Telogen effluvium is a common condition that causes temporary hair loss anywhere on your body, but it usually affects your scalp. Its causes usually include a stressor or change to your body.
The condition usually affects women over 40 years of age who complain of diffuse alopecia and may be misdiagnosed as having telogen effluvium, and has also been designated 'alopecia areata incognita' (yet another synonymous designation for the same condition proposed by Rebora [30] in 1987).
Scalp biopsy is the most useful test to confirm the diagnosis, but it is seldom necessary if gentle hair pull produces numerous telogen hairs. A white bulb and no gelatinous hair sheath can identify telogen hair. If a patient is unwilling to allow a scalp biopsy, serial hair collections can be obtained.
With telogen effluvium, it is common for hair to grow back within 3–6 months after managing the cause.
Telogen effluvium can be acute or chronic. If there is some "shock to the system", as many as 70% of the scalp hairs are then shed in large numbers about 2 months after the "shock". This sudden increase in hair loss, usually described as the hair coming out in handfuls, is acute telogen effluvium.
Most people who are healthy lose up to 100 strands of hair per day. If you have telogen effluvium, you may lose up to 300 strands of hair per day. Telogen effluvium may affect the hair all over your scalp, but it most commonly appears on the top of your head rather than the back or sides of your head.
Most cases of Telogen Effluvium hair loss see significant improvement over the course of 6 to 9 months. Patients suffering from Androgenetic Alopecia hair loss, on the other hand, will usually see a worsening of hair density over a period of 12 months.
There is normally no treatment required for telogen effluvium as the hair will start growing back once the trigger is removed. Medication does not speed up this process. A blood test may be suggested to rule out other causes of hair loss such as over- or underactive thyroid and iron deficiency.
During the telogen phase, hairs are meant to naturally fall out to allow new anagen (growth) hairs to replace them. However, with telogen effluvium, this shedding becomes excessive, often diffusely spread across the entire scalp rather than concentrated areas.
An episode of telogen effluvium can be dramatic, with hair falling out in handfuls, overall thinning, and an increased scalp show. Thinning of eyebrows and pubic hair is also a frequent feature and is generally seen to recover faster than the scalp.
Signs of telogen effluvium include seeing more hair than usual on your pillow, in the shower, or in your hairbrush. Your hair may appear thinner, though the hair loss is often subtle, and others may not notice the change.
Some people with telogen effluvium develop a form of telogen effluvium that actually leads to shedding of shorter hairs. It's an uncommon mechanism but it does occur! It's called a short anagen syndrome like mechanism. A common example is people who develop shedding with use of medications known as retinoids.
A hair pull test can determine how active your hair loss can be. 6 or more strands may possibly indicate hair loss disorders such as telogen effluvium (most common), early patterned hair loss, Chronic TE, loose anagen syndrome, & anagen effluvium.
How do dermatologists diagnose telogen effluvium? DeLuca: TE is usually diagnosed based on history and physical exam. Sometimes, when the cause of TE is not readily identifiable, or if hair loss has persisted beyond six months, we may perform blood tests and a scalp biopsy to rule out other causes.
Severe and prolonged hypothyroidism and hyperthyroidism can cause loss of hair. The loss is diffuse and involves the entire scalp rather than discrete areas. The hair appears uniformly sparse.
Rheumatoid arthritis (RA), similar to other autoimmune systemic conditions, can cause telogen effluvium presenting as diffuse non-scarring alopecia [2, 52]. Furthermore, an association between AA and RA was reported in some studies [2].
The good news is that Telogen Effluvium is often a temporary condition, and hair growth typically resumes within 6 to 12 months once the underlying trigger has been addressed.
Androgenetic alopecia (AGA), telogen effluvium (TE) are two common types of hair loss. Studies show that supplementing the diet with low levels of vitamin D can improve symptoms of these diseases. If a patient with AGA or TE has low iron levels (more commonly seen in females), supplementation is also recommended.
No Visible Pattern. With stress-related shedding, hair falls out evenly all over your scalp instead of in a defined pattern. You'll likely notice more hairs than usual coming out while shampooing, combing, or on your pillow, clothing, and bathroom floor.
According to the panelists, minoxidil has a place in TE management, since it is a vasodilator that positively influences anagen phase of the hair cycle. However, it is never recommended for patients with active TE, but can be prescribed for chronic TE.
However, telogen effluvium most often causes thinning at the top of the scalp. Thus, a widening part is one of the major telogen effluvium symptoms. People with telogen effluvium generally do not lose all their hair, but hair loss can be noticeable in more severe cases.
If iron deficiency is the only reason for your hair loss, you should start seeing improvements within a few months of taking iron supplements. Typically, it takes about 3 to 6 months to see noticeable changes, as hair growth is a gradual process.
Telogen effluvium is self-correcting. Recommendations include: Gentle handling of the hair, avoiding over-vigorous combing, brushing and any type of scalp massage. Treat any underlying scalp disorder or hormonal problem determined, if any.