Fully Exposed

Is Your Hair Falling Out?

Posted on: September 24, 2014

Telogen Effluvium Hair Loss

The average individual has about 100,000 hairs on their head. Hairs do not grow continuously, they grow in cycles. At any given moment, about 90% of the hairs are growing while the other 10% of the hair follicles are dormant and have no hair growing from them. An individual hair will grow for approximately 3 years (anagen phase) and then enter a resting state (telogen phase) for about 2 - 3 months. During this resting phase, that particular hair follicle has no hair growing from it.

Under certain conditions, more hairs enter the resting state (telogen phase) and an increased shedding of hair, or an "effluvium" is experienced (hence the name for this condition, telogen effluvium.) Patients  complain of a sudden increase in hair loss, finding hair on their pillow, on their shoulders, and in the drain when showering. The hair loss is usually diffuse, involving most of the scalp. Complete balding is not seen.  The exact cause of telogen effluvium is not known but one of the most common triggers for this condition is the hormonal changes seen at the end of pregnancy.

Some estimate that telogen effluvium occurs in up to 50% of women after giving birth with the majority of women noticing the hair loss between 8 - 16 weeks after delivery. Fortunatley, this type of hair loss is temporary for most, with hair loss lasting for 4 - 6 months before the hairs start to regrow, returning to normal in approximately 8 - 12 months.

Because telogen effluvium hair loss is a reactive process and usually resolves on its own, reassurance is the best treatment. There is no known cure for telogen effluvium but for those eager to try something, over-the-counter minoxidil may be of some benefit and is well tolerated by most patients.

There are many causes of telogen effluvium and hair loss in general. If hair loss persists or is associated with other symptoms, medical attention should be sought to rule out any underlying cause. Other etiologies of telogen effluvium, besides pregnancy, include:

  • As a result of major surgery
  • Severe trauma, physical or emotional
  • Acute illness including infections or other febrile illness
  • Chronic illness like malignancy, kidney or liver disease
  • Hypothyroidism
  • Medications (especially hormonal therapies)


Posted on: September 02, 2014

Stretch marks (striae distensae) are pink, red or purple indented streaks that most commonly appear on the abdomen, breasts, upper arms, buttocks, and thighs. They are not a significant medical problem but can cause emotional distress in those affected. Although they eventually fade to a white or gray color, it is rare that they completely dissappear. 

Stretch marks are caused by a continuous stretching of the skin placing increased stress on the underlying connective tissue. Research published in the Journal of Investigative Dermatology shows that genetic predisposition increases the odds of getting stretch marks by 40%. Anyone can develop stretch marks, however, they are more prevalent in women than men. They are most commonly associated with:

  • Pregnancy: a combination of skin stretching and hormonal factors induce stretch marks in most pregnant women. 
  • Weight gain: individuals who experience substantial weight gain, adolescents, especially during growths spurts, and weight lifters who rapidly increase their musculature can all develop stretch marks.
  • Medication: chronic use of both oral and topical corticosteroids can induce stretch marks.
  • Diseases: stretch marks may be a result of certain conditions that involve abnormal corticosteroid levels (Cushing's Syndrome and other adrenal gland diseases) and certain genetic conditions that weaken elastic tissue (Marfan's Syndrome or Ehlers-Danlos Syndrome.)

Stretch marks are mostly a cosmetic concern as the majority of them fade over time.  Various creams, lotions and therapy options exist but none have proven to be more beneficial than any other, and, little scientific data exists proving 100% efficacy for any of them.

Prescription Vitamin A derivitives, like tretinoin cream, may improve the appearance of stretch marks that are relatively new (less than a few months old) but it is not recommended for pregnant or nursing women. Tretinoin cream can be irritating and has not been shown to be effective for older stretch marks.    

Several laser therapies are used to help rebuild the underlying collagen and elastin, but again, few are 100% effective and treatments are often very costly.

Microdermabrasion is used to gently remove the top layers of skin with the hopes of stimulating underlying collagen formation. Again, little scientific evidence exists showing efficacy of this treatment modality.

Creams that contain Vitamin E, fruit acids, olive oil, botanicals, and other extracts are often touted as stretch mark treatments. Although these products will not likely cause any harm, there is little science-based research showing that these products are effective

The best treatment (although still not perfect) for stretch marks is prevention. Maintain a constant healthy weight. During pregnancy, moisturize the skin twice a day to maintain adequate skin hydration, optimizing skin elasticity and strength, eat well, and exercise.



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I've been a New York based dermatologist for over 25 years. I love music. I love triathlons. I love chemistry. (I love petroleum jelly.) I study skincare ingredients and product formulation. I listen to skincare "advice" from self-proclaimed ......Read More

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