Telogen Effluvium: What You Need To Know

Telogen Effluvium occurs when sudden stress causes an abnormal shift of hair follicles into the resting phase. This leads to increased hair shedding, typically three months after the triggering physical or emotional event.

In Telogen Effluvium, hair follicles prematurely stop growing and enter the telogen (resting) stage. After this phase, a larger-than-normal amount of hair is shed all at once.

The stressful trigger is often resolved when visible hair loss becomes noticeable. The hair loss typically appears as diffuse thinning across the scalp rather than patchy bald spots.

In most cases, Telogen Effluvium is temporary and resolves within 6 to 12 months. However, if the underlying cause persists, the shedding can become chronic and more difficult to reverse.

Telogen Effluvium appears to affect women more frequently due to hormonal fluctuations and events like childbirth. Nutritional deficiencies, medications, and thyroid dysfunction can also contribute and may affect both genders.

Temporary hair loss can be caused by:

• Childbirth
• Pregnancy termination
• Starting or stopping hormonal contraceptives
• Crash dieting or weight loss drugs
• Major surgery
• Certain prescription medications
• Severe emotional stress

Let’s dive into the details.

Hair Loss After Childbirth

It’s common for women to shed more hair than usual around three months post-delivery. This is caused by hormonal fluctuations, particularly the drop in estrogen levels after giving birth.

Studies suggest between 20% and 45% of new mothers experience postpartum hair shedding. Thankfully, hair typically returns to its normal growth cycle within 9 to 12 months after childbirth.

During pregnancy, elevated estrogen levels extend the growth phase of hair, making it appear fuller. After delivery, hormone levels drop, and many follicles enter the telogen phase at once, causing increased shedding.

Hair Loss After Pregnancy Termination

Just like after childbirth, hair loss can occur after a miscarriage or abortion. The sudden hormonal withdrawal can shock follicles into the resting phase, leading to shedding around three months later.

Although emotionally challenging, the resulting hair loss is temporary and generally resolves without intervention. It’s essential to support both physical and emotional recovery during this time.

Hair Loss From Birth Control Pills

Birth control pills alter hormone levels, and these changes can impact the normal hair growth cycle. Pills containing androgenic progestins may mimic male hormones and trigger hair thinning in sensitive individuals.

Stopping hormonal birth control can also cause temporary hair shedding, mimicking postpartum hair loss patterns. As the body readjusts hormonally, hair usually regrows within a few months.

Hair Loss After Surgery

The physical stress of surgery is a well-known trigger for Telogen Effluvium. Hair follicles may shift into the resting phase in response to trauma, anesthesia, or blood loss.

Surgical hair transplants, including micrografts or minigrafts, often lead to temporary shedding. This process is expected, and new hair typically begins to regrow after the initial loss phase.

Prescribed Drugs That Can Cause Hair Loss

Some prescription medications list hair loss as a potential side effect. Not everyone is affected, but some individuals may be more sensitive to specific compounds.

Drugs known to cause Telogen Effluvium occasionally include:

• Allopurinol (used for gout)
• Heparin and Coumarin (anticoagulants)
• Clofibrate and Gemfibrozil (cholesterol-lowering agents)

This list is not exhaustive, and drug-induced hair loss may vary in severity. If concerned, consult your prescribing physician before discontinuing any medication.

Hair Loss Due to Severe Emotional Stress

Extreme emotional trauma can trigger Telogen Effluvium in otherwise healthy individuals. Events like bereavement, accidents, or abusive experiences may lead to significant hair shedding.

Stress-related hair loss often starts about three months after the triggering incident. Most cases are temporary, and full regrowth occurs once the person stabilizes emotionally and physically.

Ongoing Hair Loss and Underlying Conditions

When hair loss is prolonged, an undiagnosed medical condition may be the cause. Several chronic illnesses are associated with persistent Telogen Effluvium.

Conditions linked to ongoing shedding include:

• Thyroid gland disorders
• Diabetes
• Iron-deficiency anemia
• Systemic lupus erythematosus

Addressing these conditions often reverses hair loss. Blood tests and medical evaluation are essential for accurate diagnosis and treatment.

Thyroid Gland Malfunction

A thyroid function test is typically one of the first investigations for unexplained hair loss. Both overactive (hyperthyroidism) and underactive (hypothyroidism) thyroid glands can disrupt the hair cycle.

Hyperthyroidism — Overproduction of Thyroxin

Hyperthyroidism results from excessive thyroxin production and can also cause hair shedding. Autoimmune diseases like Graves’ disease often accompany this condition and may worsen hair loss.

Both thyroid conditions can cause diffuse shedding rather than patchy balding. Hair regrowth typically begins once hormone levels are brought under control.

Diabetes

Diabetes affects the body’s ability to process glucose and can impair circulation to the scalp. Reduced blood flow and metabolic stress may lead to hair thinning or shedding.

Undiagnosed or poorly managed diabetes may lead to persistent hair loss. Tight blood sugar control often improves hair quality and density over time.

Systemic Lupus Erythematosus (SLE)

Lupus is an autoimmune disease that causes inflammation in various body systems. Skin rashes, joint pain, and fatigue are common symptoms, often between ages 20 and 50.

Up to half of people with lupus experience hair loss, particularly during disease flare-ups. Depending on disease activity, the pattern of hair loss may be patchy or diffuse.

Genetics, immune dysfunction, and hormonal factors all contribute to lupus development. Dermatological treatments and immune-modulating therapies can help reduce inflammation and support hair regrowth.

Wrapping up

Telogen Effluvium is a common but often misunderstood cause of sudden diffuse hair loss. It occurs when physical or emotional stress disrupts the normal hair cycle, pushing follicles into a resting phase.

Though typically temporary, persistent shedding may indicate an underlying condition needing medical attention. Identifying and addressing triggers, whether hormonal, nutritional, psychological, or systemic, is key to recovery.

Timely diagnosis and appropriate treatment often result in complete hair regrowth within several months. Patients should seek professional evaluation to rule out chronic causes and receive targeted care.