Androgenetic Alopecia vs Telogen Effluvium: same shedding, different storylines

ByGavin Larsen Updated on
A woman looking at strands of hair shed onto her brush, illustrating excessive hair loss commonly seen in telogen effluvium compared to androgenetic alopecia.

Hair Loss Recovery

If your shower drain looks like it’s starting a wig collection, you’re probably wondering what you’re dealing with: androgenetic alopecia vs telogen effluvium. From a distance they can look alike, but under the hood they’re very different, like a slow dimmer switch (AGA) versus a sudden power outage (TE).

As an acupuncturist and TCM practitioner with 10+ years in clinic, I look at hair loss on two layers: the dermatology pattern you can see, and the “growth systems” you feel – circulation, nutrient absorption, hormone signaling, and scalp repair. When those systems switch off, good products underperform. Turn them back on, and your routine finally starts working.

Quick definitions

  • Androgenetic alopecia (AGA): genetically/hormonally driven miniaturization. Hairs get thinner and shorter over time, especially on the top/front in women and crown/hairline in men.
  • Telogen effluvium (TE): diffuse shedding that kicks in weeks to months after a stressor (illness, surgery, crash dieting, postpartum, major life stress). Lots of hairs enter resting phase together, then exit dramatically.

How they act different

  • Timeline: AGA is gradual and persistent; TE is abrupt, often 2–3 months after the trigger, and usually self-limited once the cause resolves.
  • Look/feel: AGA thins density and part width over time; TE keeps the hairline but sheds handfuls, making the ponytail skinnier fast.
  • Hope meter: TE often regrows once the trigger is handled; AGA needs ongoing support and strategy.

What the microscopes say (the evidence)

A 2022 study comparing female AGA and TE used dermoscopy (think: dermatologist’s magnifying lens) to tell them apart. Highlights you can actually use:

  • AGA shows “hair diameter diversity” (>20%), meaning a mix of thick and mini hairs across the same area—classic follicle miniaturization.
  • More single-hair follicular units and more vellus (baby) hairs in AGA, especially frontally versus the occiput.
  • Yellow dots (empty, sebum-filled follicles) and perifollicular discoloration are more common in AGA.
  • TE rarely shows HDD >20%; you might see mild HDD (>10%) and diffuse signs, but not the miniaturization signature of AGA.

Cheat sheet you can screenshot

  • Cause: AGA = hormone/genetic sensitivity → miniaturization; TE = synchronized shed after stress.
  • Pattern: AGA = patterned thinning (front/top); TE = diffuse shedding with preserved hairline.
  • Dermoscopy: AGA = HDD >20%, ↑ single units, ↑ vellus, yellow dots; TE = HDD usually ≤10%, no miniaturization signature.
  • Course: AGA is progressive without treatment; TE tends to recover once the trigger is fixed.

What to actually do

If it’s leaning AGA

  1. Confirm with a clinician (dermoscopy helps).
  2. Support the systems: improve scalp blood flow, digestion/absorption, hormone balance, and barrier health so topicals can work.
  3. Consider evidence-based treatments and track photos monthly.

If it’s leaning TE

  1. Find and fix the trigger (iron deficiency, thyroid shifts, illness, crash diets, meds, major stress).
  2. Replete nutrition, reduce inflammatory load, sleep like it’s your job.
  3. Expect a delayed but steady recovery. Shedding eases first, density returns over months.

Want a plan that turns your “growth systems” back on?

If you’re stuck between harsh meds you don’t want and “natural” fixes that never seem to stick, my 30-Day Pattern Mapping™ Reset helps restore circulation, absorption, hormone signaling, and scalp repair, so what you’re already doing finally shows up on your head.

I'm a Traditional Chinese Medicine practitioner who spent 10+ years treating hair loss in clinic, and watching people follow protocols that didn't match their body. Most hair loss advice treats everyone the same. But your pattern is specific. Pattern Mapping™ identifies which of 4 internal systems is blocking your regrowth, then gives you the exact protocol to restore it. My work combines TCM diagnostics with research-backed supplements, herbs, and scalp activation techniques to address the root cause, so you stop wasting time on fixes that were never going to work for you.

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