Miniaturisation or telogen hairs? (Photo)

Question

I recently had a huge shed after I went on keto diet and lost about 20 pounds in just a month. My hair density decreased evenly and more on my part. I am 23 male Indian with no premature balding in family. My father has diffuse kind of hairloss and that too at 56 age.I was pretty sure I am having telogen effluvium but after I took a snap of my scalp I am kind of worried to see short thin hairs. Are these minituarised hair or are they just telogen hairs which will grow thicker.

Jeff Donovan, MD, PhD · Answer

Your story would suggest that a TE is at least one part of your diagnosis. Whether androgenetic alopecia is present really can’t be determined from the photos you have submitted. There may be some subtle anisotrichosis (variation in hair caliber) in the photos submitted.  However the photos are not sufficient to render any type of diagnosis.

Karl Hekimian, MD · Answer

Your story is consistent with telogen effluvium from the rapid weight loss, and this should improve with time.  However, especially given your family history of hair loss, you may also be in the early stages of androgenetic alopecia.  I would suggest a visit to a local hair restoration physician for a complete exam and discussion of what you can do to slow down and treat your hair loss, such as finasteride (Propecia), laser (LLLT), platelet-rich plasma (PRP) and minoxidil (Rogaine).

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Shvm,Hello and thank you for your excellent question. I suggest that you start Finasteride and Minoxidil, as they are the only two medications for hair loss approved by the FDA. For women of child-bearing age, I use spironolactone instead of finasteride. Both medications have different mechanism of action, and I usually recommend both medications to my patients. Other adjuncts include low-level laser light therapy, PRP, stem cell, or other regenerative medical treatment. Also, you will want to ensure that you are not taking any medications that could be contributing to your hair loss. The main objectives with the combination treatments are to stabilize your hair loss, increase your existing hair fiber diameter, and stimulate some hair regrowth. After those options are completed, I recommend hair transplant, including FUE or FUT. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
  
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Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 – 2018
  
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William Rassman, MD (retired) · Answer

Rapid weight loss can induce hair loss especially in a young man that might have genetic balding in its early stages.

Miniaturisation or telogen hairs? (Photo)

Answers (4)

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