Telogen effluvium

Telogen effluvium

Description, Causes and Risk Factors:

Abbreviation: TE.

Telogen effluvium is a condition where more than normal amounts of hair fall out. There is a general thinning of the hair. Telogen effluvium is a temporary loss of hair due to alteration of the normal hair cycle. Hair growth occurs in a cycle which is divided into three phases: a growth phase, a regression phase, and a resting phase.

Telogen effluvium appears to affect more women than men because more of the precipitating event such as childbirth are experienced by women.

Increased hair loss is due to a disturbance of the hair cycle, with hairs shifting from the growing phase (anagen) to the shedding phase (telogen). Common causes of telogen effluvium may include childbirth, severe trauma or illness, a major life event, marked weight loss or a new medication. Chronic causes can be related to nutritional factors, such as low iron, zinc, B12 or folate, disturbance in thyroid function (either over or under active) or medications.

Risk factors may include:


  • Major physical trauma.

  • Major psychological stress.

  • High fever, severe infection or other illness.

  • Extreme weight loss.

  • Extreme change in diet.

  • Abrupt hormonal changes, including those associated with childbirth and menopause.

  • Iron deficiency.

  • Hypothyroidism or hyperthyroidism.

  • Some medications.

People with telogen effluvium never completely lose all their scalp hair, but the hair can be noticeably thin in severe cases. While telogen effluvium is often limited to the scalp, in more serious cases telogen effluvium can affect other areas, like the eyebrows or pubic region.

Whatever form of hair loss telogen effluvium takes, it is fully reversible. The hair follicles are not permanently or irreversibly affected; there are just more hair follicles in a resting state than there should normally be.


The symptoms of telogen effluvium include shedding of hair, diffuse hair loss all over the scalp and an increased number of loose hairs. Although the normal amount of hair loss per day is usually around 100, people who are experiencing telogen effluvium can lose between 100 to 400 hairs a day. Sometimes hair loss can be in the lesser end of the range, and the telogen effluvium could go unrecognized. Another symptom of telogen effluvium or chronic telogen effluvium is the feeling of painful hair, where the hair feels like it is being pricked by needles or pulled. This is called trichodynia; about one third of those with telogen effluvium experience this.


Most cases of telogen effluvium can be diagnosed based on medical history and an examination of the scalp and hair. If the hair loss has been occurring for several months, there may be visible thinning patches, but often the hair loss is not dramatic enough for a doctor to notice. If you have large bald patches, you probably don't have telogen effluvium. If the doctor gently tugs on some hairs on your scalp and four or more hairs come out, you probably have telogen effluvium. Also, the hairs will look like hairs in the telogen phase — they will have a white bulb at the end that was in the scalp, and will not have a gel-like covering around that end of the hair. Occasionally iron and thyroid tests are performed to rule out an underlying disease but they areusually normal.

In some rare cases, if there is reason to doubt the diagnosis, a biopsy of the scalp may be done. In this procedure, a small piece of the scalp that includes several hair follicles is removed and examined under a microscope. Your doctor also may do blood tests to check for conditions such as thyroid abnormalities that may be contributing to hair loss.


How telogen effluvium is treated depends on what has activated it. For short-term telogen effluvium that can be linked to a trigger like surgery, the best response is to sit tight and wait for the follicles to recover of their own accord.

For persistent telogen effluvium, if the causal factor can be isolated, then the best method is to remove it. For example, if stress is the problem, stress reduction is the long-term answer. If a dietary deficiency appears on a blood test, then supplements can work. A deficiency in thyroid hormones can be treated with hormone supplements.

However, often a specific causal factor cannot be identified. If this is the case, there are few treatment options. Most dermatologists resort to prescribing minoxidil, a direct hair growth stimulator. Minoxidil can work well for some individuals with telogen effluvium, but if the underlying cause is still present, then minoxidil must be continued to block redevelopment of Telogen effluvium. With removal of the trigger, minoxidil use can be stopped.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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