Telogen Effluvium (TE) is a common type of temporary hair shedding. It occurs when an excessive number of hair follicles enter the resting phase (telogen) simultaneously, disrupting the hair growth cycle.
This condition often arises after a stressful or traumatic event, leading to noticeable hair loss.
In this article, discover everything you need to know about acute and chronic TE.
What is Telogen Effluvium?
TE is a form of diffuse, non-scarring alopecia that appears suddenly. It is characterized by increased hair shedding (up to 300 strands daily) or noticeable hair thinning. This condition is more prevalent in women and typically results from disruptions in the normal hair growth cycle.
The hair growth cycle consists of four stages:
Anagen (Growth Phase)
Catagen (Transition Phase)
Telogen (Resting Phase)
Exogen (Shedding Phase)
TE is specifically associated with the telogen phase. Normally, about 5-10% of hair follicles are in this resting phase. In TE, this percentage can rise to 30%, resulting in excessive shedding. Fortunately, the condition is usually temporary, although hair strands may become thinner.
Acute Telogen Effluvium (ATE)
Acute TE refers to hair shedding lasting less than six months. This condition doesn’t cause inflammation but may affect up to 50% of scalp hair. Shedding often peaks three months after the triggering event, such as stress or illness.
Interestingly, the shedding signals the beginning of new hair growth in the anagen phase. Many individuals notice a fine fringe of new hair along the hairline as regrowth begins. Full recovery typically occurs within 6-9 months, though complete regrowth isn’t always guaranteed.
Chronic Telogen Effluvium (CTE)
Chronic TE occurs when hair loss persists for more than six months. While it can be distressing, this condition is reversible in most cases. In some instances, hair shedding may last for years, with cycles of temporary regrowth followed by renewed shedding.
CTE is more noticeable in women, as hair loss significantly alters appearance. Though rare, this condition can reveal underlying genetic baldness. The exact mechanisms behind CTE are still being studied, but most individuals with CTE have normal hormone levels.
Causes of Telogen Effluvium
TE can develop due to several factors, including:
Stress: Major physical or emotional stress, surgery, or illness can trigger TE, redirecting energy from non-essential functions like hair growth. Shedding typically becomes noticeable three months after the stressor.
Poor Nutrition: Nutritional deficiencies, especially in vitamins D, zinc, and iron, can affect hair growth. Crash diets or excessive vitamin A can worsen the condition.
Medications: Certain medications, like antidepressants, contraceptives, or blood pressure drugs, can lead to TE.
Sudden Weight Loss: Significant weight loss or calorie restriction often results in increased hair shedding.
Pregnancy: Postpartum hair loss is common due to hormonal changes 3-6 months after childbirth.
Menopause: Hormonal shifts during menopause can trigger TE.
Toxic Exposure: Contact with harmful chemicals or metals may contribute to hair thinning.
Underlying Conditions: Autoimmune diseases, thyroid disorders, or alopecia areata can also cause TE.
Symptoms of Telogen Effluvium
Symptoms of TE include:
Diffuse hair thinning, often uneven
Increased shedding concentrated on the scalp’s crown
Intact hairline with no recession
Bulbous keratin bulbs on shed hair roots
In severe cases, shedding may occur on eyebrows or other body areas.
Diagnosing Telogen Effluvium
TE is usually diagnosed through clinical examination. Tests include:
Hair Strand Examination: Analyzing hair length and diameter to differentiate TE from androgenetic alopecia.
Pull Test: Checking how many hairs detach when gently pulled.
Hair Wash Test: Observing the number of shed hairs during washing.
Blood Tests: Identifying potential deficiencies or thyroid issues contributing to hair loss.
Treatments for Telogen Effluvium
The treatment depends on addressing the underlying cause. Once resolved, the hair cycle typically normalizes, and regrowth occurs. Common treatments include:
Dietary Changes: Ensuring adequate intake of essential nutrients like vitamin D, zinc, and iron can promote recovery. Consult a doctor to identify and address deficiencies.
Minoxidil: Topical solutions containing 5% minoxidil can prolong the anagen phase, enhance blood circulation in the scalp, and stimulate follicular activity.
Hormonal Therapies: Addressing hormonal imbalances caused by menopause or other conditions can help restore hair health.
Stress Management: Incorporating relaxation techniques and seeking professional counseling may prevent recurrent shedding cycles.
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