Telogen

Typically, abrupt diffuse hair loss is noticed several weeks to several months after the incident has initiated the biologic program for hair loss. While the most often noticed hair loss occurs on the scalp, some individuals may also notice hair loss elsewhere on the body. Significant hair shedding usually occurs when shampooing, combing, or even when gently manipulating the hair. Shedding usually slowly decreases over 6 to 8 months once the cause for the hair loss is no longer present. As some of the causes represent ongoing problems, it is important to determine the likely cause when possible and take appropriate measures to prevent continued hair loss.

These shed or loose hairs all have club-shaped “roots” typical of resting, telogen hairs and may be easily identified under the microscope. After shampooing, the bulk of existing loose hair has often been shed and loose hair may not again appear until additional hairs enter this resting phase. When there is any doubt about the presence of this condition, a small piece of skin may be taken from the scalp as a biopsy to be examined under the microscope. In this way, the condition of the hair follicles, the tissues that produce the hair, may be determined.

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.

Chronic telogen effluvium is recently recognized and not uncommon. It often occurs in men or women who previously had very thick hair in their teens and twenties and still have an apparently normal head of hair to a casual observer. It affects the entire scalp with no obvious cause apparent. It usually affects men and women of 30 to 60 years of age, starts suddenly and has a tendency to fluctuate for a period of years. Chronic telogen effluvium is sometimes mistaken for a rarer form of hair loss, alopecia areata, due to potential similarities in loss patterns with each cause. The degree of shedding is usually severe in the early stages and the hair may come out in handfuls. It does not cause complete baldness and does appear to be self-limiting in the long run.

Although not treatment options, there are some things that have been known to help slow chronic telogen effluvium loss and sometimes even help regrow hairs. These include minixodil, natural hair restoration supplements, biotin-based natural shampoos, conditioners and scalp treatments.

The only viable and permanent treatment option for chronic telogen effluvium is surgical hair transplantation. But it is important to be evaluated by a qualified hair restoration specialist to determine if you are a candidate for surgery and if surgery is right for you.