Telogen Effluvium

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Telogen effluvium treatment in NYC

Surgery, chronic illness, and other stressors are hard enough for anyone to endure. But for some, these events cause physiological stress to hair follicles, causing a significant amount of hair loss. This condition is known as telogen effluvium (TE). It’s usually temporary, but this period of sustained hair loss can severely impact self-confidence, adding to an already taxing situation. Learn more about TE including what causes it and how to treat it. 

What Causes TE?

Telogen hair is in the part of the hair cycle in which hair growth stops. This phase is what causes everyday shedding, and it’s a normal part of the hair cycle. For people with TE, the follicles don’t revert back to the anagen stage in which new hairs grow in to replace telogen hairs. Most common reasons of TE include:

  • After pregnancy (postpartum)
  • After infectious diseases or fever, common after COVID-19
  • Chronic illnesses (often autoimmune conditions – lupus erythematosus, other connective tissue disease; endocrine conditions; other chronic conditions)
  • Severe stress
  • Medications (oral contraceptives, androgens, anticonvulsants, anti-hypertensive, anti-coagulants, retinoids are among most common ones.

How Does TE Present?

Excessive shedding is the most common TE symptom. People normally lose about 100 hairs per day. A person experiencing TE may lose an average of 300. Their hair is noticeably thinner, and they may see some bald patches develop. 

Will I Lose My Hair During TE?

People experiencing TE do experience significant hair loss, but it’s not common for them to lose all their hair. With this condition, hair loss usually lasts for four to six months, then the hair begins to regrow on its own. For some, though, the condition is chronic and their hair doesn’t grow back. 

Anyone with TE may notice excessive hair loss after they brush their hair or when they shower. Some people also have tender or itchy spots on their scalp. Reduced hair volume is another sign of TE. 

How Is TE Diagnosed?

There are many reasons a person may begin shedding hair excessively. To figure out the underlying cause, a doctor will typically do a gentle hair pull to see how many telogen hairs come out. Telogen hair contains a white bulb at the end with no hair sheath. 

If the hair pull is inconclusive, doctors may take a scalp biopsy or order a blood work test to rule out other causes of hair loss like alopecia areata and other autoimmune disorders. In some cases, patients may be asked to collect all hair shed over a period of 24 hours, so their doctor can assess the volume and condition of shed hair. 

A  trichoscopy, which is a non-invasive scalp exam, can also be used to diagnose TE. For this exam, a doctor uses specialized cameras to map and evaluate the patient’s scalp, assessing areas for excessive shedding. This system offers an accurate basis for follow-up comparison. 

How Is TE Treated?

In many cases, TE will reverse on its own, but there are ways to slow the shedding while the patient is waiting for their hair to grow back. It is essential to identify the reason for shedding and execute a realistic plan to eliminate it. For cases caused by nutritional deficiencies, changing the diet is usually enough to make the hair grow back. 

Patients experiencing TE should be gentle when washing their hair and avoid harsh hairstyles like tight ponytails and updos. In some cases, common hair loss treatments like minoxidil can help stimulate regrowth. Platelet-rich plasma injections (PRP) may also be successfully utilized. If a person’s TE is due to prolonged stress, they should implement calming techniques into their lifestyle to reduce the stress and reset their hair growth cycle. 

Why Choose Dermatology Circle?

Dermatology Circle offers a personalized approach to every client, based on their needs. A careful scalp exam with magnifying lenses (trichoscopy) is a must for every patient. Additionally, for patients with TE, Dr. Kazlouskaya usually offers extensive blood work to identify the reason for hair loss.  A scalp biopsy may be considered in some cases. When needed, the treatment is offered based on the results of a thorough workup.



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