Telogen effluvium (TE) and androgenetic alopecia (pattern hair loss) are two of the most common causes of hair loss in both men and women. They can look similar, and they can happen at the same time, but they have different causes and are managed differently. This guide explains how to tell them apart.
The key differences
| Telogen effluvium | Androgenetic alopecia | |
|---|---|---|
| What happens | Many hairs enter the resting phase at once and shed | Follicles gradually shrink and produce thinner hairs |
| Onset | Often sudden, usually months after a trigger | Gradual, over years |
| Pattern | Diffuse, all over the scalp | Hairline, temples and crown in men; widening part and top of scalp in women |
| Main clue | Noticeably more shedding | Hair looks thinner and finer, often without dramatic shedding |
| Cause | A trigger such as illness, stress, childbirth or deficiency | Genetics and sensitivity to androgens such as DHT |
| Course | Often temporary once the trigger passes | Progressive without treatment |
When both happen together
TE can unmask pattern hair loss that was developing slowly in the background. After the shedding settles, hair may not return to its previous fullness because the underlying pattern hair loss is still there. This is common, especially in women, and is one reason a clinician's assessment matters.
How clinicians tell them apart
- History: any illness, stress, childbirth, diet change or new medication in the months before shedding started, and family history of hair loss.
- Pattern: where the thinning is and whether hairs vary in thickness.
- Exam: sometimes a gentle hair pull test or magnified scalp exam.
- Blood tests: often iron studies and thyroid function to look for a trigger.
How management differs
Telogen effluvium is managed mainly by finding and addressing the trigger, supporting nutrition and allowing time for recovery. See telogen effluvium.
Androgenetic alopecia is progressive, so options a provider may consider include minoxidil, and for some patients DHT blockers or anti-androgens. The most consistent benefit of treatment is slowing or stopping further loss. See female pattern hair loss and DHT and hair loss.
When to see a doctor in person
Seek in-person care for patchy bald spots, scalp pain, redness or scarring, or hair loss with other new symptoms.
Next step
If you want a licensed provider to review which type of hair loss you may have, start your online consultation.
Prescription required for prescription treatment. A licensed provider decides whether treatment is appropriate. Compounded medications are prepared by a licensed pharmacy for an individual patient and are not FDA-approved. Individual results vary. Prescribed Essence currently serves patients in California, Colorado, Florida and New York.
