Telogen Effluvium
Telogen Effluvium | Causes, Symptoms, and Treatment Options
A common form of temporary hair loss, telogen effluvium is often triggered by severe stress or other changes to the body. It occurs when a significant number of hair follicles prematurely enter the resting phase (telogen) of the hair growth cycle. This condition often results in noticeable thinning or hair shedding. It is typically triggered by a variety of factors, such as stress, hormonal changes, nutritional deficiencies, illness, or medication use. While it is generally a temporary condition, it can have a significant impact on appearance and self-confidence. Understanding the causes and symptoms can help address the underlying triggers and determine treatment options to promote hair regrowth.
What is Telogen Effluvium
Telogen effluvium is a form of temporary hair loss that is characterized by excessive hair shedding. Unlike some other forms of hair loss, telogen effluvium is typically reversible once the underlying cause has been addressed. It occurs when a significant number of hair follicles suddenly shift from the growth phase (anagen) into the resting phase (telogen). This results in a sudden and excessive loss of hair. Various factors can be triggers, including physical or emotional stress, illness, major surgery, hormonal changes, medications, or nutritional deficiencies. Hair loss will often become noticeable a few months after the triggering event, during daily activities like washing or brushing hair. While telogen effluvium can be stressful, it is often resolved once the underlying cause has been resolved. The affected hair follicles will then return to the normal growth cycle and the shedding will stop.
Causes of Telogen Effluvium
Telogen effluvium is a condition where an excessive number of hair follicles prematurely enter the resting (telogen) phase of the hair cycle. This leads to noticeable hair shedding and thinning. While this hair loss is typically temporary, the underlying causes can vary. Understanding what triggers telogen effluvium can help to manage the condition and promote regrowth.
Physical or Emotional Stress
- One of the most common triggers is stress, both physical and emotional. Events like surgery, severe illness, or trauma can shock the body, leading to an imbalance in the hair growth cycle. Similarly, emotional stress like anxiety, depression, or personal loss can cause hair follicles to prematurely enter the telogen phase. This stress-induced hair loss often occurs several months after the triggering event, making it difficult to pinpoint the exact cause. Although the hair loss is usually temporary, ongoing stress can further prolong the condition. Managing stress is crucial to prevent further shedding and hair loss.
Hormonal Changes
- Another major cause is hormonal fluctuations, particularly in women. Pregnancy, childbirth, menopause, and birth control can all lead to hormonal shifts that disrupt the natural hair cycle. Postpartum hair loss is a common example of telogen effluvium. Many women experience significant hair shedding a few months after giving birth due to the sudden drop in estrogen levels. Similarly, menopause can cause hormonal imbalances that trigger hair loss. Hormonal changes in both men and women can alter the proportion of hair follicles in the active (anagen) growth phase. This imbalance results in increased shedding and thinning.
Nutritional Deficiencies
- A lack of essential nutrients can significantly impact hair health and lead to temporary hair loss. Deficiencies in iron, vitamin D, vitamin B12, and other key nutrients necessary for hair growth can disrupt the hair cycle. Iron deficiency is known to lead to telogen effluvium, as low iron levels impair oxygen delivery to hair follicles, stalling hair production. Crash diets, restrictive eating, or eating disorders can also deprive the body of the necessary nutrients to support healthy hair growth.
Medications
- Certain medications, particularly those that effect the hormonal balance or metabolic processes can also trigger telogen effluvium. Some of the most common medications are chemotherapy drugs, antidepressants, anticoagulants (blood thinners), beta-blockers, and high-dose vitamin A supplements. The hair shedding caused by these drugs will typically occur a few months after starting the medication. It will generally subside once the medication is discontinued or the does is adjusted. It’s important to talk to a doctor before many any changes to prescribed medications.
Illness or Medical Conditions
- Medical conditions, especially those that affect the immune system or cause inflammation, can lead to telogen effluvium. Thyroid disorders (hyperthyroidism and hypothyroidism), autoimmune diseases (lupus) and chronic illnesses can disrupt the normal hair growth cycle. Infections, like a severe fever or flu, can also cause hair loss. Often, shedding occurs a few months after the illness has passed as the hair follicles react to the stress of the condition. Managing the underlying health issue is crucial to resolve the hair loss associated with these conditions.
Major Surgery or Physical Trauma
- Undergoing surgery, particularly if it involves significant blood loss or a lengthy recovery period, can place additional stress on the body. Hair follicles will react to stress and the normal hair growth cycle will become disrupted, leading to excessive hair shedding. Even minor surgery, if accompanied by prolonged bed rest or anesthesia, can sometimes trigger telogen effluvium. Physical trauma, like a car accident, burn, or other injury that requires intensive medical care, can also be a cause. Hair loss associated with these events typically occurs 3 – 6 months after the trauma and can last several months before hair regrowth beings. While recovering, your body will divert resources from non-essential functions, including hair production. Once your body has recovered from the trauma, it can reallocate resources back to hair growth.
Environmental Factors
- Environmental factors, like exposure to toxins, pollutants, or other harsh chemicals can play a role in triggering telogen effluvium. Exposure to these toxins can weaken hair follicles and disrupt the hair growth cycle. Hair treatments, such as chemical relaxers, dyes, and perms can also damage the hair and scalp. While environmental factors might not always be a direct cause of telogen effluvium, they can contribute to weakened hair. This increases the risk of shedding triggered by other causes.
Symptoms of Telogen Effluvium
The main symptom of telogen effluvium is excessive hair shedding or hair loss. This is often most noticeable during daily activities like washing or brushing.
Excessive Hair Shedding
- The main symptom of telogen effluvium is an increase in hair shedding. This is most visible during brushing or washing, as large clumps of hair may fall out or accumulate in the shower drain. The hair loss will be significantly more than normal, and often in small, non-patchy amounts. In contrast to male pattern baldness, the shedding will be diffuse and will affect the entire scalp rather than a single area. This leads to overall thinning of the hair, while the scalp remains fully covered, without any bald patches.
Thinning of Hair
- As hair follicles prematurely enter the telogen (resting) phase and stop producing hair, the scalp will begin to appear thinner. There will not be any large bald spots, but the overall thickness and appearance will be less dense. The thinning is often more noticeable on the crown where the hair is typically finer and shorter. The hair loss from telogen effluvium will lead to a general appearance of less volume and fullness. The thinning is often temporary, and hair regrowth typically begins once the underlying issue is resolved.
Slower Hair Regrowth
- While hair shedding often occurs rapidly, the regrowth phase takes time and happens slowly. After the triggering event is resolved it may take several months for hair to return to the normal growth cycle. This delay can vary depending on the severity of telogen effluvium. Even after the shedding stops, the hair may still appear thin and sparse while the hair regrows. This slow and prolonged regrowth period can be frustrating.
Noticeable Shedding After Stressful Events
- Telogen effluvium is often triggered by significant physical or emotional stress, with hair loss occurring 2-3 months after. The time lag between the event and hair loss can often make it difficult to associate the hair loss with the stressor. Once the stressor event has occurred, your body will begin to return to normal, and hair regrowth will continue.
Increased Shedding After Illness or Surgery
- Telogen effluvium often happens after significant illness, surgery, or physical trauma. 2-3 months after a major health event or recovery, there may be excessive hair loss. This is due to the body’s stress response to illness or surgery. Your body will cause the hair follicles to prematurely enter the telogen phase, leading to hair thinning and shedding. This shedding is temporary, and hair growth will return once the body has fully healed.
Absence of Bald Spots
- Unlike other forms of hair loss, like androgenetic alopecia (male pattern baldness), telogen effluvium does not typically cause bald spots. Instead, hair loss occurs evenly across the scalp, leading to general thinning. The absence of bald spots is one of the defining characteristics of telogen effluvium. In extreme cases, the scalp may become more visible due to thinning, but the overall pattern is uniform rather than patchy.
Treatment Options for Telogen Effluvium
Telogen effluvium is usually a temporary condition, but the change in appearance can impact self-confidence. In most cases, treatment is not needed to restore hair growth, as addressing the underlying cause is sufficient to return to the normal growth cycle. Even though treatment is not needed, there are several treatment options that can help speed up recovery, reduce shedding, and improve overall hair health.
Addressing the Underlying Cause
- The most important step in treating telogen effluvium is identifying and addressing the underlying cause. If stress is the trigger, focus on managing stress through relaxation techniques, counselling, or lifestyle changes to reduce further shedding. If nutritional deficiencies are the cause, then supplementing vitamins, like iron, vitamin D and B12, can help improve hair health. For situations where it is caused by illness, or surgery, treating the primary condition can help to restore the normal hair growth cycle. Once the underlying cause is treated, hair shedding will usually slow down and normal hair growth will resume.
Nutritional Supplements
- If telogen effluvium is linked to nutritional deficiencies, taking the proper supplements can help with recovery. Common deficiencies that can contribute to hair shedding are iron, vitamin D, biotin, and zinc. Supplementing these nutrients can help restore the body’s ability to support healthy hair growth. Iron supplements are particularly important for those with anemia, which is a common cause of telogen effluvium. Vitamin D and biotin are also vital for maintaining healthy hair follicles. Prior to taking any supplements, it’s important to consult with a doctor to confirm which nutrients are deficient. Taking an excessive amount of a supplement can have adverse effects.
Minoxidil
- Minoxidil is an over-the-counter topical treatment that is used to help stimulate hair growth. While it is most common for androgenetic alopecia, it can be beneficial for treating telogen effluvium. Minoxidil helps to promote the transition of hair follicles back to the anagen (growth) phase. It works by improving blood flow to the scalp and revitalizing shrunken hair follicles, leading to hair regrowth. It’s available in both liquid and foam forms and is applied directly to the scalp. Minoxidil can be used to help treat telogen effluvium, but the underlying cause must also be addressed.
Stress Management Techniques
- Since emotional and physical stress are some of the most common triggers, managing stress is a critical part of treatment. Techniques like meditation, yoga, deep breathing exercises, and regular physical activity can help reduce stress levels and promote overall well-being. Counseling or therapy may also be beneficial for those dealing with anxiety, depression, or other emotional issues. Reducing the body’s stress response can help stop excessive shedding caused by telogen effluvium and support healthy hair regrowth.
Hair Growth Shampoos and Conditioners
- While shampoos and conditioners won’t cure telogen effluvium, they can help nourish the scalp, strengthen hair, and reduce hair breakage. Products containing biotin, keratin, caffeine, or other hair-strengthening ingredients can create a healthier environment for hair to grow. Some shampoos and conditioners are designed to focus on soothing the scalp and improving circulation. While these products won’t directly address the root cause of telogen effluvium, they can support overall hair health. Used in combination with other treatments like minoxidil and nutritional supplements, they can help speed up hair regrowth.
Corticosteroids (In Severe Cases)
- In rare cases, if telogen effluvium is associated with a severe inflammatory response or autoimmune reaction, corticosteroids may be prescribed. These medications can be taken orally or topically and help to reduce inflammation. Corticosteroids are generally only used in severe cases where hair loss is prolonged, or resistant to other forms of treatment. Using corticosteroids can have side effects, and their use should be closely monitored by a healthcare professional. Typically, corticosteroids are not the first treatment to be used and are only considered after other options have been explored.
Platelet-Rich Plasma (PRP) Therapy
- PRP therapy is believed to promote hair regrowth by stimulating the hair follicles and improving scalp circulation. It involves drawing a small amount blood, processing it to concentrate the platelets, and then injecting the platelet-rich plasma into the scalp. While PRP is not typically used as the first treatment for telogen effluvium, some studies suggest it can encourage hair regrowth in those with persistent or severe shedding. It is usually reserved for those who have not responded well to other treatments.
Patience and Time
- Sometimes, the best treatment for telogen effluvium is simply giving it time. The condition is often triggered by temporary factors such as stress, illness, or hormonal changes. Once the underlying issue is addressed, the hair loss will stop, and regrowth will start. Most will see hair regrowth within 6-12 months of stopping excessive shedding, though results may vary depending on the severity. While waiting for hair growth to begin, steps can be taken to maintain scalp health and minimize stress. Patience is critical with telogen effluvium, as the regrowth process can be slow.
FAQ
What is telogen effluvium?
Telogen effluvium is a temporary form of hair loss that occurs when a large number of hair follicles enter the resting (telogen) phase of the hair growth cycle prematurely. This results in excessive hair shedding, often triggered by stress, illness, hormonal changes, or certain medications.
What causes telogen effluvium?
Common causes of telogen effluvium include physical or emotional stress, surgery, childbirth, nutritional deficiencies, rapid weight loss, or illnesses like severe infections. The condition may also be triggered by hormonal changes, such as those associated with thyroid disorders or menopause.
How is telogen effluvium different from other types of hair loss?
Unlike androgenetic alopecia (pattern hair loss), which is progressive and often permanent, telogen effluvium is usually temporary. Hair loss in telogen effluvium is diffuse, meaning it occurs evenly across the scalp rather than in specific areas.
How long does telogen effluvium last?
Telogen effluvium typically lasts 3-6 months, with shedding peaking a few months after the triggering event. In most cases, hair regrowth begins once the underlying cause is addressed, and full recovery may take 6-12 months.
Can telogen effluvium be treated?
While there is no specific treatment for telogen effluvium, addressing the underlying cause—such as managing stress, improving diet, or treating an illness—can help reverse the condition. Gentle hair care, nutritional support, and patience are key to allowing the hair cycle to normalize and regrowth to occur.
Conclusion
Telogen effluvium can be stressful due to excessive hair shedding, but it is often temporary and reversible. Identifying the underlying causes and addressing them will result in reducing your body’s response to the trigger. This allows the hair follicles to enter the anagen phase and return to the normal growth cycle. While there are treatments that can help speed up the recovery, it takes time to regrow your hair after telogen effluvium.
Want to Learn More?
View the latest scientific paper on Telogen Effluvium from the National Library of Medicine.
