Are you suddenly losing a lot of hair? Let's talk about Telogen Effluvium!

Have you ever noticed your hair starting to fall out in large amounts all of a sudden? Perhaps seeing clumps of hair on your hairbrush, on the bathroom floor, or right on your pillow fills you with worry and sadness. One common reason for this sudden change is a condition called telogen effluvium. Let us explore what this condition means, why it happens, and what you can do about it.

Hair shedding can feel alarming, but understanding the natural cycle of your hair can bring peace of mind. Your body goes through various stress responses that directly impact your hair follicles. By learning how these cycles work, you can take practical steps to care for your scalp and support healthy recovery.

Let Us First Understand How Hair Grows and Falls Out.

Simply put, your hair follows a natural cycle of growth and shedding. This cycle has three main stages:

1. The Growing Phase (Anagen): This is the most active phase of your hair growth cycle. Cells at the root of your hair divide quickly. When a new hair forms, it pushes the old hair upward and lengthens your strands. A single hair can grow in this anagen phase for about four years. At any given time, about 80% to 90% of the hair on your head is in this phase.

2. The Transition Phase (Catagen): This is a short, transitional phase. The root of the hair shrinks, and hair growth stops completely. About 5% of your hairs are in this stage at any time.

3. The Resting and Shedding Phase (Telogen): This is the resting phase of the hair cycle. The hair root becomes inactive. The root has a white, bulb-like part made of keratin, often called a club hair. Because of this keratin bulb, the hair stays in the root until it sheds. After the hair falls out, a new hair growth cycle begins. About 5% of your hair is usually in this phase.

What Is Telogen Effluvium?

During telogen effluvium, a physical or emotional stressor pushes a large number of hairs from the growing phase into the shedding phase much too early. Normally, 80% to 90% of hair stays in the growing phase. With this condition, about 70% of hair suddenly moves into the resting phase. That is why your hair starts falling out in large amounts.

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What Is the Difference Between Acute and Chronic Telogen Effluvium?

There are two main types of telogen effluvium:

• Acute Telogen Effluvium: This condition lasts for less than six months. It usually starts two to three months after you experience an illness, stress, or a major life event. The good news is that 95% of these cases get better on their own.
• Chronic Telogen Effluvium: This condition can last for more than six months. It affects the entire scalp, and sometimes it is hard to find a clear cause. Early on, you might lose hair in handfuls, but it rarely causes complete baldness.

Who Does This Condition Affect and How Common Is It?

This condition can affect anyone. However, women between the ages of 30 and 60 are more likely to experience chronic telogen effluvium without a clear cause.

This is one of the most common reasons for sudden hair loss. In fact, it is considered the most frequent cause of sudden hair shedding among women.

How Does Telogen Effluvium Affect Your Body?

A healthy person normally loses about 100 hairs a day. That is completely normal. If you have telogen effluvium, you might lose up to 300 hairs a day. Imagine how much hair that is!

This shedding mostly affects the top of your head rather than the back or sides. Your hairline usually remains unaffected, and you will not get completely bald. In severe cases, however, you might lose eyebrows or other body hair. Sometimes, this hair thinning looks like male- or female-pattern hair loss. The difference is that telogen effluvium causes rapid, heavy shedding. This pattern hair loss happens very slowly over time.

Even though there is no major physical pain, this condition can cause significant emotional distress. It can affect how you view yourself and how you interact with social settings. Some people may develop stress, anxiety, and depression as a result.

What Are the Symptoms of Telogen Effluvium?

Do you notice any of these signs? Check your daily routine:

• You see much more hair than usual on your hairbrush, on the bathroom floor, or on your pillow.
• Your hair feels much thinner when you touch or style it.
• Your hair strands look dry, and they easily pull out when you touch them.

The most important thing is that your scalp must remain healthy. This means you should not have sores, itching, burning, pain, or flaking skin. If you have those signs, you might have a different skin condition.

What Triggers Telogen Effluvium?

What triggers can cause this condition? Check if any of these happened to you recently:

• You had a high fever.
• You gave birth to a child. Many mothers experience this.
• You suffered from severe infections.
• You went through severe psychological stress, such as exams, job problems, family issues, or the loss of a loved one.
• You underwent major surgery.
• Your thyroid gland became too active (hyperthyroidism).
• Your thyroid gland became underactive (hypothyroidism).
• You stopped taking birth control pills.
• You followed strict fad diets that lack proper protein.
• You took certain medicines, such as retinoids for acne, beta-blockers for high blood pressure, calcium channel blockers for heart conditions, certain antidepressants, or nonsteroidal anti-inflammatory drugs (NSAIDs).

Is This Condition Contagious?

No, telogen effluvium is not contagious. You cannot catch it from someone else, nor can you pass it to anyone.

How Is Telogen Effluvium Diagnosed?

Diagnosing this condition is usually simple. A doctor can examine your scalp to confirm the condition. The doctor might perform a gentle pull test. During this test, they gently pull a small group of 40 to 60 hairs. Normally, only two or three hairs should come out. If you have telogen effluvium, at least four to six hairs will pull out easily with white club hair roots attached.

Your doctor will also ask about your diet and recent illnesses. They might find a connection to a nutritional issue or an illness or stress event that happened three months before your hair started falling out. Often, because people have fully recovered from that illness or stress by the time hair loss begins, they do not see the connection.

Will You Need More Tests?

Most of the time, doctors can diagnose this without special tests. However, if they suspect an underlying medical issue, such as a thyroid problem or an iron deficiency, they may order blood tests or a small scalp biopsy.

What Are the Treatments for Telogen Effluvium?

Since the main cause is often stress on the body, the most important step is finding that cause. Once you address that cause, telogen effluvium usually improves on its own within six to eight months without medical treatment.

However, there are standard supportive treatments available:

• medicines: Topical treatments like minoxidil can help stimulate hair growth. However, minoxidil can cause side effects such as headaches, scalp irritation, and unwanted facial hair growth. You must avoid using minoxidil if you are pregnant or breastfeeding.
• Multivitamins and Supplements: Iron-containing multivitamins or iron supplements help support hair growth. Biotin supplements also support strong, healthy hair.
• Hairstyling Options: You can use certain hairstyles, wigs, or hair weaves to gently hide areas where your hair has thinned.

How Long Does Telogen Effluvium Last and Will Your Hair Grow Back?

Telogen effluvium usually lasts between three and six months.

Yes, your hair will definitely grow back! This is the best news. After the shedding period ends, you will see new hair growing in the affected areas. You just need a little patience.

How Can You Lower the Risk of Telogen Effluvium?

There are steps you can take to keep your hair healthy and support its growth:

• Eat enough protein, especially if you follow a vegetarian or vegan diet. You need between 40 and 60 grams of protein daily. A Mediterranean diet rich in fruits, vegetables, and lean proteins can help reduce hair shedding.
• Take vitamins. Vitamins A, B, C, D, E, zinc, biotin, and iron help maintain healthy hair, skin, and muscles. Always consult a doctor before starting any new supplement.
• Find ways to manage stress. Stress is a primary trigger for telogen effluvium. Meditation, yoga, hobbies, and talking with friends can help.
• Get enough sleep. Adults generally need seven to nine hours of sleep each night. Good sleep helps lower daily stress.
• Avoid restrictive fad diets that cause rapid weight loss. Sudden weight loss can trigger telogen effluvium. Restrictive diets cause nutritional deficiencies that lead to hair loss. If you need to lose weight, follow a balanced Mediterranean-style diet combined with regular exercise.

What Can You Expect If You Have Telogen Effluvium?

Telogen effluvium can feel very stressful, and you might worry that you will lose all your hair. However, if you have telogen effluvium, do not worry because the outlook is positive. Hair shedding typically improves within three to six months. Your doctor can guide you through steps to support your new hair growth.

What Is the Difference Between Telogen Effluvium and Androgenic Alopecia?

Although both conditions involve hair loss, they have key differences:

• Telogen Effluvium: This condition causes rapid hair shedding over a short period. It usually occurs a few months after your body experiences physical or emotional stress, or sudden hormonal changes. Hair loss from telogen effluvium is generally temporary, and hair grows back without treatment once the stressor resolves.
• Androgenic Alopecia: This condition is known as male pattern baldness or female pattern hair loss. It involves slow and gradual hair thinning compared to telogen effluvium. The exact cause is linked to genetics and hormones. Without ongoing treatment, hair loss from androgenic alopecia is permanent.

What Should We Remember From This Discussion?

Telogen effluvium is a common condition that causes temporary hair loss across the scalp. It is triggered by physical stress or bodily changes. While it can be emotionally challenging and cause worry about going bald, the most important thing to remember is that your hair will grow back over time.

If you notice sudden hair loss, especially if it causes ongoing stress or anxiety, talk to a doctor right away. They can help find the exact cause and start the right care plan for you.

Sources & References:

• Cleveland Clinic. (2023). Telogen Effluvium: Causes, Symptoms & Treatment. Link.
• Mayo Clinic. (2022). Hair loss - Symptoms and causes. Link.
• American Academy of Dermatology (AAD). (2023). Hair Loss: Who gets and causes. Link.
• National Health Service (NHS UK). (2022). Hair loss. Link.
• National Institutes of Health (NIH / StatPearls). (2023). Telogen Effluvium. Link.