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Telogen Effluvium vs Male Pattern Baldness

By: Author Health Guide's Editorial

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This article reveals the differences between telogen effluvium and male pattern baldness:

Telogen Effluvium (TE)

It is one of the most common forms of non-scarring alopecia for which sufferers present to a dermatologist. TE is characterized by diffuse shedding of telogen hairs in response to psychological or metabolic stress.

TE was first described by Kligman in 1961 as a disease of the hair follicle.

The hair cycle has three phases:

  • growth phase (anagen);
  • transitional phase (catagen);
  • resting phase (telogen).

TE is associated with the telogen phase. In a patient with TE, some change pushes more hairs into the telogen phase.

Typically, 5 to 10% of a person’s hair is in the resting phase at any one time. However, in people with TE, about 30% of the hairs stop growing and go into the telogen phase before falling out.

It usually starts 8 to 12 weeks after a triggering event, like – major illness, pregnancy, or complicated surgery, and resolves within 3 to 6 months.

Chronic telogen effluvium is a diffuse hair loss of the scalp which persists for more than 6 months. It can affect both women and men, however, it is mostly women between the ages of 18 and 50 who experience it.

Male Pattern Baldness (MPB)

Male Pattern Baldness

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Male pattern hair loss, also referred to as androgenetic alopecia, is a form of hair loss with a particular pattern. The first stage is typically a receding hairline and a thinning of the hair on the temples and crown. Over time, the loss of hair continues around the top of the head as well as on the sides and rear of the head.

Accounting for more than 95 percent of all hair loss cases, MPB is the most common cause of hair loss in men. According to statistics, approximately 50 million men in the US are affected.

Causes

The increased hair shedding in TE occurs due to a disturbance of the normal hair cycle. Common triggers of TE include:

  • severe emotional stress;
  • severe fever;
  • surgical operations;
  • accidental trauma;
  • nutritional deficiency;
  • sudden starvation;
  • crash diet;
  • horrible hemorrhage;
  • chronic systemic diseases;
  • pregnancy.

MPB is thought to occur mainly due to an elevation of dihydrotestosterone (a hormone with powerful androgenic actions), that is produced from testosterone. This elevation of dihydrotestosterone causes the follicles to shrink and eventually stop functioning properly. Occasionally, baldness has other causes, like:

  • anabolic steroids;
  • thyroid conditions;
  • medications;
  • certain cancers.

Symptoms

Common symptoms of TE include:

  • hair color changes from dark to brown;
  • noticeable hair loss during washing;
  • lusterless hair which is easily pluckable;
  • healthy looking scalp;
  • losing hair which has a white bulb and lack of shiny sheath;
  • hair loss which is temporary;
  • a generalized hair thinning.

Common symptoms of MPB include:

  • excess hair in other parts of the body;
  • hair loss which starts at the temples or the middle of the back of the head;
  • irregular periods;
  • acne;
  • progression of hair thinning and loss over time;
  • hair thinning on the top of the head.

Diagnosis

The diagnosis of TE can be made by a healthcare professional experienced in treating people with hair disorders after a thorough examination of the hair and scalp and a discussion of the patient’s medical history. In addition, blood tests should be carried out if the hair loss is longer than 6 weeks.

A trichologist can easily identify MPB and ”stage it” appropriately with a video microscope.

Treatment

TE

There is no treatment required for TE as the hair will start growing back as usual once the trigger is removed. In patients where hair growth has not returned to normal levels, your healthcare professional may prescribe a lotion that is applied to the scalp which may stimulate hair growth, called – minoxidil (Rogaine).

In addition, nutritional changes should be adopted if TE is caused by a deficiency in iron, zinc, vitamin B-12, and vitamin B-6.

MPB

There is no cure for this condition. However, the treatment is aimed to slow down and control the progression of hair loss.

The most effective treatments for MPB are:

  • finasteride (sold under the brand names Proscar and Propecia) – it works by blocking the enzyme which converts testosterone to dihydrotestosterone;
  • minoxidil – it is an antihypertensive vasodilator medication that enlarges hair follicles and stimulates hair growth;
  • dutasteride (sold under the brand name Avodart) – this medication is used mainly to treat enlarged prostate in men and works similar to finasteride, however, it may be more effective;
  • low-level laser therapy – it has been shown to stimulate hair growth in both women and men;
  • hair transplantation – it involves harvesting follicles from the back of the head which are dihydrotestosterone resistant and transplanting them to the affected areas.

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Prognosis

TE

Although your hair will eventually return to its normal growth pattern within 3 to 6 months (in acute TE), it may take between 12 and 18 months before the hair returns to its previous appearance.

MPB

MPB does not indicate a medical disorder, however, it may cause anxiety and affect self-esteem. The hair loss is permanent.

Prevention

Prevention of TE can be achieved through:

  • reducing intake of junk foods which increase body toxins;
  • eating a healthy diet rich in fruits, legumes, seeds, nuts, and veggies;
  • avoiding medications that cause hair loss with the help of your doctor;
  • getting enough sleep – aim for 7 to 8 hours of uninterrupted sleep per night;
  • managing stress by practicing regular physical exercise, mindfulness meditation, and spending time in nature.

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MPB

If you have noticed hair loss, one of the most effective ways is to block dihydrotestosterone using a combination of minoxidil, finasteride, and a dihydrotestosterone blocking shampoo.

Important Note

Minoxidil and finasteride can have side effects, such as:

  • changes in the color or texture of the hair;
  • severe scalp irritation;
  • confusion;
  • fast heartbeats;
  • dizziness;
  • unwanted growth of facial hair;
  • headache;
  • chest pain;
  • a light-headed feeling;
  • rapid weight gain;
  • swelling in the hands or feet.

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Bottom Line – Telogen Effluvium vs Male Pattern Baldness (MPB)

TE is a non-scarring alopecia that is described by excessive shedding of telogen club hair diffusely from the scalp. Depending on the length of time, or whether this increased shedding persists, it is referred to as acute or chronic. In acute TE, the shedding can persist for up to 6 months, whereas chronic TE can last for several years, and it is more common in women.

Male pattern baldness affects over fifty percent of men over the age of 50. It is thought that dihydrotestosterone has adverse effects on hair follicles.

Key differences between the two conditions are:

  • in TE, the hair loss is temporary;
  • in MPB, the hair loss is permanent;
  • TE results in overall thinning of hair and diffuse hair loss;
  • MPB causes bald patches on the scalp.
Sources

http://jddonline.com/articles/dermatology/S1545961616P1235X/1
https://www.omicsonline.org/open-access/etiological-role-of-ferritin-and-vitamin-d-in-patients