People often count the hairs in the drain and assume the number itself gives the diagnosis. It does not. The more useful clues are when the shedding started, whether the scalp is visibly thinner, whether there was an illness or major stress a few months earlier, and whether close relatives have a similar pattern of thinning.
Telogen effluvium often has a story before the shedding
Hair follicles cycle. After a significant trigger, more follicles can shift into a resting phase and shed later. The delay between trigger and hair fall is why people may not connect the two. Fever, surgery, childbirth, rapid weight loss, major psychological stress and some nutritional or thyroid problems can be relevant.
Pattern hair loss is usually more gradual
In androgenetic or pattern hair loss, follicles progressively produce finer hairs in genetically susceptible areas. People may first notice a widening part or reduced density rather than handfuls of hair. Early assessment can be useful because preserving existing follicles is often easier than trying to reverse advanced miniaturisation.
Both can happen at the same time
A person with early pattern thinning can also develop a temporary shed after illness. The temporary component may recover while the underlying pattern remains. This is one reason internet photographs are a poor substitute for longitudinal assessment.
Useful information for the consultation
Think back three to four months: fever, dengue or another illness, new medicines, crash diet, surgery, childbirth or a major life event? Bring previous blood reports if you already have them, but do not delay a visit just to complete a long checklist of tests.
Related clinic page: Hair Restoration