Telogen Effluvium vs. Androgenetic Alopecia: Differences and Similarities

If you’ve started to notice hair loss, you might be wondering whether it’s telogen effluvium vs. androgenetic alopecia. 

Telogen effluvium is caused by stress and causes temporary hair shedding. Androgenetic alopecia, however, is caused by genetics and sensitivity to a hormone called DHT, and it causes permanent hair loss, usually in a specific pattern. 

Below, we explore how to tell the difference between telogen effluvium vs. androgenetic alopecia, and how to treat them both.

Telogen effluvium, or TE, is a form of temporary hair loss that’s triggered by severe stress on your body. 

This stress could include: 

• Illnesses that cause fever

• Infections

• Severe trauma

• Surgery

• Fluctuations in your levels of certain hormones

• Medications 

• Dietary issues such as iron deficiency, low protein intake, or heavy metal ingestion

• Severe stress from life events 

• Medical conditions like hypothyroidism, which can cause chronic telogen effluvium

During telogen effluvium, your hair prematurely enters what’s known as the telogen phase — the resting phase — of the hair growth cycle.

What’s the hair growth cycle? Well, your hair constantly grows, rests, and sheds as part of a multi-phase cycle. 

This cycle includes the: 

• Anagen phase — the growth phase

• Catagen phase — the transition phase 

• Telogen phase — the resting phase

• Exogen phase — the shedding phase 

In a healthy person’s scalp, about 85 percent of all hairs are in the anagen phase at a given time. Hairs in this phase grow to their full length over the course of several years.

Approximately 15 percent of your hairs are in the telogen phase. Telogen hairs stop actively growing and prepare to shed. Hairs that enter the telogen phase eventually fall out, only to be replaced by new hairs in the anagen phase.

Severe stress can suddenly move your hair follicles into the telogen phase prematurely, causing 70 percent or more of your hairs to stop actively growing. 

These hairs may rest for one to six months, then shed en masse, causing your hair to appear thinner and lack density.

The good news about telogen effluvium is that it isn’t permanent. Once the stressor has passed, your hair should start growing back. Phew. 

Androgenetic alopecia — aka androgenic alopecia, or AGA — is a form of permanent hair loss. In men, it’s known as male pattern baldness. This type of hair loss can also develop in women (referred to as female pattern hair loss), although it’s less common and usually less noticeable. 

Androgenetic alopecia often comes down to genetics and is caused by the effects of the hormone dihydrotestosterone, or DHT.

DHT attaches to androgen receptors in your scalp. This can start a process called follicular miniaturization, in which your hair follicles become progressively smaller and spend less time in the anagen phase of the hair cycle.

Over time, your hair follicles can become so damaged that they’re no longer able to grow hairs that penetrate through your epidermis — the outermost layer of your skin.

Androgenetic alopecia usually starts near your frontal hairline, resulting in the classic receding hairline that many guys first spot in their 20s, 30s, or 40s. 

Over time, it may affect almost your entire scalp, leaving behind a horseshoe-shaped pattern of hair.

If you’re experiencing hair loss, it can be hard to figure out by yourself which type of hair loss is to blame. But a healthcare provider or dermatologist can determine whether you have telogen effluvium or androgenetic alopecia — or another type of hair loss entirely.

If your healthcare provider suspects you have telogen effluvium, they may perform a hair pull test to check for signs of excess hair shedding. This test involves gently tugging on your hairs to see if a large number of loose hairs shed at once.

If you have a positive hair pull test result, your healthcare provider may perform a scalp biopsy to identify the underlying cause of your hair loss.

They may also look at the length of the hairs you’re losing. Shorter hairs indicate androgenetic alopecia as they’ve been affected by hair follicle miniaturization. 

Your healthcare provider may perform further tests if necessary, such as a blood test to check for nutritional deficiencies.   

FYI, it’s possible to have both telogen effluvium and androgenetic alopecia. 

Androgenetic alopecia and telogen effluvium can look similar at first, but they have several key differences. Here’s what to look out for:

Telogen Effluvium is Temporary, Androgenetic Alopecia is Permanent 

Telogen effluvium is a temporary type of hair loss, whereas androgenetic alopecia is permanent. 

Although there are treatments for androgenetic alopecia that can prevent further hair loss and promote some hair regrowth, your hair won’t grow back on its own. 

With telogen effluvium, shedding will eventually stop and your hair should grow back on its own once the stressor has passed.

Telogen Effluvium Happens All Over, Androgenetic Alopecia Happens in a Pattern 

With telogen effluvium, it’s more common to experience diffuse hair loss that affects your entire scalp fairly evenly. Your hairline remains intact, but you’ll see a reduced hair count, producing a generally “thin” look to your hair.

With androgenetic alopecia, you may notice some recession around your temples or other parts of your hairline, usually followed by a bald patch near the crown of your scalp. 

Because there’s a genetic component to androgenetic alopecia, the precise pattern of hair loss can vary from one person to another. 

Telogen Effluvium is Sudden, Androgenetic Alopecia is Gradual 

Telogen effluvium can happen suddenly. After a triggering event, your hair may go into a resting state for several months, only to suddenly fall out en masse a few months later as the proportion of anagen follicles goes back to normal.

Androgenetic alopecia, on the other hand, usually develops gradually over the course of years or decades.

If you have androgenetic alopecia, you may notice your hairline slowly getting higher when you look at old photos of yourself and compare them to recent ones. Or, you might notice that some techniques for styling hair don’t provide the same frontal coverage that they previously did. 

Telogen Effluvium Affects Every Age, Androgenetic Alopecia is More Common With Age 

Telogen effluvium occurs in people of all ages, without a clear increase as people grow older. 

However, it’s more common in women than in men due to the severe, often sudden changes in hormone levels women experience, such as after menopause. Women are also more likely to seek help for hair loss, so that may skew the results. 

By comparison, androgenetic alopecia can affect men of all ages, but it’s most common — and usually most severe — in middle-aged and older white men. 

As many as 50 percent of white men are affected by age 50, with up to 80 percent affected by 70 years of age.

Although they have different causes and can produce different symptoms, telogen effluvium and androgenetic alopecia also have several similarities. 

Here’s how they’re similar: 

• Both conditions can cause hair shedding. Because telogen effluvium and androgenetic alopecia are both forms of hair loss, they can both cause hair shedding beyond the usual 50 to 100 hairs you shed per day.

• Both types of hair loss can cause thinning. Androgenetic alopecia generally begins at your hairline or crown, but it can also result in diffuse alopecia (hair loss) that makes the hair across your entire scalp appear thin and lacking in coverage. As we mentioned above, telogen effluvium causes an overall thin look to your hair.

• Both forms of hair loss are treatable. Finally, some good news! Although losing your hair from androgenetic alopecia or telogen effluvium can be frustrating, you don’t need to accept it if you don’t want to. Treatments are available for both forms of hair loss. 

Androgenetic alopecia is the most common type of hair loss in men, and telogen effluvium is pretty common too — it affects many people at some point in their life. But they aren’t the only causes of hair loss. 

Other conditions that may cause permanent hair loss or temporary hair shedding include:

• Traction alopecia. Traction alopecia is a form of permanent hair loss that’s caused by damage to the hair follicles from tight hairstyles. You may be more at risk of this type of hair loss if you wear your hair in styles such as dreadlocks, cornrows, or a tight bun. 

• Tinea capitis. Tinea capitis is a form of scalp fungal infection that can cause hair loss. When the infection causes severe inflammation of the scalp (referred to as kerion), it may result in permanent damage to your hair follicles.

• Alopecia areata. Alopecia areata is a form of patchy hair loss that’s associated with certain forms of autoimmune disease. It can cause round patches of hair loss and exclamation mark hair strands — hairs with narrowed hair roots and other growth defects.

• Alopecia totalis. Alopecia totalis is a rare form of alopecia areata that causes widespread hair loss on your scalp, likely due to an autoimmune condition.

Usually, the treatment for telogen effluvium involves identifying the underlying cause of your hair shedding, and then taking steps to treat the condition and stop further hair loss from occurring. 

Most of the time, telogen effluvium hair loss stops once the underlying problem is treated. 

You may need to change medication, correct a dietary imbalance, or make changes to your lifestyle to limit your stress in order to prevent shedding. Hair loss medications like minoxidil may also help in some cases.

Androgenetic alopecia is treatable with medication and surgery. Because this type of hair loss is permanent, it’s important to take action and consider treatment options as soon as possible after you notice the symptoms of hair loss developing. 

Here are your options. 

Medications for Androgenetic Alopecia

Currently, the U.S. Food and Drug Administration (FDA) has approved two medications as hair loss treatments for androgenetic alopecia: 

• The prescription oral medication finasteride 

• The over-the-counter topical medication minoxidil 

Let’s dive in.

Finasteride 

Finasteride works by preventing your body from converting testosterone into DHT, the hormone that damages your hair follicles. 

This reduction in your DHT levels can slow down, stop, or even reverse the effects of androgenetic alopecia on your hairline and scalp.

Numerous studies have found that finasteride works well as a hair loss treatment: 

• In one study, more than 90 percent of men with androgenetic alopecia who took finasteride for 10 years showed signs of improvement in hair growth.

• In another study, published in the Journal of the American Academy of Dermatology, men with androgenetic alopecia who used finasteride over the course of two years experienced slower progression of hair loss and increased hair growth.

We offer finasteride online, following a consultation with a licensed healthcare provider who can let you know if finasteride is right for you. 

Minoxidil 

Minoxidil, sold under the brand name Rogaine®, works by moving your hair follicles into the anagen phase — reminder, that’s the growth phase of the hair growth cycle. 

It also stimulates blood circulation to your hair follicles, which may trigger growth and supply your hair with extra nutrients.

Like finasteride, minoxidil is supported by a lot of scientific research. 

In fact, a study published in the journal Dermatologic Therapy found that it’s particularly effective when it’s used at the same time as finasteride.

In the study, researchers found that 94.1 percent of men with androgenetic hair loss who used both finasteride and minoxidil showed improvements over the course of 12 months, compared to 80.5 percent for finasteride on its own and 59 percent for minoxidil alone.

We offer minoxidil topical solution and minoxidil foam online, as well as our combination minoxidil and finasteride spray.

You can also purchase minoxidil, finasteride, and other evidence-based treatments for hair loss together in our Hair Power Pack. 

Hair Transplant Surgery

Hair transplantation is a surgical procedure that involves extracting hair follicles from the back and sides of the scalp — areas that are resistant to the effects of DHT — then moving them to your hairline, crown, and other areas affected by male pattern baldness.

There are several different kinds of hair transplants: 

• Stem cell hair transplants

• NeoGraft hair transplants 

• FUT hair transplants 

• FUE hair transplants

And if you are looking for non-surgical hair replacement, we have a guide for you, too.

Hair transplants can range in price from $3,000 to $15,000 or more based on the number of hairs to be grafted. 

Our guide to the cost of hair transplant surgery goes into more detail about how hair restoration surgery works, current techniques, pricing for this type of procedure, and more. 

BTW, medication may help, even if you go the transplant route. Minoxidil can speed up hair growth and stop further hair loss to make your hair transplant more successful. You can learn more in our guide to taking minoxidil after a hair transplant.

Male pattern baldness vs. telogen effluvium — it’s not always clear what’s causing your hair loss.

Here’s what you need to know: 

• They have some key differences. Telogen effluvium usually involves temporary, diffuse hair loss, while androgenetic alopecia is permanent and typically develops as a receding hairline and bald patch on the crown of your head. 

• They also have similarities. Both types of hair loss can cause hair thinning and shedding.

• Both types of hair loss are treatable. You may need lifestyle or medication changes, hair loss medications, or, in some cases, a hair transplant.  

If you’re starting to lose hair and want to do something about it, talk to your primary care provider, schedule an appointment with a dermatologist, or use our range of easy, FDA-approved hair loss medications. 

Interested in learning more about your options before you start? Our guide to finasteride for hair loss goes into more detail about how the most effective prescription medication for androgenetic alopecia works, as well as potential side effects that you should be aware of.