Telogen Effluvium
- Best Results6 months+
- Treatment Recovery3-4 months
- Procedure TimeNA
- Skin SpecialistMedical dermatologist
- Duration of ResultsExcellent prognosis
- AnaestheticNA
- Back to WorkNA
- Cost$
Telogen Effluvium
Telogen effluvium is one of the most common causes of hair loss. It mainly affects. The most common association is childbirth. This condition is self-limiting and most patients will have normal hair density within 9 to 14 months, depending on the length of your hair. Treatments are rarely required.
FactsFacts on Telogen Effluvium
- Telogen refers to the resting or sleep cycle of your hair follicle
- Telogen effluvium refers to an aberration of the normal hair cycle
- This results in synchronized hair fall 3-6 months after a precipitating event
- Common triggers include pregnancy, stress, trauma & surgery
- Ceasing the OCP is another frequent cause of hair loss
- In some cases, TE may occur with other conditions such as androgenic alopecia
- Other causes of hair loss that mimic TE include anagen effluvium, drugs, autoimmune & thyroid dysfunction
- A medical dermatologist can diagnose & manage appropriately
- Majority of cases self-correct without intervention
What is Telogen Effluvium?
This is one of the most common causes of acute hair loss. It is due to shedding or dormant hairs (known as telogen hairs). Unlike most other forms of hair loss, telogen affects the scalp globally.
Other causes of diffuse hair loss include androgenetic alopecia & alopecia areata. Your dermatologist can tell the difference between these conditions based upon simple examination & examination of hair.
*Anagen effluvium, loose anagen, drug induced causes, endocrine & immune causes can mimic TE. Your medical dermatologist can investigate as required.
How does telogen effluvium present?
Patients become aware of losing hair in increased amounts, accompanied by decreased density & volume. This is most noticeable after washing or brushing. Some people will notice increased hair on the pillow in the morning or around the house. Most cases are asymptomatic, but occasionally telogen effluvium can be accompanied by tenderness and altered sensations in the scalp, known as trichodynia.
How is this diagnosed?
Telogen effluvium can be diagnosed with a history & a simple hair examination. Microscopy will reveal club hairs- which is the shape of the hair root. In contrast, anagen effluvium has a pointy tip.
A simple hair pull test conducted by your dermatologist can diagnose different types of effluvium. Do not wash or comb your hair for 36 hours preceding the appointment as this test may yield a false negative result.
Disclaimer: I am a procedural dermatologist. I do not treat hair loss medically. For a diagnosis & management plan, consult my colleagues at Clinic Cutis.
What are the common causes of telogen effluvium?
Common triggers of telogen effluvium include childbirth, trauma, significant stress, marked weight loss & extreme dieting, a severe skin problem affecting the scalp, a new medication or withdrawal of a hormone treatment. Not all cases of TE have a cause.
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What is the relationship between the oral contraceptive pill & hair loss?
Hair loss can occur when stopping the OCP or when switching from one pill to another. Hair loss caused by birth control pills is usually temporary. It should stop within a few months after your body gets used to the pill. Hair loss should also stop after you’ve been off of the pill for 3-6 months. (Just don’t get knocked up, otherwise you will have postpartum hair loss 3-6 months after childbirth).
The reasoning behind OCP and hair loss is a shift in hormone profile. Estrogen OCP tends to keep hair in (anagen cycle). Once estrogen drops, it promotes hairs to go into telogen resting phase (much like after childbirth). This results in telogen effluvium.
Another cause is a relative increase in androgens. OCPs such as Diane, Estelle, Juliet, Yaz, & Yasmin have anti androgens such as cyproterone acetate or drospirenone. Left unchecked hormones such as testosterone get converted into DHT (the hair destroying form of testosterone).
My advice: discuss with your GP, endocrinologist or dermatologists the timing of hormone withdrawal.
Will my hair return to normal?
Telogen effluvium usually resolves completely without any treatment, typically over 3 to 6 months.
Depending on the length of the hair, it may take many months for the overall hair volume & length to gradually return to normal. Remember, new hair will need to grow out to match the length. If you have long hair it may take 18 – 24 months for a match. Telogen effluvium can recur, especially if the underlying cause is not treated. Chronic telogen effluvium is hair fall lasting longer than 6 months. Refer below for understanding of CTE/ chronic telogen effluvium.
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😎Davin Lim
Dermatologist
Brisbane/Sydney🇦🇺
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😎Davin Lim
Dermatologist
Brisbane/Sydney🇦🇺
.
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#drdavinlim #davinlim #dermatoloigstsydney #brisbanedermatology
Can vitamins help with hair loss?
Yes, if you are deficient. Some cases of telogen effluvium may be related to low iron, folate, B12 & other deficiencies. Your medical dermatologist can request a blood test to check for these levels & manage you appropriately.
Simple hair supplements containing vitamins including biotin can be purchased from all pharmacies. Given the banal nature of vitamin supplements, taking them may make you feel better.
Can PRP help with recovery?
In theory yes, but it has not been proven with large studies. PRP, in theory, can add growth factors to accelerate hair growth for miniaturized hair follicles that occur in female pattern baldness. Telogen effluvium lacks these features however in some cases dual pathology can accelerate hair loss.
The decision to undertake PRP rests on the discussion you have with your medical dermatologist.
What is chronic telogen effluvium?
CTE or chronic telogen effluvium is due to a short growth cycle or anagen period. In this condition hair shedding continues to occur over many years. By definition CTE lasts longer than 6 months. The cause is not certain, & it mainly affects women with dense long hair. There are some reports that oral minoxidil can help reduce hair shedding.
What is the role of microneedling?
Recent papers have shown that early microneedling can markedly improve telogen effluvium as it reduces hair fall & stimulates new follicles to grow. Microneedling can also extend the anagen or growth phase of hair follicles.
Microneedling not only increases the hair density, but also increases the hair shaft diameter.
Who to see for a diagnosis?
A medical dermatologist can assist in the diagnosis of TE. They can investigate appropriately to rule out rare causes & conditions that may mimic TE.
Most perform an in-office hair pull test. This consists of gentle traction with the fingers (not actually ripping out your hairs!). These strands of hair are examined under the microscope or dermatoscope for club hairs (telogen hairs). It is important not to wash or brush your hair for the preceding 36 to 48 hours prior to your dermatologist visit as this may give a false negative result.
Disclaimer: I am a procedural dermatologist. I do not manage hair loss conditions such as telogen effluvium. Clinic Cutis has 3 hair loss, medical dermatologists. Please book an appointment with my colleagues.
Davin’s viewpoint on telogen effluvium
Dermatologists see a few cases a week. Diagnosis & management is straightforward in most cases. A normal adult loses up to 160 hairs a day as part of the normal hair cycle. Telogen effluvium occurs when there is an increase in the amount of hair in the telogen phase (resting phase). Normal hair growth has 10% in telogen, in TE, it increases to 30-50%.
There are many other causes that may resemble TE, including Chronic TE, female pattern hair loss/baldness (can occur with TE), anagen effluvium, LAS or loose anagen syndrome, endocrine causes including thyroid abnormalities, autoimmune disorders including lupus & dermatomyositis, as well as diffuse alopecia areata. Your dermatologist is well versed in these conditions and can investigate accordingly.
The vast majority of telogen effluvium will resolve within 6 months. Supportive care is appropriate. The role of microneedling & PRP is at the discretion of your treating specialist.
Disclaimer: I am a procedural dermatologist. I do not treat hair loss medically. For a diagnosis & management plan, consult my colleagues at Clinic Cutis.
