouts of chronic telogen effluvium.  Some people are very vulnerable to any hormonal or other significant change in the body.  So, for these folks, it doesn’t take a whole lot to induce a bout of shedding.  This was the case with me until I figured out that I had to watch what supplements and medications that I was using and I even sometimes had to watch my diet.  I had to be very consistent in my habits.  Any hormonal change could influence my hair.

Other times, you could be continuing to shed because you may have a trigger that you haven’t identified.  Sometimes this is an unrecognized medical condition or unrecognized stress that keeps happening over and over and keeps triggering the hair loss.  If you can figure out the trigger and remove it, that can sometimes stop the shedding.

Finally, there are hair loss conditions that are continuous but that are not telogen effluvium. People sometimes ask me if TE can make you so thin that you will need a wig or will eventually look as if you are nearly bald.  It shouldn’t.  Because TE is just a resetting of the hair cycles.  The hair is going from growing to resting.  But only a percentage of the hairs are affected (although I know that it doesn’t feel that way) and hair continues to grow throughout this.  The hair and the follicles ideally should not suffer any damage.

However, with other types of hair loss (like androgenetic alopecia,) the follicles are shrinking and being compromised so it becomes harder for that follicle to produce a healthy hair.  Therefore, the loss goes on and on.  There is another hair loss condition called alopecia areata where the loss can be so severe that loss is patchy or eventually total.  However, in both cases, the appearance of your hair would make these conditions hard to ignore or misdiagnose.  AA often presents with hair loss that is in round patches.  And AGA often brings with it much thinner hair over time.  I’m not a doctor, by in my observation and from my own experience, if you aren’t seeing either of these things and are instead just shedding in the long term, you’ll want to look at any hormonal vulnerabilities, the possibility of inflammation at your scalp, and a trigger that has yet to be identified. You can read more about my own struggles with hair loss on my blog at

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Apr 25

I’ve Almost Developed A Compulsion To Check The Status Of My Hair And Gently Tug It While Having Telogen Effluvium

By: Ava Alderman: If you have never experienced telogen effluvium or severe hair shedding, the topics discussed in this article may seem very strange to you.  However, if you have had this type of hair loss, you may be very familiar with the idea of counting hairs, finger combing your hair to avoid any pulling, or the idea of wearing dark clothing so that your spent hairs are not as noticeable.  These habits might sound strange, but for many of us, they become our reality as our hair loss becomes severe or goes on for a long period of time.

When you have this type of hair loss, you are always trying to look forward and you are always waiting for the day that you will start to recover and not see so many hairs.  That is why many of us become preoccupied with trying to gauge our hair loss on any given day.  And although this is understandable, it can, and often does, become a problem.  Because you can become so invested in the result, you can start to gauge your hair loss almost compulsively.

For example, sometime might say: “my hair has been falling out for just a little over three months.  If you listen to all of the experts, my hair loss should have ended by now.  And yes, I count my hair fall.  I know that I am not alone in this because when you read topics about this on forums, you’ll see that people often reference ‘100 hairs per day’ or ‘200 hairs per day,’ etc.  How would people even know how many hairs there were if they weren’t counting?  So yes, I count.  But that’s not all that I do.  I also always catch myself running my hands down the shaft of my hair and gently tugging so that I am able to remove all of the loose hair.  Then I will eyeball it to see how much hair is in my hands.  I find myself doing this countless times per day.  And I’m always sad and disappointed when I come away with a bunch of hair.  The other day, a friend asked me what I was doing and I was embarrassed. But I feel like I need to take inventory to see where I’m at.  Still, I know that it isn’t speeding up my recovery or anything and I’d like to stop this or slow down.  But it’s almost become a compulsion.  How do I stop?”

I am so sorry that you are going through this.  I know what you mean. I counted my hairs for more than half a year when I had telogen effluvium.  And I used to sort of touch the end of my ponytail fishing for spent hairs.  (I wore my hair in a ponytail all of the time to keep it out of the way and to try to keep my mind off of it.)  This created a cycle where I was always very stressed out about my hair.  And the more I counted or played with my ponytail, the more stressed I got.  I actually started putting my hair in those twist clips so that there was nothing that I could put my hands on anymore.  Because I realized that by taking inventory like this, I was only creating stress and anxiety, and both of these things can cause more shedding or prolong your trigger, which are two things that you don’t need.

I also decided that since I had spent so much time counting hairs, I could honestly eyeball my hair while washing (by checking the drain) to know how much I was loosing.  I could look at a little ball of hair and know roughly how many hairs it contained without needing to count.  So I stopped that, too.  I have no idea if no longer feeding this impulse helped to stop the shedding or if that was just a happy coincidence, but I do know that it eased things for me a bit until the shedding slowed so much that I no longer needed to count anyway.

I do understand the compulsion, but I also agree that it is beneficial to stop.  It really doesn’t aid you in any way.  You’ve likely been at this long enough to know when you’re having a light shedding day or a heavy one.   Whatever it takes, keep your hands off of your hair.  Put it up and leave it alone.  Wash it and then give it a quick glance and then move on.  I know that this is easier said than done.  But I promise that it is a relief when you begin to put it into practice.

You can read more about some things that helped me cope and get through this on my blog at

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Mar 22

Growing Out Your Hair After Telogen Effluvium

By: Ava Alderman:  I think it’s safe to say that when you are going through severe hair shedding or telogen effluvium, you are noticing RE-growth much more than you are noticing typical growth.  In other words, you spend a lot of time looking for tiny, baby, regrowth hairs poking through your regular hair.  And if there are tons of these small hairs, you probably are focused more on them than on any particular style of the normal hair that you have left.  But once you have been regrowing hair for a while and all of these shorts hairs are now becoming noticeable (and sometimes unmanageable,) you wonder how you go about growing them all out.

Someone might say: “I’ve got all of these regrowth hairs peaking up through my regular hair.  I’m grateful for them.  And it appears that my hair loss is slowing down, but I have no idea how to tame these little hairs or how to best regrow my hair so that it doesn’t look silly.  How do people regrow their hair after telogen effluvium?”

Some people are lucky enough to only have short term or mild shedding so that no special plan is needed.  Because we are all shedding a little bit all of the time.  We all lose some hair every day.  But it is not usually noticeable because it’s a gradual and small amount.  However, when the amount is very large and not so gradual, a lot of hair comes in at all once and this can be quite noticeable.

I know that some will shorten their hair and add layers, trying to blend in the new regrowth.  This works well for some.  I was always afraid that the layering and the short hair would expose my scalp.  Plus, I always felt that a blunt bob made the most of what I had and made my hair look more full.  So in my own case, I wore a ponytail for a while.  I would use mousse or gel to tame the short hairs to lay down.   Once the hair became long enough (which took a while) I cut it to be even with my regular hair once it was chin length.

It really depends on the hair style that you start with and if you want to keep the same style or if you want to try something new in an attempt to  blend in the regrowth.  In my own case, I just put the new hair with the grain of my old hair and I tapped it down with a ponytail or a large barrette.  Once everything was dry, I could remove the ponytail and the hairs would be dry but they would be swept back, in place, and generally semi-well- behaved.

There’s no question that there might be some awkward, “bad hair” time when you’re growing out your hair, especially if you have a longer style.  Try to look at it like growing out any hair cut.  You can use barrettes or pony tails while you are waiting, or you can keep getting trims to keep things as neat as possible until everything is evened up.

If you’d like to read more about my hair loss experience and things that helped (and hurt) check out my blog at

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Mar 21

An Alternative To The No Poo Method With Telogen Effluvium – Pre Poo

By: Ava Alderman:  Many people are interested in trying the “no poo” method when they are shedding hair or suffering from a hair loss condition like telogen effluvium or androgenetic alopecia.   The reason for this is that they notice that more hair comes out when they shampoo. So they wonder if they should skip the process all together or at least limit or alter it.  The idea behind no poo is that you use a very thin, easy rinsing conditioner to wash your hair and you just use water (or baking soda and water or apple cider vinegar) to get your hair freshened up between washings.   Unfortunately, some find that this method makes their hair loss worse (because you are not regularly removing androgens / debris) and the build up of oils allows hair to become more limp and oily looking, which is the last thing that you need.

I tried no poo when I had telogen effluvium and it was a disaster.  My scalp itched.  My hair looked greasy.  And my hair loss actually increased after a few weeks so I went back to regular shampooing. This was upsetting because I really wanted it to work.  My hair is fine and wavy.  I had hoped that  no poo would help to bring out the curl.  Obviously, hair that has more curl looks more full.  I wanted this to work so badly that I tried again after my shedding stopped.  Unfortunately, I still had disappointing results. My hair still looked heavy and greasy.  And the curls were limp.  Then I read about a method called “pre poo” which is where you put conditioner on the ends of your hair BEFORE you wash it normally.  This protects the hair and it DOES bring out the body and curl.  Dry hair looks much healthier and your hair has more body and bounce – exactly what you are looking for when your hair is shedding.

Now, there’s a trick to this, especially if you are actively shedding hair.  When you’re putting the conditioner in before you shampoo, you want to be very gentle.  If you try combing conditioner through dry hair, a lot is going to come out.  I basically just put it on the ends and I tend to pat it rather than finger comb if I can help it.  Then I use less shampoo than I am used to.  I work the shampoo into my scalp with my finger tips, but I don’t manipulate the hair or get the shampoo any where near the ends.  I am just taking care of my scalp and clearing debris.  Then I rinse the shampoo, apply more conditioner (gently with the patting motion) and rinse again.  Yes, you use a lot more conditioner, but it is worth it. And while you may notice a little more hair coming out in the wash because you are adding an extra step, in my experience you notice LESS hair coming out the rest of the day.  For one thing, you manipulated your hair when you did the procedure.  And for another, your hair will be so manageable (because it’s so conditioned) that you don’t need to comb as much after shampooing.  There shouldn’t be tangles because of all of the conditioner.  In my experience, the shedding should be a little less throughout the day AND your hair looks better.  I know that everyone is different, but this method is certainly worth a try.  My hair has been stable for a long time now, but I still use this method because it makes my hair look much more healthy. There’s more about my bouts with hair loss and how I dealt with it on my blog at

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Mar 15

I Have Telogen Effluvium Once Again And I’m Freaking Out

By: Ava Alderman:  I think it’s safe to say that most of us pray for the day when our telogen effluvium ends and we can anticipate putting this horror behind us and moving on with our lives.  Many of us get telogen effluvium after unavoidable changes in our health and our lives – like giving birth, becoming ill, aging, dieting, etc.  Even though most of these things are unavoidable, the good news is that once it’s over, our hair growth patterns return to normal.  And hopefully, barring any inflammation or damage, we will eventually get our hair back.

Most of us hope that this is the end of the story – until it isn’t.  There are those of us who know that telogen effluvium isn’t always just an isolated incident in one life time.  Some of us get it more than once, or multiple times.  It’s normal (and understandable) to panic each time.  Someone might say: “I almost didn’t want to get pregnant a second time because I was so afraid of getting telogen effluvium again.  The first round nearly ruined my looks.  My hair looked so pathetic and it was so traumatic watching helplessly as my hair fell out. Much to relief, I didn’t have full blown telogen effluvium with my second child.  I did have some hair loss.  But it was nothing like the first time, so it was tolerable.  So imagine my horror when I got telogen effluvium after I went into perimenopause. This is the only thing that I can figure caused it.  My gynecologist did find a slight decline in my thyroid health, but not enough for medication.  I am beside myself.  I don’t know if I can deal with this again.  As if getting older isn’t bad enough.  How do I deal with this again?”

You deal with it the way that you did the first time – one day at a time.  And you use your experience to know that, as bad as this is, it is going to one day end.  You know that because it ended before.  Many people, and I include myself in this, are hormonally vulnerable.  What I mean by that is that even small hormonal changes cause hair loss.  Honestly, I shed some every time I have a menstrual period. It’s not full blown TE – but it’s definitely a higher amount of hair coming out.  I don’t enjoy it, but I know that it’s going to end.  And I know that the hair that falls out is going to grow back.

I’m certainly not a doctor, but it may not hurt to see an endocrinologist to evaluate your thyroid.  Other than that, you can try to avoid any supplements or medications that are going to cause huge swings in hormones.  Obviously, we don’t always have control over menstruating, giving birth, or approaching menopause, but we can try to keep ourselves stable with the health of our bodies, scalps, and hair.  It’s important to keep the scalp clean, stimulated, and free of inflammation  – and you can certainly address all of these things if you haven’t.

I’m sure you already know that stress and despair makes the shedding worse.  As someone who has had more than a few bouts with TE, I concede that it isn’t fun.  But it does pass.  You do get through it.  And if you saw my hair today, I doubt you could tell that anything was wrong.  In fact, in times past when I have told close friends about my hair issues, most of them were shocked.  Which is proof that the hair is growing back as it is shedding.  Yes, the overall affect is hair that is more thin than before.  But TE by definition is temporary and it ends.  Take it one day at a time.  Be kind to yourself.  Take care of your hair.  And make the most of the hair that is still actively growing.If it helps, you can read about my own way that I’ve dealt with this on my blog at

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Mar 01

Telogen Effluvium Recovery Signs

By: Ava Alderman:  It goes without saying that if you are suffering from telogen effluvium, you are likely regularly inspecting your hair and scalp for signs of things either worsening or getting better.  And after some time has gone by, even the most pessimistic of us are going to hope that we start seeing some improvements.  So we start looking for recovery signs, but we aren’t always clear on what they are.

Someone might say: “it has been about four and 3/4 months since my hair started shedding.  Because the hair fall is just so very severe and started so suddenly, everyone thinks that this is telogen effluvium.  Frankly, the past several months have been a nightmare.  My hair doesn’t look the same.  The hair fall has definitely taken its toll.  However, I’ve started to see a tiny bit of light at the end of the tunnel.  I’m noticing a little less fall for the past ten days, although it’s still an alarming amount by most people’s standards.  However, I don’t notice much else.  I want to start seeing fuller-looking hair.  What signs should I be looking for in order to know that I’m actually in recovery?

It might be slightly early to be able to see any signs that hit you over the head because they are very obvious.  But below, I will list some early signs of recovery that are often there if you look for them.

Tiny Spouts Of Regrowth:  Hair grows pretty slowly.  For most people, a whole month of growth is only a half an inch of hair. So ten days is a little early.  But if you pull your hair against the grain in very bright light, you might see little hairs popped up everywhere, which will at least offer you reassurance that regrowth has kicked in.

A Healthy Sheen To Hair That Was Looking Dull Before: Sometimes, even before your telogen effluvium starts, you might notice that your hair is dull, limp, and no longer shiny.  There is a reason for this.  When hairs are going to fall out, the follicle switches from growing to resting.  This means that the follicle is no longer getting nourishment before it actually falls – which is why you see it look dull and lifeless.  By that same token, once the telogen effluvium is over, many follicles will go from resting to actively growing and will get nourished again, which is when you might notice your hair look healthier – even if it is not yet full with volume.  (Since hair takes a while to grow and then fill in.)

Psychologically, You Know (Or At Least Sense) That Something Is Different:  This is really hard to describe, but I will try.  I’ve had really bad telogen effluvium twice.  Both times, I panicked because I would have some improvement and then I would relapse.  However, both times when it was “really over,” I sort of knew it.  I’m not sure if I realized that I knew it.  But after a while, I realized that a good deal of time had gone by and I’d not counted hairs or become obsessed with taking inventory, which was something new (because previously I had done both excessively.)  I think that I must have subconsciously realized that I just didn’t need to do this anymore.  And I’ve heard from other people who have done the same.  I think that subconsciously, we notice that we’re seeing less troublesome signs and so, we silently turn our attention elsewhere.  We may not notice at first (I didn’t.)  But one day we turn around and realize that hair is no longer the focus of our world.

I think that if you suspect that you are seeing recovery signs, you probably are.  Know that sometimes, recovery isn’t linear.  But over all, you get there.  And the trend toward total hairs lost is down. I know that we all want to wake up with our previous head of hair.  So it’s so easy to get impatient.  But it really is a marathon and not a sprint.  As the shedding gets better, your hair will eventually catch up once the growth fills in.  If it helps, you can read about my own experience with recovery at

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Feb 10

Do You Notice Regrowth Before The Shedding Stops In Telogen Effluvium?

By: Ava Alderman:  It’s normal to immediately begin thinking about your regrowth very shortly after you notice your hair shedding.  Some of us know what is happening when our hair starts shedding because we have had it happen to us before.  And, we also know that in order for our hair to begin to look better, we are going to need for it to regrow.  So, it’s normal to start looking for regrowth even when your hair is still actively falling out.

However, some people are just starting this process or are in their first bout of shedding.  And they wonder how soon they can begin to look for regrowth.  Someone might say: “my hair has been shedding since I started taking a diet supplement.  I did it to lose weight and it has worked.  But it has also brought on some weird side effects.  I’m cold all of the time.  I feel somewhat jittery.  And my hair has started to shed.  My sister has gone through this before and she says I probably have telogen effluvium.  She said the hair loss can last up to three months.  That feels like a very long time to me.  And I need to see my hair start growing back before three months. I have stopped taking the supplements.  And I know that now I just have to wait for my hair to stop falling out.  But is it possible that I will notice some regrowth before that time?”

It’s certainly possible.  But how much regrowth you actually see depends on for how long your shedding lasts.  Here is an example. Let’s say your hair loss lasts for about the average – or around three months.  Hair begins to grow back immediately after it is shed.  It basically goes from the shedding cycle to the growing cycle – without much of a pause.  However, its growth rate is relatively slow. The average person grows hair at the rate of about 1/2 inch per month.  So, the hairs that fell out first are going to grow in first.  Hair that fell out in the first month of your shedding will be about 1/2 inch in length after a month’s time.  This is very short hair and many people would not notice it.  Often, you have to look for it by parting your hair against the grain under bright light.

Now, if your shedding has gone on for 2 – 3 months, your early hairs that have shed out would have grown to about an inch long – making it easier to see.  People who have had loss for 4 – 6 months have even longer regrowth to notice.

The bottom line is that for every month of hair you shed, you should see 1/2 inch of regrowth from those shed hairs.  But the hair that fell out last week isn’t going to be noticeable growing in for about four weeks.  So, at any given time, you are going to have regrowth of various lengths.

This cycle happens in our heads all of the time.  It is normal to have a small amount of strands actively undergoing this process.  But, most of the time, only a small amount of your hair sheds out at once. However, when we have telogen effluvium, many more of our hairs are actively shedding and growing at one time.  The more that is shed out, the more of those little regrowth hairs are going to be cropping up.  But how much of it you see while you are actively shedding depends upon how long your shedding lasts.

Sometimes, it is challenging to see your regrowth.  Since my hair is dark, I would sprinkle baby powder or dry shampoo at my hair line in order to help me see my regrowth more clearly. You can read more on my blog at

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Jan 24

Chronic Telogen Effluvium Or CTE: If My Hair Is Falling Out Less And Less, Does it Mean It’s Over?

By: Ava Alderman:  If you have CTE or chronic telogen effluvium, I know first hand that you are very often looking for a sign – any sign – that your hair loss might be coming to an end.  The thing is though, that if you have this chronic type of hair loss, you have probably been looking for those signs for quite some time.  In fact, in order to have CTE, you have to have been waiting for the loss to stop over three months, or you would have had telogen effluvium.

I’ve experienced an excruciating bout with CTE and people often want to know how it ends.  Many hope that it will end suddenly, but when they start seeing a gradual improvement, they doubt that a gradual resolution is a REAL or lasting resolution.

For example, someone might say: “I’ve had hair loss for seven months. My understanding is that this is chronic telogen effluvium.  But for about six and a half of those months, I have had non-stop very dramatic loss every day.  I mean, it never, ever lets up.  I sometimes read comments from people on forums who say that they’ve had periods of improvement and then it will start up again.  I can hardly identify with that.  For me, it is bad every single day for the most part.  Well, for the last few weeks, it has gotten somewhat better.  It’s certainly not like it was before hair loss, but it’s not as severe as it’s been.  I want to be relieved, but I always thought that it would just stop one day and be normal like it was before.  And reading about the people who get improvement but then start shedding again only reinforces my belief that I’m not gradual.  So how does it end?”

It can be different depending on the person.  I know someone who had CTE for nearly eight years.  During that time, she would have periods of slight improvement and would regress again.  However, one day she just woke up and simply stopped shedding.  And it never started back up. I used to read this story over and over when I had CTE.  But for me, the change was definitely gradual.  My hair did not just return back to normal one day.  It would get a little better and then it would regress a bit.  And then the improvement would come back.

What ultimately happened is that eventually there was enough improvement for enough days in a row that I felt comfortable enough to stop eyeballing (or in severe cases, counting) my hair.  I turned my attention to other places for the first time in quite a long time.  I probably wouldn’t have done that when I was shedding badly.  And while my attention was focused elsewhere, one day I noticed that there was very little hair in the drain and I wondered when that happened.  Now, I had been experimenting with different regimens all along and perhaps everything finally gelled.  But for me, it was gradual enough that I didn’t specifically notice one particular day which I could point to when it ended for good.

That said, I’ve had more than one bout of hair loss, unfortunately.  With the TE that I had after the birth of a child, that instance resolved more instantly – meaning that it was less gradual.  I’ve also had miniaturization as a result of these hormonal changes and shedding.  This improvement was gradual also – as I found some things that helped and was able to place my focus on what I knew was helping. You can read more on my blog at

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Jan 18

Telegen Effluvium Vs (Versus) Androgenetic Alopecia: Which Is Worse To Have?

By: Ava Alderman:  I hear from a lot of folks who are trying to determine what type of hair loss they have.  Understandably, figuring this out is of great concern to them because there are different treatments and outcomes for specific types of hair loss.

The most two common types that are of concern are telogen effluvium (TE) and androgenetic alopecia (AGA.)  These can present somewhat similarly.  With both, you notice more hair shedding out. And over time, you can notice thinning with each.  People often ask me which type is worse.

Someone might say: “I always thought that I would prefer to have telogen effluvium over androgenetic alopecia.  My brother has AGA and I’ve watched my sister go through TE after she had a baby.  Well, now I’ve started having severe shedding after I started a new medication.  I believe that this is probably telogen effluvium.  It’s so bad that I sometimes feel like I am going bald.  There is literally hair every where.  And every day, I start over and I go through the very same thing. I know that technically, TE should eventually end.  And I guess there is some comfort in that, but it is hard to remember it when my hair seems to be coming out in handfuls.  Maybe I am exaggerating a bit, but that’s how it feels sometimes.  In contrast, my brother who has AGA has only moderate shedding.  It really doesn’t seem to bother him too much.  I saw him combing his hair, and it wasn’t like my situation where it just rains hair from the brush.  I told my brother this and he had that although he could see my point, at least with TE, it should one day end.  I see what he’s saying, but this constant raining hair is awful.  So which is worse?”

It Can Be A Matter Of Perspective: Well, certainly the one that you have at the time can seem to be the worst. I’ve had two bouts of TE (one was a very lengthy case of CTE) and I’ve also had some lingering miniaturization as a result (which has resolved.)  At the time though, it did feel like the beginning of AGA.  All of these instances were very upsetting.  As I was going through them, they ALL felt like the worst.  When you’re right in the middle of TE, it does feel like it’s never going to end. And there are times when you can’t bear to take it another day and you fear that you’ll go bald.  You tell yourself that at least with AGA, it would be gradual and just a little bit at a time.

However, people would argue that at least with TE, there is hope.  Theoretically, barring any additional complications, it will one day end and you will have regular hair again.  With AGA, this is a hereditary condition that can be ongoing and can get worse with time.  However, AGA can be treated, and the outcome can be good – especially if you treat it early.  I know people who have AGA and I only know it because they have told me, but I would not have known it to look at them.  So having AGA does not mean that you will bald – or even have hair that looks thin – assuming that you have an effective treatment plan.

And even CTE DOES end one day, although sometimes it doesn’t feel like it. So with each condition, it isn’t all good or all bad.  Most people would prefer to have TE because as dreadful as it is, if you can get through that period of time, there is a light at the end of the tunnel (although some people do suffer through multiple bouts of TE through their lives.) However, people with AGA can find light at the end of the tunnel also with proper treatment.  And there are things that you can do to support yourself and make your hair look presentable with either condition.  The bottom line is that whichever condition you have, you can often make it better and you can usually make it tolerable.

I know that this is no fun either way. As I said, I’ve had aspects of both type of hair loss.  Along the way, I learned some tricks and tips that helped.  You can read more on my blog at

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