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Telogen effluvium is a type of hair loss that occurs after a triggering event. In this image, a woman is brushing her hair and looking at hair on her brush with a concerned expression.

Telogen Effluvium: Possible Causes of This Type of Hair Loss

Telogen effluvium is a common cause of temporary hair loss. The abrupt hair shedding typically occurs several months after a triggering event.

It usually lasts for about 6 months, but chronic telogen effluvium can last longer. No specific treatment exists, but lifestyle and dietary changes can be effective in beginning hair regrowth.

Diagnosing Telogen Effluvium

When diagnosing telogen effluvium, a dermatologist will examine the hairs that have fallen out, as the diameter and length of the hairs can signal this condition. This may also help the doctor differentiate between telogen effluvium and alopecia (a disease that develops when the body attacks its own hair follicles and can cause hair loss anywhere on the body).

Hair pull tests and wash tests may also be carried out to see how much hair is being shed.

An additional step that may be taken is a blood test, which can help identify iron deficiency or thyroid insufficiency as factors for the hair loss.

Finally, dermatologists will consider other indicators of hair health, such as the appearance of the scalp or more generalized hair thinning.

The Hair Loss Pattern in Women

Telogen effluvium was first described in 1961. It is the most common cause of diffuse hair loss, and women with telogen effluvium more frequently present to dermatologists.

A peculiar type of chronic telogen effluvium does seem to exist that preferentially affects women in their middle ages. It has been described as diffuse cyclic hair loss in women.

This type of hair loss tends to be distinctive: the typical patient is an otherwise generally healthy woman with a full, thick head of hair. On examination, there is some bitemporal thinning and a positive hair pull test equally over the vertex and occiput.

With telogen effluvium, hair follicles tend to behave in a similar way. Hair follicles are subject to constant turnover. Cyclic hair growth activity occurs in a random mosaic pattern, with each follicle possessing its own individual control mechanism over the evolution and triggering of the successive phases.

A dermatologist uses a magnifying glass to inspect the top of a woman's scalp. Telogen effluvium hair loss is especially common in women.

To identify possible causes of hair loss, dermatologists will consider indicators of hair health such as the appearance of the scalp.

Possible Causes

A wide variety of triggers have been implicated as possible causes of telogen effluvium. These include systemic factors as well as external factors linked to the environment, such as hormones, toxins, nutrient deficiency, vitamins, energy/calories, and cytokines and growth factors.

As presented by author Shashikant Malkud in the Journal of Clinical and Diagnostic Research, studies have suggested that telogen effluvium may be related to:

  • Physiological causes: Postpartum effluvium, physiological effluvium of newborn
  • Febrile states: Typhoid, malaria, tuberculosis, HIV infection
  • Stress: Severe febrile illness, emotional stress, serious injuries, major surgery, difficult labor, hemorrhage, starvation, crash diet
  • Drugs: Oral retinoids, oral contraceptives, antithyroid drugs, anticonvulsants, hypolipidemic drugs, heavy metals, beta blockers, captopril, amphetamines
  • Endocrine: Hyperthyroidism, hypothyroidism
  • Organ dysfunction: Renal failure, hepatic failure
  • Disorder of hair cycle: Short anagen syndrome
  • Nutritional: Iron deficiency anemia, acrodermatitis enteropathica, acquired zinc deficiency, malnutrition
  • Local cause: Hair dye application
  • Others: Syphilis, systemic lupus erythematosus

If you are concerned about hair loss, it is important to see a dermatologist for a proper diagnosis.  For more information, please make an appointment to see one of our dermatologists at Associated Dermatologists.