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Telogen Effluvium: Understanding, Causes, and Prevention

Telogen effluvium (T.E.) is a temporary hair loss condition that results from the interruption of the telogen phase in the hair growth cycle. Trigger factors can be extreme levels of stress and various other reasons. 

To find out if you’re suffering from this condition, understanding some key points can be an eyeopener: 

  • TELOGEN EFFLUVIUM CAUSES MORE HAIR TO SHRED. 
  • IT WILL TAKE 3 TO 6 MONTHS FOR THE HAIR TO REGROW.
  • TRLOGEN EFFLUVIUM IS TEMPORARY.
  • T.E. IS NOT CONTAGIOUS. 
  • HAIRS ON YOUR BODY AND EYEBROWS CAN BE SHED ALONG WITH THE ONES ON YOUR SCALP. 


Let’s take a more comprehensive look at telogen effluvium to explore its causes, symptoms, diagnosis, and
prevention methods.

What Is Telogen Effluvium?

Telogen effluvium (pronounced /ˈtɛlədʒən ɪˈfluviəm/) is a common type of temporary hair loss that can be caused by extreme physical or emotional stress, shock, or post-trauma. It interrupts the telogen (resting) phase of the normal hair growth cycle.

10-15% is a normal number for a healthy person’s hair follicles to be at the telogen phase. If this number goes up to 25% or more it means telogen effluvium is affecting the hair follicles.

But what does telogen effluvium really look like? While losing 100 strands of hair per day is normal, this disorder can cause up to 300 hairs or more

Is Telogen Effluvium An Autoimmune Disease?

Recent studies suggest that telogen effluvium can’t be categorized as an autoimmune disease, there is not much evidence.

T.E. is mostly associated with severe stress and trauma. However, Hashimoto’s thyroiditis, an autoimmune condition, might be related to telogen effluvium.

Is Telogen Effluvium Contagious?

No, telogen effluvium is not contagious. It’s also not hereditary. There’s no way someone can pass it on to you. It’s a way your body responds to severe stress.

Is Telogen Effluvium Permanent?

No, telogen effluvium is temporary and it can take 3 to 6 months for hair to regrow after experiencing this type of hair loss.

Even if it takes more than that, it will eventually grow back. However, keep in mind that in severe cases, it can progress into chronic telogen effluvium.

Is Telogen Effluvium Reversible?

Because it’s a temporary scalp disorder, it can be reversed. As for how to reverse telogen effluvium, the most essential thing you should do is go to a professional and find out if there are any underlying causes. 

As telogen effluvium is related to excessive stress and problems with hormone levels and nutrition, taking care of the underlying issues can help a lot in reversing it.

Does Telogen Effluvium Cause Miniaturization?

No, telogen effluvium is not a cause of hair miniaturization, which basically is a condition that makes the hair follicles shrink and cause thinning.

It’s normal to get confused about it because with telogen effluvium you can also experience thinning as a result of hairs falling out in large amounts. 

The Importance of Telogen on the Hair Cycle

Healthy hair goes through 4 essential phases which are respectively: anagen phase (growth), catagen phase (transition), telogen phase (resting), and exogen phase (shedding).

Telogen’s job is to keep the hair in its follicles so that it can rest and recover until the anagen phase starts again.

Protecting old hair, it gets rid of damaged ones. The telogen phase lays a strong foundation for new hair to hold on to.

So eventually, disturbance to the telogen stages of the hair cycle results in telogen effluvium. 

What Are the Symptoms of Telogen Effluvium?

Telogen effluvium symptoms usually are:

  • HAIR THINNING 
  • UNUSUAL HAIR SHEDDING
  • ITCHING
  • STINGING SENSATION
  • TENDERNESS
  • TINGLING
  • PAIN

 

While most don’t experience any skin-related issues, some may notice scalp pain with telogen effluvium.

Which Spots Does Telogen Effluvium Affect?

Telogen effluvium can affect all over the scalp including:

  • BACK OF THE HEAD
  • TEMPLES
  • CROWN
  • EYEBROWS
  • BODY HAIR

 

However, on top of the head is the most common area, while body and eyebrow hair loss is observed in severe cases. Still, it’s not likely for it to make only eyebrow or body hairs shed.

What Causes Telogen Effluvium?

Although it’s mostly triggered by physical and psychological stress, there can be various other causes of telogen effluvium. Among other common triggers are;

  • MAJOR SURGERIES
  • EXTREME WEIGHT LOSS
  • HORMONAL IMBALANCES (THYROID DISORDERS)
  • NUTRITIONAL ISSUES (ESPECIALLY IRON DEFICIENCY)
  • CHRONIC STRESS DUE TO PSYCHOLOGICAL DISORDERS (DEPRESSION, ANXIETY, ETC) 
  • CHILDBIRTH

Are There Different Causes for Males and Females?

Regardless of gender or age, anyone can experience this type of hair loss.

It’s worth mentioning that females are more commonly affected by it as rapid hormonal changes can cause telogen effluvium. T.E. is also expected during pregnancy.

Are There Medications That Cause Telogen Effluvium?

Although medications are not the sole cause of telogen effluvium, there are several medications that cause hair loss when combined with other numerous factors:

  • BLOOD THINNERS, 
  • BETA-BLOCKERS, 
  • ANTIDEPRESSANTS, 
  • ANTICONVULSANTS, 
  • HORMONAL MEDICATIONS (BIRTH CONTROL, HORMONE REPLACEMENTS, ETC),
  • RETINOIDS,
  • NONSTREROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)

How Long Does Telogen Effluvium Last?

Telogen effluvium usually lasts about 3 to 6 months until your hair starts growing again with the anagen phase. However, this applies to acute telogen effluvium, not the chronic type, a.k.a diffuse hair loss.

🖋️ Studies show that chronic shedding mostly affects middle-aged women.

Telogen Effluvium Diagnosis

You can either self diagnose or consult a dermatologist for your telogen effluvium diagnosis.

Although it’s fairly easy to detect, without a proper diagnosis, it can be hard to understand the cause of your hair loss in the first place. It can be confused with different types of hair loss types such as androgenetic alopecia, alopecia areata, or others. 

So, after you make sure the amount of hair you’re losing is not normal, consult a dermatologist to find out the underlying cause of the issue. 

Self Diagnose

Before consulting a health care provider, you can actually self-diagnose telogen effluvium by performing a hair pull test

Start by grabbing about 60 strands of your hair between your fingers and gently pull. If you’re seeing more than 6 strands coming out with their white root bulbs, you likely have telogen effluvium. 

Dermatologist - Professional Diagnosis

After doing a physical examination such as pulling tests, and getting information about your medical background, any recent triggering events, and your diet, your dermatologist can diagnose you with telogen effluvium without any medical test. 

It’s still possible to run some diagnostic tests for an accurate diagnosis.

  • Bloodwork
  • Scalp biopsy
  • Trichogram
  • Phototrichogram 

How to Prevent Telogen Effluvium

There are a couple of ways to prevent telogen effluvium. To prevent hair loss from telogen effluvium, taking care of your health is essential. 

Keep in mind that there’s always a possibility to experience this, regardless of how much you pay attention. Still, you can take precautions by;

  • AVOIDING STRESSFUL SITUATIONS
  • HAVING A BALANCED DIET 
  • SUFFICIENT SLEEP
  • STAYING AWAY FROM CRASH DIETS
  • EXERCISING REGULARLY
  • PRACTICING PROPER POSTPARTUM CARE
  • TAKING VITAMINS
  • NOT OVER-STYLING YOUR HAIR
  • NOT USING HARSH CHEMICAL PRODUCTS ON YOUR HAIR

How to Take Care of Your Hair If You Have Telogen Effluvium

If you are diagnosed with Telogen Effluvium, taking care of your hair will be essential for your hair health. 

Hairstyles and the products you use need to be chosen carefully. Let’s see what you need to be careful about.

Can I Dye My Hair With Telogen Effluvium?

Dyeing your hair won’t have a negative effect on telogen effluvium. However, as thinning happens due to TE-related hair loss, bleaching or dyeing the hair can cause breakage and snapping since it damages hair excessively. 

What Hairstyles Should I Do For Telogen Effluvium?

It’s suggested that loose hairstyles are the best to not cause further shedding. Hairstyles you can do if you have telogen effluvium are wearing your hair down or loose with hair clips. 

Hairstyles that can lead to hair loss should be avoided. You can also consider using volumizing hair products to create a fuller effect. 

Should I Cut My Hair If I Have Telogen Effluvium?

No, cutting your hair does not strengthen your hair or hair follicles. 

Some patients might have the idea that if they were to cut their hair, their condition would get better but this is just a myth.  The decision is really up to you.

Telogen Effluvium Treatment

There are various available treatments for telogen effluvium, including:

  • TOPICAL/SYSTEMATIC CORTICOSTEROIDS
  • MINOXIDIL
  • FINASTERIDE
  • CNPDA 
  • PROPER VITAMIN/IRON/FOLIC ACID SUPPLEMENTS 

 

To treat telogen effluvium, the first step is finding and addressing the cause. Once the cause is identified, follow your doctor’s guidance for appropriate treatment. 

During this time, it’s advisable to avoid catagen-inducing drugs that can make hair loss worse. 

As a treatment for chronic telogen effluvium, professionals usually advise using corticosteroids. Corticosteroids should be used under a doctor’s supervision. Otherwise, misuse or using them for too long can cause more serious problems. 

Is It Necessary to Do Any Treatment with Telogen Effluvium?

Most of the time, treatment is not really necessary since telogen effluvium goes away by itself after the underlying reason is addressed. It may seem like telogen effluvium is still going on as it may take a while for the hair to grow back, but don’t worry.

If the underlying cause has been addressed, the hair will grow back in 6-8 months.

Do Weight Loss Cause Telogen Effluvium?

Yes, telogen effluvium can occur because of sudden or extreme weight loss. Well, losing weight too fast can lead you to face multiple complications such as nutritional deficiencies, hormonal imbalances, and physiological stress which are actually some causes of T.E. happening in the first place. 

Does Nutrition Deficiency Lead to Telogen Effluvium?

Yes, telogen effluvium can be triggered by especially iron deficiency. According to a study, another kind that is causing most women to experience telogen effluvium is the deficiency of vitamin D. They also suggested that low levels of mainly vitamin D3 can be related to it. 

References: 

[1] Hughes EC, Saleh D. Telogen Effluvium. PubMed. Published 2023. Accessed August 16, 2023. 

[2] Asghar F, Shamim N, Farooque U, Sheikh H, Aqeel R. Telogen Effluvium: A Review of the Literature. Cureus. 2020;12(5). doi:https://doi.org/10.7759/cureus.8320

[3] Nguyen B, Hu JK, Tosti A. Eyebrow and Eyelash Alopecia: A Clinical Review. American Journal of Clinical Dermatology. Published online October 2, 2022. doi:https://doi.org/10.1007/s40257-022-00729-5

[4] Whiting DA. CHRONIC TELOGEN EFFLUVIUM. Dermatologic Clinics. 1996;14(4):723-731. doi:https://doi.org/10.1016/s0733-8635(05)70398-3

[5] Turkan TA, Al-Rawi JR. Vitamin D level and telogen hair loss: A Case control study. Journal of the Faculty of Medicine Baghdad. 2021;63(3). doi:https://doi.org/10.32007/jfacmedbagdad.6331846