Some of the most common questions that I get on my blog have to do with how to tell the difference between hereditary or androgen driven hair loss (AGA) and shedding or medical / stress related hair loss (which is called TE or telogen effluvium.) The shedding condition is often thought (sometimes incorrectly) to be more temporary in nature. Often, a distinction between the two is thought to be the presence of thinning, sickly, fly away, or miniaturized hair that shows in the regrowth of androgenic alopecia. Sometimes though, people will come out and ask "is it possible to have miniaturized hairs with TE?" I'll answer this question in the following article.
What Is Miniaturization, Exactly?: You may already know this and you may not, but hair becomes miniaturized because of hormones, DHT, or aging. What happens is that the hair is affected by these various factors and it then falls out prematurely and grows back more thin. This happens over many cycles of hair loss and regrowth, so that in the first round it may only be a 10% reduction in the diameter of the hair (and not be very noticeable.) But by the time several of these cycles have taken place, you may have a 50-70% reduction in hair thickness. This is when it becomes noticeable and this is when folks will often seek help. But by this time, you're already deep into this process.
Sometimes the miniaturization will only occur in those areas that are most affected by DHT, which is often the temples, the crown, and the top. But some individuals will have an all over or more diffuse thinning and this diffuse thinning does not always mean that you don't have AGA. It's also possible the have both AGA and TE going on at the same time, as unlucky as this would be.
Can TE Or CTE Cause Miniaturization?: The short answer is yes, but it's not completely common for this to happen. It's much more likely that thinner or finer hairs are due to androgens or age. However, some medical conditions (especially having to do with your thyroid or adrenals) can affect the density of your regrowth. (This is also true of the medications used to treat these conditions.)
And, some severe cases of telogen effluvium or CTE can cause an inflammatory process that can stunt or thwart your follicles so that they are no longer producing high quality, thick hair. Sometimes, they will have a few faulty or unproductive hair cycles and will eventually work their way back to normal. But sometimes, you will have to lessen the inflammation, heal the scalp, and then follow both of these things up by aggressively stimulating the scalp so that it is producing the best quality hair that is possible for it at the time.
How Do You Know If It's AGA Or TE That Is Causing Your Hair To Miniaturize?: This question is a bit more tricky. You can look to see if you have any of the common triggers for temporary shedding and you can look at any family history that you may have or see if you have any other symptoms of excess androgens (excess facial hair in women or oily skin and scalp for both genders.) You can also try to determine if your loss pattern is androgenic patterned and is more evident in those high androgenic areas.
But honestly, the treatment is the same no matter which is the case. Step one is eliminating any triggers. Step two is addressing the inflammation. And step three is stimulating the regrowth that is going to offer appropriate coverage.
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