Androgenetic Alopecia Diagnosis from Scalp Biopsy

Dr Rassman,
I’m a 27 y-o female who has experienced major thinning all over the scalp. I wrote to you earlier this year regarding how my low ferritin levels (14-ish for the past 10 years) could impact my hair loss.

I recently received my scalp biopsy results which gave me a diagnosis of “Scalp skin with intermediate and terminal hairs. No significant immunopathology. This suggests an early androgenetic effect”. It also stated that “no clear cut diminution of hairs is apparent”.

Why would this history lead to a diagnosis of androgenetic alopecia rather than CTE? If I don’t have clear cut miniaturization, and my ferritin is so low, could this be true? I am just reluctant to go on Propecia since my insurance won’t cover it for women.

Thanks very much for your time.

These terms chronic (meaning long term) telogen (refers to a part of the hair cycle where hair goes into resting phase) effluvium (means hair shedding) and Androgenetic (means genetic and a weak sex hormonally combined into a single word) Alopecia (means hair loss) are descriptive terms, which in your case does not help. Much of medicine is rooted in the descriptive arena based upon Latin language usage. This makes doctors sound very intelligent, when the actual meaning reflects more of our ignorance. See EHRS for a better understanding of the difference between the two possible diagnoses listed above (chronic telogen effluvium/ CTE and Androgenetic Alopecia). You might identify with this piece: Channel4.com – Women Who Lose Their Hair.