Telogen Effluvium or misdiagnosis

[curbed my enthusiasm]

lossing, happy to post the info, i wish i had found it 5 months ago when i first started shed. From your description it sounds like you may be going through just a normal tel.eff. w/ no accelerated male pattern baldness. Do you have more severe symetrical loss in male pattern baldness affected areas (hairline), had you had any hairloss prior, even just a little. i think this process is that if you are predisposed to male pattern baldness than a tel.eff. is like pressing a fastforward button on your hair development, when it ends you press play, however far progressed your hairloss is where you restart. It sounds like you should be hopeful if you didn't have any signs of hairloss prior. normal tel.eff recover completely, but unfortunately for me male pattern baldness affected ones don't. :cry: :evil: :cry:

 

[lossing my hair]

Curbed, my last 2 years been hell. I had major episodes of stress to the point that i got headaches from it similar to doctor lee patient from the panama, but it wasn't noting until i got on a ssri med and withdraw from it. the withdrawal was so severe for 5 month straight without stopping. the same time i lost almost 40% of my top. my hairline is still Norwood 1.5 but i had diffuse female pattern hair loss. front mid scalp and all of a sudden on the crown too. each month it's getting worst. I know i had Telogen Effluvium shed before because when i showered i saw hair coming out from everywhere but it was never noticible until i had the chronic stress from the ssri med.

my advise to anyone thinking on going on antidepression medication. try the most u can to over come your depression without the medication.

 

[Mickey]

Just comeback from having my haircut been told that its getting darker and the roots is starting to thicken up and its slowly improving so im going to to wait the 6 months and see how i get on before i consider any treatment.

 

[rapidfrontal]

I have been offered medication to get past my current bout with anxiety/depression, but I turned it down. I really do think I am coming out of it, with the inciting event now being over 6 months distant. My question is this: if I do have male pattern baldness developing more rapidly due to Telogen Effluvium, then when does this rapid development stop? When the shedding stops, or what, because the shedding is still going strong. In fact, I have noticed more recession on my hairline this weekend. Thanks for the Dr. Lee posts. Interesting, but somewhat disturbing because I feel that my male pattern baldness is accelerating with no end in sight.

 

[rapidfrontal]

Also, are you all telling me that if I am undergoing Telogen Effluvium, then when it comes back I am not going to get it back at all in the areas where I may have had accelerated male pattern baldness, like on my temples? Or will it come back, just thinner than before the Telogen Effluvium?

 

[rapidfrontal]

Sorry, but one more thing. Is everybody sure that my shedding is going to stop at some point, because it has been pretty heavy for at least 3 months now and to me it just seems like it'll never stop. Does anybody have any information on this?

 

[Mickey]

Sorry, but one more thing. Is everybody sure that my shedding is going to stop at some point, because it has been pretty heavy for at least 3 months now and to me it just seems like it'll never stop. Does anybody have any information on this?

From my experience i had heavy shedding for almost 4 months everyday was hell as i was losing hair rapidly.It has got so bad in the 4 months that when my hair was wet i could see the horseshoe pattern forming.I couldnt and still cant use any styling products on it as its so thin.But about a month -6 weeks ago it stopped just like that and its gone back to normal before all this started.And regrowth is sprouting up all over the place.My vertex is really thin and bald in places but regrowth is starting to sprout up now.

 

[wotsthedeal]

rapidfrontal, I'm in the 9th month of a Telogen Effluvium so I know what you are going through. My advice to you, stop stressing about it. Healthy hair follicles will not simply die overnight, it is a long process. If indeed you do have some accelerated male pattern baldness due to Telogen Effluvium, get on some treatments once it stops and you should be ahead of the game.

Think about it this way:
Most people notice their balding when they have lost 25% to 50% of their hair already. People like me and you, who have Telogen Effluvium, lose so much hair so quickly that we notice it much sooner. Although Telogen Effluvium causes us to lose lots of hair, at least it alerts us to our male pattern baldness quickly if we have it. You are shedding a lot now, but at least you know that a vast majority of your hair is going to grow back and then you can treat whatever doesn't. Your situation is much better than someone who looks in the mirror and realizes male pattern baldness has claimed half their hair, because they are going to have a much harder time getting it back.

 

[Mickey]

rapidfrontal, I'm in the 9th month of a Telogen Effluvium so I know what you are going through. My advice to you, stop stressing about it. Healthy hair follicles will not simply die overnight, it is a long process. If indeed you do have some accelerated male pattern baldness due to Telogen Effluvium, get on some treatments once it stops and you should be ahead of the game.

Think about it this way:
Most people notice their balding when they have lost 25% to 50% of their hair already. People like me and you, who have Telogen Effluvium, lose so much hair so quickly that we notice it much sooner. Although Telogen Effluvium causes us to lose lots of hair, at least it alerts us to our male pattern baldness quickly if we have it. You are shedding a lot now, but at least you know that a vast majority of your hair is going to grow back and then you can treat whatever doesn't. Your situation is much better than someone who looks in the mirror and realizes male pattern baldness has claimed half their hair, because they are going to have a much harder time getting it back.

I AGREE Before all of this started my hair was thick healthy everything was fine.Now in 4 months it is so damaged thin dry etc.

 

[rapidfrontal]

Thanks for the encouragement. I am realling looking forward to the next 6 months +. If I don't regrow all that I have lost on my hairline it is okay, but I just hope my hairline doesn't get too much worse before the shedding stops, if it stops. Because I guess that is what I am hearing, that my frontal recession is accelerated now dutasteride to the Telogen Effluvium and once I am over the Telogen Effluvium my frontal recession will return to the rate it is at before the Telogen Effluvium. Afterall, it is clear that I had some, however mild, male pattern baldness before the Telogen Effluvium set in. Thanks all, and I will keep you updated.

 

[curbed my enthusiasm]

rapid, i think when the shedding from the Telogen Effluvium stops then the accelerated male pattern baldness development will stop. I'll try to share the way i very roughly understand it. If anyone has a more accurate understanding or recognizes any misinformation i'm giving, please correct me.

your hair goes through cycles, at any time 90% of your hair is in a growth phase which lasts 3-8 yrs and 10% is in a resting phase which lasts 90days. at any point during this resting phase that hair can be shed w/ minimal effort (shower) and at the end of the phase the hair is ejected if it didn't shed earlier. since 10% of the hairs around your whole head are in this phase at any time, that is why it's normal to shed 50-100 hairs a day. what i think the problem is that when you go through Telogen Effluvium, alot more of your hair is thrown in the resting phase all at once and is shed. your hair is only supposed to go through these resting phases every few years for 90days. but this Telogen Effluvium has cause the majority of your hair to go through what normally would have been a longer process, in a shorter amount of time. the male pattern baldness affected hair only has so many growth cycles in it and miniaturizes w/ every cycle i believe. from what i've acertained, so much hair constantly being in the resting phase and shedding has progressed the miniaturization process.

rapid, i'm not sure when the shedding stops. i've been shedding a disturbing amount for over 5 months. but i havn't resolved my issues that i believed incited the Telogen Effluvium (seeing 300+ hairs per shower hasn't done me any favors). i suspect that since there is a delayed onset of 3-4 months after the Telogen Effluvium, that once the Telogen Effluvium is resoved there may be a delayed onset of cessation to shedding of 3-4 months. I got another response from dr.lee, in which i asked how long after the Telogen Effluvium is resolved would the shedding subside, and he said "the physiology of the hair growth cycle dictates that the 100day telogen phase must first be completed before new follicles can replace the ones that have shed. You should see new growth 4 months or so after the beginning of the telogen phase." This dosn't address when the shedding will stop, i can only guess he also meant the shedding will stop at that point to.

i think the sooner we are able to resolve what insighted the Telogen Effluvium the sooner it will subside, and the less time the male pattern baldness affected hair will be vulnerable, and more can be salvaged. as i said in my case i have remained in a constant state of stress and depression since the inciting event, i personally have decided to begin anti depressant medication as i believe it gives me the best opportunity to stabilize this Telogen Effluvium. if you are not completely recovered emotionaly from the events that led to this i would consider medication, if you are feeling much better than before than mabey your on your way to resolving this Telogen Effluvium, but if you were on meds it might reconcile it even quicker. The way i look at it the sooner we fix this Telogen Effluvium the better the chance we give our hair of surviving. i'm not trying to convince you of anything, just giving another point of view from a standpoint of what might have the best impact for your hair. Once you recover from Telogen Effluvium and feel your circumstances are more stable you could always quit the anti dep. if you want.

cont.

 

[rapidfrontal]

Curbed, you are the source of a great deal of information for me. I really appreciate it. and I have decided not to go the way of medication because I am truly feeling better for nearly a week now. I am going to give it a few more months and see what happens, but did I happen to mention that I am on Propecia already. If I could just stop shedding and receeding at the rate that I have been I would be thrilled to death. I am always haunted, however, by the idea that my shedding may just never stop. Thanks much.

 

[curbed my enthusiasm]

curbed, year that info i got from lee wasn't what i wanted to read either, but now i know i've got to do what ever is in my power to get this under control as soon as possible. as far as your hair coming back in male pattern baldness affected areas i think it will come back but miniaturized, to what degree you and significance you can't know. I would imagine the longer in a Telogen Effluvium the worse your chances are, seeing how a resting phase lasts 90 days. i

I don't know if your on finasteride but One thing that was some what optomisitic i learned from dr.lee is that if you are on finasteride, barring your not a responder and you go through a Telogen Effluvium it should protect your follicles from miniaturization when it regrows. if your not on finasteride i would get on it. i found this out in a response from an email i sent him, i'll post some of my questions and his responses where he touches on it. in them he believes finasteride to be involved in my Telogen Effluvium, but i think it is more stress related.

If finasteride is causing tel.eff. and I stay on it will I experience an accelerated rate of male pattern baldness than if I were not on tel.eff. inducing finasteride? Is finasteride causing irreperable damage or atleast loss i would not be experiencing til later?

Finasteride is not causing irreparable damage to your hair follicles. As I mentioned, although it may cause a telogen effluvium, it can protect against miniaturization during the Telogen Effluvium process.

>
>
> You wrote:
> "NO. Massive shedding from drug induced telogen effluvium usually grows back.
> Massive shedding and miniaturization of follicles from genetically predisposed
> accelerate hair loss does not grow back, and it is difficult but possible to
> reverse such loss with treatment."
>
> -5.So if you think I have tel.eff. due to finasteride and accelerated hairloss, where does that leave me regarding recovering the hair lost? What chance does my male pattern baldness shed hair have to recover after the telogen effluv. subsides, having been extreme shedding for 5 months at this point? will it come back at all? If so will it likely be so minitiarized to be significantly obvious?

I do not know. It depends on your genetic predisposition to treatment. Finasteride should protect your follicles from miniaturization regardless of the telogen effluvium or not. But that does not mean that it has protected your follicles. You will have to wait an see.

 

[pleasegodno]

curbed, please keep us updated on your antidepressant therapy. i've been suffering some stress loss as well, but it's so f*****g hard to stay calm when your hair keeps falling out. so, i've been considering getting on an AD/anxiolytic as well for a while now to help me out for a few months at least.

also, have any of you guys experienced a tender/burning scalp?

 

[Bismarck]

Stress does contribute to hairloss. There are recent scientific findings for what people knew for decades:



INDUCTION OF NEUROPEPTIDES IN SKIN INNERVATING SENSORY NEURONS BY STRESS AND NERVE GROWTH FACTOR AS A POSSIBLE REASON FOR HAIR GROWTH ALTERATION

A. Kuhlmei1, Q.T. Dinh1, E.M.J. Peters1, J. Kandil1, R. Paus2, B.F. Klapp1, P.C. Arck1

1Department of Internal Medicine, Charité, University Medicine Berlin, Germany

2Department of Dermatology, University Hospital Eppendorf, Hamburg, Germany



Recently, we introduced a mouse model to launch experimental evidence for stress-induced hair growth inhibition (HGI), pointing to the existence of a ‘brain-hair follicle axis (BFA)’. We suggested that nerve growth factor (NGF), besides neuropeptide substance P (SP), are candidate mediators along the BFA. Published data further indicate that stress related neuropeptides, e.g. calcitonin gene related peptide (CGRP) and SP may be involved in HGI. SP and CGRP are synthesized in dorsal root ganglia (DRG) and released after axonal transport in the skin. Thus, the aim of the present study was to investigate the effect of stress or subcutaneous injection of NGF, which mimicks stress and regulates neuropeptide genes in sensory neurons, on the expression of SP and CGRP in DRG.

Anagen was induced in C57BL/6 mice by depilation and retrograde tracing was employed on day 9 post depilation (pd). On day 14 pd, mice were either exposed to sound stress (n=4), injected subcutaneously with NGF (n=4) or served as controls (n=4). On day 16 pd, DRG (mean of 30/mouse) were harvested and SP and CGRP in skin specific sensory neurons, as identified by the tracer dye, were labelled by immunohistochemistry and counted double blindly.

Stress exposure as well as NGF injection leads to a significant induction of SP and CGRP in retrograde labelled neurons. Moreover, stress induced premature onset of catagen and an increased percentage of SP and CGRP positive dermal nerve fibres. This allows us to conclude that sensitive dermal nerve fibres are likely to originate from the presently identified neuropeptide-positive neurons. Peripheral activation of SP-expressing afferent nerve fibres via NGF-dependent pathways may cause neurogenic inflammation, eventually resulting in HGI.

 

[lossing my hair]

yesterday i got a 1# clipper hair cut. which gave me a more clear view of my hair density. in general if im going trough a male pattern baldness phase i should see miniaturised hair which i didn't. the hair i have is thick but less. i know when
hair are cut short it appears more thick. but when the miniaturised hair is cut it isn't visible. One more sign which has me confuse if it's male pattern baldness or Telogen Effluvium. once again im not on any denial im on propecia but my hair loss happend so fast that sometimes makes me think otherwise.

 

[pleasegodno]

yep, i'm very familiar with that and related research. the fact that i've experienced burning scalp syndrome (trichodynia, which is likely due to excess substance p) coincident with very rapid hairloss confirmed my notion that stress was accelerating my loss.

 

[Mickey]

curbed, please keep us updated on your antidepressant therapy. i've been suffering some stress loss as well, but it's so f*****g hard to stay calm when your hair keeps falling out. so, i've been considering getting on an AD/anxiolytic as well for a while now to help me out for a few months at least.

also, have any of you guys experienced a tender/burning scalp?

I did it kept coming and going somedays was fine then others i had like a warm burning feeling.Then when that went sometimes i was left with a dull pain for a bit.And i got itching aswell.This was mainly on the left side of my scalp even though the right side got thinner.

 

[rapidfrontal]

Just last week my shrink told me to seriously consider going on an anti depressant, it can't remember the name, but it wasn't zoloft or prozac although he said it was a cousin of prozac and I told him that I would think about it. That was 5 days ago, and when I see him again I am going to tell me absolutely not, because I will get through all this on my own eventhough it is like nothing I have ever experienced before in my life and hope to never again. It is tough now and has been unbearable, nothing short of total depression that takes all enjoyment out of life to the point that you have to seriously force yourselft to smile around friends, for 6 months now, without a single moment where it didn't consume my thoughts and made focusing on anything else, work, family, friends, impossible. I am coming out of it on my own now, I think, and things are really looking up and the only thing, in the end, that really seemed to help was TIME. I had three huge problems just one week ago, the inciting event (which is nobody's business), my career or lack there of, and my hairloss. I have successfully removed the inciting event, hopefully, the career is all up to me because if I work hard I'll make it and if I don't I'll fail, and the hairloss is out of my control, but the one thing I know is that when I am single again I'll be successful and successful, and good providing men are always in demand. Moral of the story is to take care of the things that are under your control. If you are losing you hair get your life in order as much as possible because the more you improve your own life before you lose your hair, the less you will care about stupid old hairloss.

 

[pleasegodno]

to the guys whose shedding has subsided: how long after the inciting stress/events (after they had subsided as well) did it take for you to notice a reduction in hair loss? thanks.