Everything To Know about Telogen Effluvium

Telogen effluvium is a common condition that causes hair to shed rapidly and eventually regrow. This hair loss occurs in response to emotional or physical stress, certain medications, hormonal changes, and underlying health conditions.

While rapid hair loss with telogen effluvium can be distressing, it's important to remember that the hair loss is rarely permanent, and treatments can help regrow your hair effectively.

Types of Telogen Effluvium

Healthcare providers categorize telogen effluvium based on the length of your symptoms. There are two main types: acute (short-term) and chronic (long-term).

Acute Telogen Effluvium

In acute telogen effluvium, hair shedding lasts less than six months. Triggers like stress, medications, or an illness can cause your hair to shed. Symptoms typically occur two to three months after exposure to a trigger. The hair loss is usually temporary, growing back in about 95% of cases.

Chronic Telogen Effluvium

In chronic telogen effluvium, symptoms last longer than six months. There is a rapid onset of hair loss, causing people to lose clumps of hair, usually on the sides of the scalp. Chronic telogen effluvium can often cause more permanent damage to your hair, requiring more extensive treatment. While anyone can develop a chronic case, it's more common in people assigned female at birth.

Telogen Effluvium Symptoms 

Unlike other types of hair loss, telogen effluvium is usually temporary and doesn't permanently affect your hair thickness or hairline. Telogen effluvium won't cause a rash, scaliness, or other skin-related symptoms.

If you develop telogen effluvium, you may experience these symptoms:

• Rapid hair loss that comes out in clumps or after using a brush or comb
• Hair thinning on the scalp
• Loss of hair volume
• Dry or brittle hair that falls out easily
• Temporary bald spots
• Scalp pain or sensitivity

In rare cases, you may also lose pubic, arm, leg, armpit, and eyebrow hair. In the case of acute telogen effluvium, hair loss will slow down, and hair will eventually grow back.

Why Does It Happen?

Hair follicles go through three stages, and hair shedding is a normal part of that process. Hair grows in the anagen phase, stays at rest in the catagen phase, and eventually sheds in the telogen phase. Telogen effluvium occurs when hair follicles abruptly shift to the telogen phase, causing an increase in hair shedding.

This abrupt shift in the hair follicles is your body's response to emotional or physical stress, certain medications, and health conditions. Common triggers of telogen effluvium include:

• Emotional distress or traumatic events
• High fever
• Hemorrhage or internal bleeding
• Surgery
• Severe infection or illness
• Hormonal changes after giving birth
• Hypothyroidism (underactive thyroid)
• Changing birth control or stopping estrogen therapy
• Lack of protein, zinc, vitamin, or iron in the diet
• Certain medications, such as beta-blockers, retinoids (vitamin A), anticoagulants, or antidepressants
• Chronic conditions, including liver failure, HIV/AIDS, and syphilis
• Autoimmune skin diseases, such as seborrheic dermatitis and psoriasis

Risk Factors

Anyone can develop telogen effluvium, and people of all ages are equally susceptible. However, this condition is more prevalent among people born female because it can occur due to changes in levels of the hormone estrogen.

The Diagnostic Process

If you're rapidly losing your hair, you may want to see a healthcare provider for a diagnosis. Your provider may ask about your medical history, lifestyle changes, and recent illnesses or medications. They will also try to rule out other potential causes of hair loss, such as alopecia (hair loss due to autoimmune disorders) or anagen effluvium (a rare disorder that affects the anagen hair follicles).

Your provider may order the following tests to learn more about the cause of your symptoms:

• Hair pull test: Gently pulling on hair to see how easily it comes out
• Blood test: Analyzing cell count, electrolytes, proteins, vitamin levels, and other signs of chronic diseases
• Biopsy: Collecting small samples of scalp skin or fallen hair follicles to confirm a diagnosis
• Phototrichogram: Taking pictures of your hair and scalp on different days to assess hair growth
• Videodermoscopy: Using a specialized video microscope to see signs of anagen hair regrowth after telogen effluvium

Telogen Effluvium Treatment

Telogen effluvium is temporary in most cases, resolving on its own. Managing triggers and taking certain medications can help stimulate hair regrowth and reduce shedding.

Managing Triggers

For acute telogen effluvium, treatments involve identifying your trigger and managing it. This may mean:

• Changing your medication or adjusting the dosage
• Taking zinc, iron, or other vitamin supplements to improve nutritional deficiencies
• Trying Synthroid (levothyroxine) to treat hypothyroidism
• Treating underlying illnesses or infections
• Managing stress through healthy coping mechanisms or therapy

Medications

Chronic cases of telogen effluvium may benefit from medications. If your hair is not growing back as fast as you'd like, your dermatologist (a doctor specializing in skin, hair, and nail conditions) may prescribe medications to stimulate hair growth.

Medications may be topical (applied directly to the skin) or oral (taken by mouth). Your provider may recommend Rogaine (minoxidil), an FDA-approved medication for hair loss. Topical corticosteroids, such as Ala-Cort (hydrocortisone) or Clobevate (clobetasol), can also help.

How To Prevent Telogen Effluvium

There's no surefire way to prevent telogen effluvium. However, certain lifestyle changes can help you avoid triggers and support hair regrowth. These include:

• Eating a nutritious diet rich in fruits, vegetables, and proteins to prevent nutritional deficiencies
• Getting 7-9 hours of sleep per night
• Practicing good hair care, such as combing your hair gently and avoiding heat tools
• Managing stress through strategies like meditation, yoga, or spending time with loved ones

Complications

Telogen effluvium is a self-limiting condition—meaning it doesn't cause permanent changes to your hair or put your health in danger. That said, rapid hair loss can often cause changes in your mental health, leading to complications like:

• Anxiety: Rapid hair loss can cause excessive worry, irrational fear, or insecurity, which can also trigger more hair loss
• Depression: Losing your hair may cause sadness or low self-image, increasing the risk of depressive moods

Help is available if you're experiencing mental health changes after losing your hair. Leaning on your loved ones and asking for their emotional support is a good first step. When you're ready, talking to a therapist can also help you learn coping strategies.

A Quick Review

Telogen effluvium causes temporary hair loss, usually due to a physical or emotional stressor, such as trauma, infection, or certain medications. The hair loss can often be rapid, but in acute cases, the hair will grow back. Treatments such as topical and oral medications may be necessary for chronic cases.

While it's not always possible to prevent telogen effluvium, managing triggers can help reduce your risk of experiencing a similar hair loss episode in the future.