Sudden, rapid, generalized shedding of normal club hairs a few months after a stressful event like parturition, major surgery, high fever, etc. indicates TE, while gradual diffuse hair loss with thinning of central scalp or widening of central parting line or frontotemporal recession are common indicators of FPHL.
Excessive, alarming diffuse shedding coming from a normal looking head with plenty of hairs and without an obvious cause is the hallmark of CTE, which is a distinct entity different from TE and FPHL. Complete blood count, routine urine examination, and levels of serum ferritin and T3, T4, and TSH should be assessed in all cases of diffuse hair loss without an apparent cause, as iron deficiency and thyroid hormone disorders are the two common conditions often linked with diffuse hair loss, and usually no apparent clinical features rule them in.
CTE can be reliably differentiated from FPHL through biopsy which shows a normal histology in CTE and miniaturization with significant reduction of terminal to vellus hair ratio in FPHL.
Reassurance, support, and explanation that the condition manifests excessive shedding and not the actual loss of hairs, and it does not lead to baldness, are the guiding principles toward management of TE as well as CTE.
TE is self limited and resolves in 3-6 months if the trigger is removed or treated, while the prognosis of CTE is less certain and may take 3-10 years for spontaneous resolution. Topical minoxidil 2% with or without antiandrogens, finestride, hair prosthesis, hair cosmetics, and hair surgery are the therapeutically available options for FPHL management.
Read more on : Choosing the Right Treatment for Hair Loss
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