17
Nov

Hair loss and (or) shedding?

hairlosswoman

Telogen effluvium

Telogen is the resting phase in the hair cycle and lasts until approximately 3-6 months

It is normal to lose up to about 100 hairs a day on one’s comb, brush, in the sink or on the pillow. This is the result of the normal hair growth cycle. Hairs will grow for a few years, then rest for a few months, shed, and regrow. Telogen is the name for the resting stage of the hair growth cycle. A telogen effluvium is when some stress causes hair roots to be pushed prematurely into the resting state. Telogen effluvium can be acute or chronic.

If there is some “shock to the system”, as many as 70% of the scalp hairs are then shed in large numbers about 2 months after the “shock”. This sudden increase in hair loss, usually described as the hair coming out in handfuls, is acute telogen effluvium. This is a different problem than gradual genetic hair thinning. However, this can be seen in the less common chronic telogen effluvium, only after a significant amount of hair has already been lost.

A considerable number of different causes for telogen effluvium exist. Among the common causes are high fevers, childbirth, severe infections, severe chronic illness, severe psychological stress, major surgery or illnesses, over or under active thyroid gland, crash diets with inadequate protein, and a variety of medications. Most hair loss from medications is this type and causes include retinoids, beta blockers, calcium channel blockers, antidepressants, and NSAIDS (including ibuprofen).

No treatment is needed for most cases of telogen effluvium. Remember that the hairs fall out when a new hair growing beneath it pushes it out. Thus with this type of hair loss, hair falling out is a sign of hair regrowth. As the new hair first comes up through the scalp and pushes out the dead hair a fine fringe of new hair is often evident along the forehead hairline. The most important issue in telogen effluvium is to determine if an underlying cause for the problem is present. Blood tests may need to be done if the cause is not obvious, such as mild iron deficiency. If the telogen effluvium is caused by a medication, the medication needs to be stopped. When the cause of the hair loss is something like giving birth, a transient illness, or other self-limited problem the induced telogen effluvium is also usually self-limited and requires no treatment.