Posts Tagged: Telogen Effluvium

Which Contributes More to Hair Loss: Stress or Genetics?

September 26th, 2006

Q: Can stress accelerate hair loss? I am 25 and there is balding on my dad’s side of the family. I never had any thinning or hair loss till this year. I guess you can say I’ve been under a lot of stress. When I did notice shortly after my 25th birthday I started stressing even more, which led to more hair loss. It is thinner up front and it is thin on top. I have heard of some hair docs mapping your head for miniaturization, do you do this too?

A: Yes. The presence of miniaturization (decreased hair diameter) in the areas of thinning allows us to distinguish between hair loss due to heredity (i.e. androgenetic alopecia) in which hair progressively decreases in diameter under the influence of DHT and other causes such as stress where there is no miniaturization. The degree of miniaturization can be assessed using a hand-held instrument called a densitometer.

The pattern of hair loss and the family history are also important in the diagnosis.

Stress more commonly produces telogen effluvium, a generalized shedding that is not associated with miniaturization and is often reversible without treatment.

Topic: Hair Loss

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Posted by Robert M. Bernstein M.D. at 11:22 am

Is Asymmetrical Hair Loss from Telogen Effluvium or Androgenetic Alopecia?

September 12th, 2006

Q: Over the past three months, my hair seems to be thinning more on one side. Is it common in male pattern hair loss for it to be more on one side? I had a lot of stress about three months ago and have heard that this could be the cause. Is this possible? Should I use Rogaine to treat it?

A: Regardless of the cause, hair loss is usually not perfectly symmetric. This applies to male pattern hair loss as well.

In your case, it is important to distinguish between telogen effluvium (shedding that can be due to stress) and hereditary or common baldness. The three month interval from the stressful period to the onset of hair loss is characteristic telogen effluvium, but you may have androgenetic alopecia as an underlying problem.

The two conditions are differentiated by identifying club hairs in telogen effluvium and miniaturized hair in androgenetic alopecia. In addition, a hair pull will be positive in telogen effluvium (when a clump of hair is grasped with the fingers, more than five hairs pull out of the scalp at one time) and will be negative in common baldness. The hair loss diagnosis can be made by a dermatologist.

Hair cuts do not affect either condition.

Rogaine (Minoxidil) is only effective in androgenetic hair loss and only marginally so. Finasteride is the preferred treatment if your hair loss is genetic when it is early and a hair transplant may be indicated if the hair loss progresses.

Shedding from telogen effluvium is reversible and does not require specific treatment.

Topic: Hair Loss

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Posted by Robert M. Bernstein M.D. at 10:08 am

Can Hair Loss be Caused by Thyroid Problems or Fluctuations in Levels of Hormones Produced by Thyroid?

August 14th, 2006

Q: One of the things that I have noticed as a person who has needed to take thyroid medication for a long, long time, is that when my thyroid gets a little bit out of balance – when I’m not getting quite enough, I begin to notice is that my hair starts falling out. What about the role of thyroid for hair loss?

A: Both increases and decreases in thyroid levels can cause hair loss and changes in the levels of thyroid hormone can change the consistency of one’s hair. Elevated hormone levels cause scalp hair to be fine and soft, with diffuse thinning being relatively characteristic.

When thyroid hormone levels are low, the hair becomes dry, coarse, and brittle. Hair loss can be either patchy or diffuse (involving the entire scalp).

Low levels of thyroid hormone are associated with the loss of the outer 1/3 of the eyebrows and a decrease in body hair. When changes in thyroid hormone levels are abrupt, there can be dramatic shedding (telogen effluvium).

The most important thing to do if you have thyroid disease is to try to keep the levels within a normal range and keep them as steady as possible. If you are taking thyroid medications, try to use them on a regular basis, because alterations of ones in hair can be caused by large fluctuations in the levels, as much as by the absolute values.

Topic: Medical Conditions

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Posted by Robert M. Bernstein M.D. at 11:16 am



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