The Beginning of My Hair Loss
I used to have super thick hair before going to college. When I went to college, at 18, my hair started to shed like crazy. At first, I thought it was typical MPB but my hairline did not recede and eventually my hair stopped shedding without me having to do anything.
Since then I have had periods of time where my hair started shedding like crazy. Usually, this would coincide with my hair being very long. Usually when my hair shedding my scalp was also feeling inflamed and somewhat itchy. Scalp massages and very hot showers felt relieving on my scalp. I recently started using Nizoral (ketoconazale) shampoo.
I have been going with a buzz cut from time to time these last few years. When my hair gets long its extremely noticeable everywhere that it is falling out. Whenever I would come out of the shower and comb my hair a massive amount of hair would appear in the drain and on the comb.
Why is my hair falling out?
At this point I am unsure what the cause of my hair loss is. I think the cause is one or more of the following:
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Chronic Telogen Effluvium
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Alopecia Areata (Diffuse?)
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Androgenic Alopecia (AGA, DUPA?)
Here is the case for each:
Chronic Telogen Effluvium:
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Extreme Shedding Periods
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Hashimoto’s (a few months ago a blood test revealed TPO Antibody count of 180)
- Recently, I have been supplementing with Selenium. Although, I stopped both Selenium and the AIP diet and the shedding started again.
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For a very long time I have been supplementing with Vitamin D.
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I occasionally supplement with Zinc, Iron, B-Complex as well. My blood tests show that my vitamin D and iron/ferritin is good.
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Telogen bulbs appear in my recent microscopic photos of my scalp.
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The thinning is diffuse (and not just in androgen sensitive zones).
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Problem with this diagnosis: Why is there miniaturization
Areata Alopecia (diffuse):
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I had a coin-shaped bald spot a while ago. It went away after a long period of time on the AIP Diet (I also supplemented with probiotics and fiber in case it was due to gut issues).
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I eventually stopped the AIP diet and the shedding increased and a new coin-shaped bald spot appeared in my scalp.
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Auto-Immune History:
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I have hashimoto’s and coin-shaped bald spots (so likely alopecia areata)
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My mother has Hashimoto’s and vitiligo. She also has incredibly thin hair. So does my sister.
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Both parents are on levothyroxine (My father could also have Hashimoto’s but we haven’t tested him.)
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The thinning is diffuse (and not just in androgen sensitive zones).
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The fact that the “coin-shaped” areata symptoms appear, increase the likelihood of diffuse alopecia areata as well.
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Problem with this diagnosis:
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In many photos, it does seem like the crown is thinner than the sides but it could be lighting. It could also be the fact that I tried minoxidil in that region but then stopped (leading to increased shedding in that region.)
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The original density has never actually returned.
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Androgenic Alopecia:
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Miniaturization was found in microscopic photos. I am uncertain if it is enough miniaturization (>20%) to definitively say the cause of all my hair loss is due to androgenic alopecia.
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My hairline seems very high when I get a buzz cut. But when I compare photos over the past few years, it seems that it was always high. Also, wouldn’t it have gotten higher over the past few years?
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I previously tried finasteride and minxodil for several months but there was no improvement (It is possible I did not use them long enough.)
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Problem with this diagnosis:
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Nobody in my father’s side of the family was bald and my mother’s father did not go bald. My maternal uncle is bald though.
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Why is there extreme thinning on the back and sides? These are not supposed to be androgen sensitive zones.
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My hairline is not really going that far back. I can compare it to older photos and it seems there is no regression.
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I am considering a biopsy to get some more clarity.
Photos Using the Microscope Camera:
Back of Scalp:
https://imgur.com/a/back-of-scalp-ZlxN5NH
Crown of Scalp: