Diagnosing Hair Loss: Who Should I Consult?

[Lightspeed85]

Yes. DHT is primarily involved in classic male pattern baldness, whereas virtually ANY hormone (especially with drastic changes) can be involved in increased hair shedding (telogen effluvium or otherwise).

Just curious if a dermatologist or specialist would be able to distinguish between TE/shedding versus MPB? I'm 10 weeks into TRT and have been struggling with the decision to continue as I've had mixed results. My inclination was to give a little longer and see if my condition improves, but I've recently become very concerned by some hair shedding that I've never experienced before. At 41 years old, I've had absolutely no previous signs of MPB so I wondering if the recent shedding event was caused by hormonal fluctuations. I haven't had my 3 month blood work checked yet, but I did get an E2 sensitive test and it came back at 10pg/ml so I think I went a little too heavy on the Arimidex. I believe my E2 has come back up a bit as I'm feeling better, but when it was that low, my hair was dry and brittle and I wondering if E2 or changing E2 might have been the cause of my shedding event (and hopefully it will taper off?). Any thoughts?

 

[CoastWatcher]

Just curious if a dermatologist or specialist would be able to distinguish between TE/shedding versus MPB? I'm 10 weeks into TRT and have been struggling with the decision to continue as I've had mixed results. My inclination was to give a little longer and see if my condition improves, but I've recently become very concerned by some hair shedding that I've never experienced before. At 41 years old, I've had absolutely no previous signs of MPB so I wondering if the recent shedding event was caused by hormonal fluctuations. I haven't had my 3 month blood work checked yet, but I did get an E2 sensitive test and it came back at 10pg/ml so I think I went a little too heavy on the Arimidex. I believe my E2 has come back up a bit as I'm feeling better, but when it was that low, my hair was dry and brittle and I wondering if E2 or changing E2 might have been the cause of my shedding event (and hopefully it will taper off?). Any thoughts?

You asked if a good doctor can distinguish between TE and MPB. Emphasis is on "good doctor." I consulted a dermatologist, pre-TRT, regarding a scalp/hair-loss issue, and this man was able to distinguish between the two. A good dermatologist should be able to help you. Good luck.

 

[Nelson Vergel]

I would not spend energy on "diagnosis" and instead would concentrate on "solutions"

Testosterone and Hair Loss: What You Need to Know

 

[Dr Justin Saya MD]

I would not spend energy on "diagnosis" and instead would concentrate on "solutions"

Testosterone and Hair Loss: What You Need to Know

While this philosophy can hold in some cases, in other cases the actual treatment can be vastly different DEPENDING on the diagnosis...in which case the diagnosis would be a prerequisite to treatment itself.

To OP - yes, a good dermatologist can often use clues from patient history, labs, physical exam, and sometimes skin samples to arrive at a definitive diagnosis.