The Telogen Phase of the Hair Cycle
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One must distinguish this form of hair loss from other conditions affecting the scalp. When significantly more than 10% of the scalp hair follicles are in the telogen growth phase, this will manifest in certain patients as a rather dramatic hair-shedding event. Effluvium simply refers to the shedding of excess matter (in this case, hair). Hair is made in tiny pouches in the skin, called hair follicles. Most scalp hairs last about three years and grow about 1 cm a month. After a period of time (about three years), each hair on the scalp comes to the end of its life and falls out.
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Stress Management
They’ll likely use a combination of your health history — including any recent illnesses, surgeries, life stressors, and family history — and a physical exam to help narrow down the causes. This type of hair loss typically resolves on its own once the underlying cause is addressed. It’s also the most common cause of hair loss, affecting up to 50% of people. It’s typical to lose between 50 and 100 hairs a day, according to the American Academy of Dermatology (AAD). With about 100,000 hairs on your head, that small loss isn’t noticeable. New hair normally replaces the lost hair, but this doesn’t always happen.
What are risk factors for telogen effluvium?
Telogen effluvium happens in the telogen, or resting, phase of the hair growth cycle; anagen effluvium happens in the anagen phase, when your hair is growing. Anagen effluvium causes a lot of hair loss very quickly, while telogen effluvium is usually a more gradual thinning. However, a negative test result does not necessarily exclude those conditions. Patients with telogen effluvium usually present with an increased number of hairs in their hairbrush or shower, and sometimes thinning of the hair in the scalp, axillary, and pubic areas. A detailed history may indicate the cause of the hair loss, which usually has occurred two or three months before the hair falls out. On examination, there is generalized hair loss with a positive hair pull test, indicating active hair shedding, particularly at the vertex and scalp margin.
Treatment / Management
Diffuse hair loss involves loss of hair evenly across the scalp. The most common form of diffuse hair loss is telogen effluvium, which results in loss of more than 200 scalp hairs per day. It typically develops after an acute event, such as a severe illness, major surgery, thyroid disease, pregnancy, iron-deficiency anemia, malnutrition or rapid weight loss, or vitamin D deficiency. Hair shedding usually starts about 2 to 4 months after an acute inciting event and typically resolves within 6 to 9 months. Patients with hair loss will often consult their family physician first.
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Female pattern hair loss
DermNet does not provide an online consultation service.If you have any concerns with your skin or its treatment, see a dermatologist for advice. The best way to treat the condition is to figure what’s triggering it — your environment, hormones, or lifestyle choices. If vitamin supplements are your primary source of these nutrients, you should talk with your doctor or dietician. Crash dieting should be avoided, as it has been known to cause TE. Other side effects to be aware of include those in the eye (diabetic retinopathy) and serious allergic reactions.
A scalp biopsy may be necessary if the cause of hair loss is unclear. Alopecia areata presents with smooth hairless patches, which have a high spontaneous rate of resolution. Tinea capitis causes patches of alopecia that may be erythematous and scaly. Male and female pattern hair losses have recognizable patterns and can be treated with topical minoxidil, and also with finasteride in men. Sudden loss of hair is usually telogen effluvium, but can also be diffuse alopecia areata. In telogen effluvium, once the precipitating cause is removed, the hair will regrow.
Medical tools and resources
Try to find ways to manage stress, and strive for a well-balanced diet that includes plenty of fruits and vegetables. If you have alopecia, you can help hold onto your tresses by avoiding behaviors that are known to contribute to temporary and permanent hair loss, Mirmirani says. A 2021 review of 15 studies — including several large randomized control trials that are the gold standard for medical research — found that laser therapy increased hair count in both men and women.
Physiology of Hair Growth
They may identify a dietary cause or a stress or illness that occurred about three months before you noticed hair loss. In many cases, someone with telogen effluvium has fully recovered from a stressor or illness and doesn’t see a connection between it and their hair loss. Although reducing your stress levels might seem insurmountable, making sure you’re eating the right things will go a long way to setting a good foundation for optimum hair growth. A healthy balanced diet is also important in stress reduction too as it can support a healthy immune system, repair damaged cells and even reduce elevated cortisol levels.
Telogen effluvium
The bulb of a hair follicle is under the skin at the bottom of a strand of hair. It is how blood gets to the hair to nourish it and help it grow. If you pull out a hair and see a white substance at the end, that's the bulb. It's made of a protein called keratin that is important for healthy hair. The resting scalp club hairs remain firmly attached to the hair follicles at first.
They can assess your symptoms and recommend a different medication. It's often due to an event such as major surgery, chronic illness, or a high fever. Reach out to your healthcare provider as soon as you notice hair loss, especially if it causes additional stress. “A lack of essential vitamins and minerals such as iron, zinc and vitamin D can contribute to hair loss, particularly if you are experiencing an iron deficiency.
Some researchers believe that hair loss may be the result of a vitamin or nutrient deficiency. If it does thin in multiple places, you may find that some areas are affected more than others. The main symptom of telogen effluvium is an increase in the amount of hair a person sheds.
Chronic telogen effluvium with no clear precipitating cause tends to present in otherwise healthy women 30–60 years of age. Some antidepressants and other medications like antihypertensives and oral contraceptives, may cause hair loss. If you started a new medication before you started experiencing hair loss, it may be worth speaking to your doctor.
Telogen effluvium is a type of hair loss that involves rapid shedding of hair over a short period. It typically happens a few months after your body goes through something physically or emotionally stressful. Hair loss due to telogen effluvium is usually temporary, and your hair often grows back without treatment once you no longer have that stress. Telogen effluvium can be stressful, and you may fear that you’ll lose all of your hair.
Alopecia areata is an autoimmune disease that causes hair to fall out in nickel- or quarter-size patches. “Your body’s immune system is attacking the hairs,” Brodell says. People who notice a significant increase in hair loss when taking a medication should contact a doctor. The doctor may be able to lower the dosage of the medication or prescribe an alternative that is less likely to cause hair loss. Infections like scalp ringworm and scabies should be treated by a medical professional who can prescribe topical and/or oral medications.
It occurs due to disruption of the normal hair follicle growth cycle. Tinea capitis requires systemic treatment; topical antifungal agents do not penetrate hair follicles. Because griseofulvin may have lower cure rates in the treatment of T. Tonsurans infections, it may not be as effective when used empirically.15 All close contacts of patients with tinea capitis should be examined for signs of infection and treated, if necessary. Androgenetic alopecia is the most common form of hair loss in men and women and is a normal physiologic variant. It is most prevalent in white men, with 30%, 40%, and 50% experiencing androgenetic alopecia at 30, 40, and 50 years of age, respectively 2 (Figure 1).
Because so many things can cause hair loss, it’s best to schedule an appointment with a medical professional if you notice any changes in your hair. There are several types of hair loss, some are common and some are rarer, and each with different underlying causes. A good well-rounded diet is necessary for normal hair growth, and vitamin and or/mineral supplementation may need to be considered. They are caused by different circumstances and cause hair loss in different ways. During the telogen phase, the hair follicle is completely at rest, and the club hair is completely formed. Pulling out a hair during the telogen phase of the cycle will reveal a solid, hard, dry, white material at the root.
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