Telogen Effluvium
Telogen effluvium is a common form of hair loss that occurs when a significant number of hair follicles prematurely enter the telogen (resting) phase of the hair growth cycle. This leads to excessive shedding of hair and noticeable thinning, typically a few months after a triggering event or stressor.
Hair Growth Cycle:
- Anagen Phase (Growth Phase): The active phase when hair is growing.
- Catagen Phase (Transitional Phase): A short phase where hair stops growing and detaches from its follicle.
- Telogen Phase (Resting Phase): Hair remains in the follicle but does not grow. After this phase, hair sheds and is replaced by new hair.
In telogen effluvium, a large number of hairs prematurely enter the telogen phase, resulting in hair shedding. Typically, 85-90% of hair is in the anagen phase, and 10-15% is in the telogen phase at any given time. In telogen effluvium, the percentage of hairs in the telogen phase can rise significantly, leading to noticeable shedding.
Causes and Triggers:
Telogen effluvium is often triggered by stressors or changes in the body that disrupt the normal hair growth cycle. Common causes include:
- Physical or Emotional Stress:
- Severe illness (e.g., fever, infection, surgery)
- Emotional stress or trauma (e.g., death, divorce, major life changes)
- Childbirth (postpartum telogen effluvium is common)
- Nutritional Deficiencies:
- Iron deficiency, protein deficiency, or other nutrient imbalances.
- Hormonal Changes:
- Pregnancy, menopause, or thyroid disorders can trigger telogen effluvium.
- Medications:
- Certain drugs, such as chemotherapy, anticoagulants, or antidepressants, can lead to hair shedding.
- Infections:
- Fungal or bacterial infections can sometimes cause telogen effluvium.
- Environmental Factors:
- Significant environmental changes like extreme heat or cold exposure, toxins, or pollution.
Symptoms:
- Hair Thinning: Noticeable thinning of hair, especially on the scalp.
- Excessive Shedding: An increase in hair loss during washing or brushing.
- Diffuse Pattern: Hair loss is often widespread and not localized to one area.
Diagnosis:
- Clinical Evaluation: Based on history and pattern of hair loss, and identification of recent stressors or changes in health.
- Pull Test: A test where a small amount of hair is gently pulled to check for increased shedding.
- Scalp Biopsy: In rare cases, a biopsy may be done to rule out other causes of hair loss.
- Blood Tests: To check for underlying causes like thyroid disorders or nutritional deficiencies.
Treatment:
- Addressing the Underlying Cause:
- If the trigger (e.g., stress, illness, or nutritional deficiency) can be identified and treated, the hair may begin to regrow on its own.
- Hair Growth Products:
- Minoxidil (Rogaine) may help stimulate hair regrowth, although results can vary.
- Nutritional Supplements:
- Iron, vitamin D, biotin, and other supplements may be recommended if deficiencies are identified.
- Stress Management:
- Stress reduction techniques such as meditation, exercise, or therapy may help in cases triggered by emotional stress.
Prognosis:
- Temporary: Telogen effluvium is usually temporary, and hair often begins to regrow within 6-12 months after the trigger is addressed.
- Recovery: In most cases, once the underlying cause is resolved, the hair returns to its normal growth cycle.
- Chronic Cases: In some individuals, telogen effluvium may persist for months or become a recurrent issue, especially if the underlying trigger is not managed.
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