Is Your Hair Falling Out?

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. Fortunately, 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)
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