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Telogen Effluvium

What Is It?

Symptoms

Diagnosis

Expected Duration

Prevention

Treatment

When To Call A Professional

Prognosis

Additional Info

What Is It?

At any given time, about 85% to 90% of the hairs on the average

person's head are actively growing (the anagen phase) and the others

are resting (the telogen phase). Typically, a hair is in the anagen

phase for two to four years, then enters the telogen phase, rests

for about two to four months, and then falls out and is replaced by

a new, growing hair. The average person naturally loses about 100

hairs a day.

In a person with telogen effluvium, some body change or shock pushes

more hairs into the telogen phase. Typically in this condition,

about 30% of the hairs stop growing and go into the resting phase

before falling out. So if you have telogen effluvium, you may lose

an average of 300 hairs a day instead of 100.

Telogen effluvium can be triggered by a number of different events,

including:

Surgery

Major physical trauma

Major psychological stress

High fever or severe infection

Extreme weight loss

Extreme change in diet

Abrupt hormonal changes, including those associated with childbirth

and menopause

Iron deficiency

Hypothyroidism or hyperthyroidism

A new medication

Because hairs that enter the telogen phase rest in place for two to

four months before falling out, you may not notice any Hair loss

until two to four months after the event that caused the problem.

Telogen effluvium rarely lasts longer than six months, although some

cases last longer.

Although losing a great number of hairs within a short time can be

frightening, the condition is usually temporary. Each hair that is

pushed prematurely into the telogen phase is replaced by a new,

growing hair, so there is no danger of complete baldness. Because

hair on the scalp grows slowly, your hair may feel or look thinner

than usual for a time, but fullness will return as the new hairs

grow in.

Symptoms

If you have telogen effluvium, you'll notice more hair than usual

accumulating on your pillowcase, on the shower or bathroom floor and

in your hairbrush. Your scalp hair may feel or look less dense than

usual. Often, though, the hair loss is subtle, and other people may

not notice anything different about your hair.

Diagnosis

Most cases of telogen effluvium can be diagnosed based on medical

history and an examination of the scalp and hair. If the hair loss

has been occurring for several months, there may be visible thinning

Patches, but often the hair loss is not dramatic enough for a doctor

to notice. If you have large bald Patches, you probably don't have

telogen effluvium. If the doctor gently tugs on some hairs on your

scalp and four or more hairs come out, you probably have telogen

effluvium. Also, the hairs will look like hairs in the telogen

phase - they will have a white bulb at the end that was in the

scalp, and will not have a gel-like covering around that end of the

hair.

You may be asked to gather all hairs that fall out of your head over

a 24-hour period, and count them to see if the hair loss is truly

excessive. Losing fewer than 100 hairs in a day is considered

normal. You also may be asked to gather and count lost hairs every

one or two weeks to see when the shedding starts to decline.

In some rare cases, if there is reason to doubt the diagnosis, a

biopsy of the scalp may be done. In this procedure, a small piece of

the scalp that includes several hair follicles is removed and

examined under a microscope. Your doctor also may do blood tests to

check for conditions such as thyroid abnormalities that may be

contributing to hair loss.

Expected Duration

Typically, hair loss begins two to four months after the event that

triggered the problem, and lasts approximately six months. New hairs

begin growing immediately after the hair falls out, but significant

growth may not be noticed for several months.

Prevention

Nothing can be done to prevent most of the types of physical shock

that can start telogen effluvium. Some cases may be caused by a poor

diet, and these might be prevented by eating a balanced diet that

provides enough Protein, Iron and other nutrients.

Treatment

No treatment for active telogen effluvium has been proven effective.

Some causes of the disorder can be corrected. For example, if you

have a poor diet, consult a dietitian to help you balance it. If the

hair loss began after you started a new medication, talk to your

doctor to see if the medication should be discontinued. Many times,

however, the cause is a specific event in the past, and you can

expect that the hair will grow back. In cases where Hair growth has

not returned to a satisfactory level, your doctor may prescribe

minoxidil (Rogaine), a lotion applied to the scalp that stimulates

hair growth in some people.

When To Call A Professional

See your doctor if you experience excessive hair loss or obvious

thinning patches on your scalp.

Prognosis

The outlook for telogen effluvium is very good. Most cases run their

course within six to nine months, and the hair usually grows back.

In some cases, the disorder may last longer. In other cases, not all

hairs grow back.

Additional Info

American Academy of Dermatology

P.O. Box 4014

Schaumburg, IL 60168-4014

Phone: (847) 330-0230

Toll-Free: (888) 462-3376

Fax: (847) 330-0050

http://www.aad.org/