Telogen effluvium is hair loss due to an increased number of hair follicles entering the resting stage. It is largely caused by stress, either emotional or physical. 

What triggers telogen effluvium?

Telogen effluvium is triggered by stress, usually extreme stress on the body. Most commonly this will be events such as childbirth, severe trauma or illness, loss of a loved one, extreme diet changes, or changes in hormonal medication or treatment. 

Medications

Some medications can cause telogen effluvium, such as:

  • High doses of Vitamin A
  • Blood pressure medications
  • Gout medications

Changes to diet 

Telogen effluvium can sometimes be brought on by extreme changes to diet. For example, many franchised diet programs that aim to replace regular meals with prescribed meals, dietary supplements or vitamin ingestion can lead to hair loss. This is often due to a lack of vitamins required to create hair follicles, causing the hair to shed faster than it can be created. 

Sometimes vitamins are a necessary part of the program to prevent hair loss associated with dieting. However, the vitamins cannot prevent hair loss associated with rapid, significant weight loss. Furthermore, many of these supplements are high in vitamin A which can magnify the hair loss.

Physical and emotional stress

Emotional stress, such as the death of a loved one or work-related stress, is widely recognised to have substantial effects on hair. Stress puts the body into a fight or flight mode, where the body conserves nutrients for core functions. 

This means that the body simply shuts down production of hair during periods of stress since it is not necessary for survival and instead devotes its energies toward repairing vital body structures. 

Read more about the effects of emotional stress →

Stress can also be physical and can bring on telogen effluvium. Surgery or severe illnesses are perfect examples of this, where the body conserves as many nutrients as it possibly can to repair the essential organs or cells of the body whilst in recovery. This means that hair is lost quicker than it can be replaced, ultimately leading to hair loss. 

Read more about the effects of physical stress →

How much hair do you lose with telogen effluvium?

Telogen effluvium causes roughly 30% of the follicles present on the scalp to enter the resting phase (telogen phase, hence the name). Those with telogen effluvium report roughly 300 hairs falling out per day. 

It is important to remember that telogen effluvium affects everyone differently and that one single persons experience is not representative of what everyone will experience. 

Can telogen effluvium make you bald?

It is highly unlikely that telogen effluvium will cause complete baldness. Instead, a thinning of the overall hair is more likely to occur. You will not have bald patches, but rather a generalised thinning across the entire scalp. 

How long does it take for telogen effluvium to stop?

Once the underlying cause of stress has ceased, telogen effluvium will resolve itself naturally. The hair should start to regrow after roughly 3 to 6 months. 

This relies on the underlying cause of stress having resolved though. If there is still stress present, then the telogen effluvium may either continue or return later. 

Does telogen effluvium cause itchy scalp?

Yes, some people who suffer from telogen effluvium complain about itchy scalps. This can sometimes also be accompanied by a sense of pain or stinging on the scalp too. 

How do you know if you have chronic telogen effluvium?

Chronic telogen effluvium is diagnosed as telogen effluvium lasting over 1 year, and can be diagnosed at home by a gentle hair pull test which will reveal an increased number of hairs; most of which are in the telogen phase and have an epithelial sac.

Those most at risk from chronic telogen effluvium are otherwise healthy women aged 30-60. Chronic telogen effluvium is most often diagnosed in women that have thick or long hair, as they are the most likely to notice the hair is shedding at an increased rate for a long period of time. Those that suffer from chronic telogen effluvium may have an increased tendency to genetic balding, i.e. female pattern hair loss. 

Unfortunately, the exact mechanism of chronic telogen effluvium has not been well studied and is therefore not well understood. Middle-aged women with a long fluctuating course of telogen effluvium, producing widespread thinning lasting many years have normal hormonal studies.

If you think you have chronic telogen effluvium, it is important to consult your doctor. This can be the result of chronic emotional stress, such as the result of a high-pressure job or chronic anxiety, and should be resolved. However, it can also be the result of an underlying medical condition, for example, thyroid conditions, which should be looked into by your doctor. 

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