TE or AGA? Please help a newbie :(

[Skylark]

Hi,

I'm new here and am really hoping someone can help me. I started shedding suddenly about 6 months ago. GP noticed dandruff & prescribed anti-dandruff shampoo. She also did basic bloodwork - iron/thyroid/vitamin B were normal. Shampoo didn't help & I was referred to a dermatologist. She did a pull test & although she didn't mention if it was positive or negative, she said they were all telogen hairs. I've been put on steroid lotion to minimise what she thinks is eczema/dermatitis. A month has passed and the shedding & scalp seem better - there is still some eczema/dermatitis but a bit less inflamed. She's put me on steroid cream to calm it down further and says she may do a biospy when I come back in 3 weeks. She said this is to see how much is eczema and how much is related to genetics. I'm worried that this is a bit drastic (and expensive) so here are the facts:-

-Diffuse hair loss for 6 months. Was up to 150+ a day, now up to 110 a day & generally decreasing since starting steroid lotion. Probably I lose an average of 80 a day but this still feels like more than normal.
-Lose mainly long hairs from back where eczema is worst, some medium and I also sometimes notice a few baby hairs when washing.
-My parting is becoming wider although not noticeable yet to others.
-Not sure about regrowth although some hairs that come out are finer than others and a couple have been kinky.
-Patches of inflammation & flakes although not noticable
-Sometimes itching or burning scalp - esp with the lotion which is why we're trying cream
-Had wedding stress/came off pill 3 months before shedding started (although I previously came off BCP and went back on and it didn't seem to affect hair)
-Dad and brother have thinning hair (brother is only 29, I'm 32) Mother had thick hair, no female baldness in any family members
-Periods regular since coming off pill and basic blood test showed hormone levels ok

My questions are:-

1) Should I be asking for more blood work first or go straight for the biopsy? Any point in starting medication before biopsy result?
3) Is an inflamed scalp more likely to be TE or AGA? (or could this simply be hairloss due to eczema/dermatitis?)
3) Is AGA common and does it normally lead to noticeable baldness? Is this likely to be a time-frame of months or years?
4) Can you have AGA and still maintain your hair as normal with medication if caught early?

I'm worried since she mentioned the biopsy. Until then I just thought I had eczema or at the worst, a case of TE. I read that 90% of biopsies come back positive for AGA and that treatment is the same whether TE or AGA so I would prefer not to go through all the worry and expense unless necessary. However, if AGA is treatable then I guess I should start treatment as I don't want my parting to widen any further.

Please help, this is all new and I'm not sure what to do for the best

Many thanks!

Skylark

[Tracy C]

Hi Skylark,

The very first thing you need to do is do your best to try not to worry. I know this is very hard to do - but it is very important that you try your best.

You also need to know that it is normal for humans who are not experiencing hair loss to shed up to 100 hairs per day. It is when you are shedding more than 100 hairs per day that is a sign of a potential problem.

It's sounds like you are in good hands. If you do have androgenetic alopecia, it is treatable with meds. I've been successfully treating my androgenetic alopecia for over four years.

All my best to you,

Tracy

[Skylark]

Hi Tracy,

Thank you so much for replying. I have been good at controlling the worry for the last 6 months when I thought it would stop sooner or later. But since specialist has mentioned the biopsy and the possibility of AGA, I've become worried that this will go on indefinitely. Your reply is very encouraging. Did you have a biopsy to diagnose? When you say that you're successfully treating it, does that mean you have grown back hair, or that you're successfully maintaining the hair you have?

My hairloss has gone back up during the last couple of days, along with an itchy and painful scalp - maybe stress related I guess.

Is there anything I can do to soothe my scalp while I wait for the derm to mail the script for the steroid cream?

Anyone else able to shed light on any of my questions? Particularly whether eczema on its own could cause this loss, in which case it is treatable.

I am glad to have found such a supportive community and a wealth of info.

Skylark x

[Tracy C]

Hi Skylark,

I am not a doctor but I do believe the eczema is probably the major player in your situation. I have never experienced that and I am not qualified to provide advice for that situation.

A biopsy is not always needed. In my case it was pretty obvious I have androgenetic alopecia. I have it, my sister has it, my brothers have it, my mother has it, my mother's sisters have it and all my cousins on my mother's side have it - both the boys and the girls. All us girls have a similar pattern. So yeah it was obvious, I was doomed.

I have managed to stop the loss and grow hair back. Not all of it but a lot of it. It took a long time though. My hair loss was extensive when I started treating it. After two years of treating it I had grown a lot of hair back but I still had patches that wouldn't grow any hair, so I had transplant surgery to fill those patches back in.

Treating hair loss is a painfully slow process. The sooner you start treating it the better your outcome will be. My sister and my cousins are younger than me by at least sseven years and their hair loss is not as bad as mine. So they will probably not need surgery because they started treating it shortly after seeing me respond to treatment.

Hang in there, it sounds like you are going to be O.K..

All my best to you.

Tracy

[Skylark]

Hi Tracy,

Thanks for your advice, it's really helping to talk to someone who has AGA and I sympathise with what you've been through. I'm really happy for you that you have been able to regrow most of your hair.

I guess a biopsy might be necessary in my case as while some men in my family have hair loss, some men and all women are ok. Are biopsies common in initial stages of diagnosis?

I'd want to catch AGA early, but as we are planning on trying for children in 6 months or so, I'm worried that I wouldn't be able to start treatment anyway. Are there any methods of treatment that you can stay on while trying to conceive? I've read that regaine, etc. are not suitable. I know I'm jumping ahead, but I think I'd rather not go through the trauma of diagnosis unless there is something I can do while in child bearing years.

Let's hope is is just scalp inflammation & irritation. Do you know if an inflamed scalp can be a sign of AGA or TE? I've been shedding loads again today. I read somewhere that large sheds are more likely TE than AGA (although I know that one can unmask the other.)

Thanks again for your replies

Skylark

[Tracy C]

Hi Skylark,

I do not know if biopsies are common for the initial stages of diagnosis. I just that know that it was not necessary in my case.

Unfortunately I am pretty sure all the medications that can be used to treat female hair loss are potentially harmful to an unborn male baby. They also make breastfeeding harmful to the baby while taking them. The only treatment I can think of that wouldn't do that is low level laser therapy.


Some folks may suggest natural treatments as a possibility. I personally do not believe natural treatments are helpful in any meaningful way to treat hair loss. I also feel if natural treatments actually could be helpful in treating hair loss, they would also be just as harmful to the baby.

Take care,

Tracy

[Skylark]

Hi Tracy,

Many thanks, I suspect that about meds for AGA. So I'm in a dilemma about whether to have a biopsy to confirm something I can do nothing about at this stage.

In your experience, did you shed lots or did your hair just gradually thin? I read that shedding is more a sign of TE than AGA.

Anyone else shed any light on my situation?

Thanks again Tracy

Skylark

[Tracy C]

Hi Skylark,

I thinned out gradually. Though looking back now it seems like I just suddenly noticed that I was loosing my hair. Then of course it got worse because I worried about it so much.

[Skylark]

Hi Tracy,

Thanks for your reply. Mine seemed to get better and then when I began to worry about genetic loss, I seem to be shedding more. It might be the fact that I'm using eczema cream. It's a vicious circle of worry!

I don't think I'll have the biopsy at this stage as there would be no meds I could take until I've finished having kids and it would be depressing to not be able to do anything about it.

I really sympathise that you've been going through this for years, although I'm glad that you've managed to stop and reverse the loss!

Skylark