This article will detail a quick and easy way to determine whether or not you are experiencing male pattern baldness or telogen effluvium (temporary shedding).
If you've seen my other posts discussing hair loss, you probably already know that there is a difference between follicular miniaturization triggered by androgens, and shedding triggered by nutritional deficiencies, hormonal fluctuations, environmental factors, toxins, allergens, hypothyroidism, radiation therapy, and other stressors.
Telogen effluvium is more or less just temporary shedding induced by some sort of stress on the body.
These stressors can force your hair into the shedding phase quicker than they would otherwise.
Once that stressor is removed, the hair life cycle returns to normal.
I'm sure you've heard of people losing their hair during stressful times like final exams.
That's a perfect example of telogen effluvium.
There's a big difference between hair follicles being deprived of adequate circulation (a consequence of the cascade of events triggered by androgens) and a hair prematurely falling out of your head due to some form of stress.
How To Distinguish Androgenetic Alopecia and Chronic Telogen Effluvium
This is a good study to reference: “Distinguishing Androgenetic Alopecia from Chronic Telogen Effluvium When Associated in the Same Patient” [R].
While you can do this test in your sink, I would recommend getting a hair catcher to gauge your progress moving forward.
When evaluating if a treatment is efficacious or not for you, having a reference of your baseline shedding levels before and after starting treatments will be very useful.
When determining if a hair is miniaturized or not, it more or less breaks down to the length of the hair.
Hairs that are 5 centimeters or longer are considered healthy, non-miniaturized hairs, at least as that is the standard outlined in the clinical study linked above.
Hairs that are 3 centimeters or less are considered miniaturized hairs.
Patients who had alopecia areata, scarring alopecias, or had very short clipped hair were excluded of course.
If your hair isn't 3 cm to begin with, obviously this test will be useless for you.
When patients appear to have male pattern baldness, they shed shorter and thinner telogen hairs as a result of androgen induced miniaturization.
When hairs are 3 cm or shorter, they are called vellus hairs.
Hair diameter was determined to be an irrelevant metric to look at because diameter and length proved to vary in parallel.
The shorter the hair, the thinner it was too, so measuring the length proved to be all that was necessary to make a diagnosis.
As concluded by the study, counting the telogen hairs shed during a standardized shampooing and measuring the number of those hairs that are 3 cm or shorter is good tool to diagnose type and severity of hair loss, and this number may serve as a diagnostic tool for male pattern baldness/androgenic alopecia and chronic telogen effluvium.
To do this test yourself, all you need to do is collect the hair you shed during your shower and then count how many there are, and measure the length of them.
If less than 10% of your shed hairs are 3 centimeters or less, according to this study, you can then conclude that you aren't experiencing androgenic alopecia
If 10% or more of the hairs you shed are miniaturized (3 centimeters or less in length), then you can conclude that you are experiencing male pattern baldness.
If you shed more than 100 hairs per shower, you are also experiencing telogen effluvium, and if you shed less than 100 hairs per shower, you aren't.
- You shower and lose 150 hairs – 20 hairs (13.3% of the total) are 3 cm or less = Androgenic Alopecia AND Telogen Effluvium
- You shower and lose 80 hairs – 20 hairs (25% of the total) are 3 cm or less = Androgenic Alopecia
- You shower and lose 150 hairs – 10 hairs (6.67% of the total) are 3 cm or less = Telogen Effluvium
- You shower and lose 80 hairs – 6 hairs (7.5% of the total) are 3 cm or less = No Androgenic Alopecia Or Telogen Effluvium
So, the goal is to shed less than 100 hairs per shower, and also have less than 10% of those shed hairs be 3 cm or less in length.
The less miniaturized hairs you shed the better.
Obviously this is a very crude way to assess if you are experiencing male pattern baldness or telogen effluvium, but it is interesting nonetheless and can give you a good baseline metric to reference as you start implementing hair loss prevention protocols.
Telogen Effluvium Among Males and Females
Even if 9% of the hairs you shed are miniaturized, if you're a male, I think it's still safer to assume that you're likely experiencing androgenic alopecia regardless.
In my experience, most cases of chronic telogen effluvium are women, and most the overwhelming majority of cases of hair loss among men are male pattern baldness.
How many elderly men have you seen have that have teenage-like hair density with a Norwood 0 hair line?
I'd bet the answer is none, or very close to none relative to the amount of hairlines you've seen over your lifetime.
When it comes to men, the likelihood is very high that you're experiencing androgenic alopecia to some degree.
But, it's still interesting nonetheless to assess, especially if you're experiencing a massive shed.
If fewer than 10% of the hairs you shed are 3 centimeters or shorter, and you shed at least 100 hairs during a shower, you likely have telogen effluvium.
If fewer than 10% of the hairs you shed are 3 centimeters or shorter, and you shed less than 100 hairs during a shower, you likely don't have either male pattern baldness or telogen effluvium.
If 10% or more of the hairs you shed are 3 centimeters or shorter, and you shed at least 100 hairs during a shower, you likely have male pattern baldness and telogen effluvium.
If 10% or more of the hairs you shed are 3 centimeters or shorter, and you shed less than 100 hairs during a shower, you likely have male pattern baldness.
This method of assessment is simple, non-invasive and suitable for office evaluation.