Hair Constantly Falling Out With Telogen Effluvium And Androgenetic Alopecia?

I sometimes hear from folks about their hair constantly falling out and they are trying very hard to determine what cause of hair loss they might experience. One concern that I often hear regarding this is how hair sheds out through out the day with different hair loss conditions.

I might hear a comment like: "since my hair loss started after an illness, I suspect that I might have telogen effluvium. However, I have some miniaturized regrowth that bothers me.

 So I suppose that it's possible that I might also have a touch of androgenetic alopecia. However, I have a friend with AGA and she tells me that she really doesn't lose a lot of hair. She says that she will notice some hair loss after she washes and then combs out her wet hair, but she doesn't notice loss that continues throughout the day. 

My experience is almost the opposite. Of course, I notice the most loss when I wash my hair, but my hair continues to shed all day long. I can look down at my shirt at any given time and I can notice tons of fallen hairs on my clothing. 

I've looked at my friend's shirt and she doesn't have all of the fallen hairs. She says that everything pretty much comes out when she combs and styles her hair in the morning. I'm wondering if anyone with androgenetic alopecia has hair coming out all day. Or is this impossible?"

I don't think that it's impossible. It's just less common. With this said, plenty of people with androgen driven loss have heavy hair loss, which is one thing that makes it seems as if you are seeing fallen hairs all day long. 

If you're shedding out a smaller amount of hair, then the manipulation of the comb or of washing that same hair may be all that is needed to release the hair that is going to fall that day. But, when a very large amount of strands are falling out, you likely won't get them all with styling so you will continue to see them throughout the day. 

Frankly, this can happen with all different causes of hair loss and not just with telogen effluvium. Any loss that presents with a huge amount of shedding can also present with hair raining down on your clothing all day long.

 With this said, typically we think of androgenetic alopecia as a condition where there is less shedding, but there is also less regrowth. The hair looks more thin not because so much is shedding out, but because the smaller amount that is falling out isn't being replaced by a healthy hair. 

Instead, the hair grows back is being miniaturized by the androgens. And this makes it look more sickly and thin. Over time, it can provide much less coverage as well.

I've known and heard from people who had very aggressive androgen driven loss which presented with a high amount of shedding hairs that came out all day long. This isn't the normal presentation, but it does happen. 

And the normal presentation of telogen effluvium doesn't often have miniaturization present. However, this does sometimes happen also, although it is most likely to happen when you have the chronic form of the condition (which lasts for more than six months.)

So to answer the question posed, it's not completely common to lose hair all day with androgenetic alopecia, but it's certainly not impossible either. The next thing that you would look at is the quality of regrowth. 

But since there was miniaturization here also, there were still several possibilities. The next thing to consider would be whether the loss was patterned and in high androgen areas or if it was more diffuse and all over the head. 

A diffuse loss is more suggestive of telogen effluvium while a patterned loss is more indicative of androgenetic alopecia, but again, there are always exceptions. That's why you usually have to look at the situation in its totality and then consider the circumstances that lead up to it as well as the over all health of the person, as well as any family history.

My hair definitely fell out all day long when I had chronic telogen effluvium. And I also had some miniaturization so I tried to formulate a regimen that covered both bases. If it helps, you can read more here.