Hair Loss: Differentiating Between Male Pattern Baldness and Telogen Effluvium

Hair problems

Dear Dr.
Huang,
Is it true that men with male pattern baldness tend to have a stronger libido? Recently, I experienced hair loss and thought it might be male pattern baldness.
After visiting a dermatologist, I was diagnosed with scalp inflammation (seborrheic dermatitis).
Since then, I've been returning for follow-ups, and the inflammation has been well controlled.
I have consistently asked the doctor whether I have male pattern baldness.
He examined my forehead and inquired about my emotional state.
I also noticed that the hairline at the back of my neck has thinned, and I am extremely worried about going bald.

Later, after the doctor's diagnosis, he mentioned that I have stress-induced hair loss.
He said it is telogen effluvium (the doctor noted that I am overly stressed).
I just read many articles, and I wonder if the severity of telogen effluvium is not always the same? I know that hair lost due to male pattern baldness is also fine and thin.
Is the hair lost during the telogen phase also fine and unhealthy? Visually, it seems okay and not severe, but some areas have significantly lower density.

The doctor told me that my condition would gradually improve once I manage my stress, but the recovery time may not be quick.
(I always see the same doctor, who is very patient and answers all my questions.) I hope you can take the time to help me answer my questions.
Thank you.

Wulong Cha, 20~29 year old female. Ask Date: 2005/05/10

Dr. Huang Ruiyun reply Dermatology

No, you don't look like you have male pattern baldness at all; you're just overthinking it.

Reply Date: 2005/05/10

More Info

Understanding hair loss can be quite complex, especially when differentiating between conditions like male pattern baldness (androgenetic alopecia) and telogen effluvium. Both conditions can lead to hair thinning and loss, but they have different underlying causes and characteristics.

Male Pattern Baldness (Androgenetic Alopecia):
This condition is primarily influenced by genetics and hormones, particularly dihydrotestosterone (DHT), which is a derivative of testosterone. Men with male pattern baldness typically experience a gradual thinning of hair, often starting at the temples and crown of the head. The hair follicles shrink over time, leading to shorter and finer hair strands, and eventually, hair may stop growing altogether in affected areas. It is important to note that male pattern baldness does not directly correlate with sexual desire or libido; rather, it is a common genetic condition that affects many men as they age.

Telogen Effluvium:
On the other hand, telogen effluvium is a temporary condition that occurs when a significant number of hair follicles enter the telogen (resting) phase of the hair growth cycle prematurely. This can be triggered by various factors, including stress, hormonal changes, illness, or nutritional deficiencies. In cases of telogen effluvium, individuals may notice increased hair shedding, often occurring a few months after the triggering event. The hair loss is usually diffuse and can affect the entire scalp rather than specific areas.

In your case, it sounds like your dermatologist has diagnosed you with telogen effluvium due to stress and inflammation from seborrheic dermatitis. This is a common scenario where stress can lead to hair loss, and the good news is that this condition is often reversible. Once the underlying cause (in your case, stress and inflammation) is addressed, hair growth can resume, although it may take several months to notice significant improvement.

Regarding your concerns about the appearance of your hair, it is common for hair that is shedding due to telogen effluvium to appear thinner and less dense, but this does not mean that it is permanently damaged. The hair that grows back may initially be finer, but it can regain its normal thickness over time as your scalp health improves and stress levels decrease.

It's also worth noting that while you may be experiencing hair thinning, it is essential to maintain a healthy lifestyle, manage stress, and follow your dermatologist's recommendations for treating seborrheic dermatitis. This holistic approach can significantly aid in the recovery of your hair and overall scalp health.

In conclusion, while male pattern baldness and telogen effluvium can both lead to hair loss, they are distinct conditions with different causes and implications. If you have any further concerns about your hair loss or scalp health, it is always best to continue discussing these with your dermatologist, who can provide personalized advice and treatment options based on your specific situation.

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