What you should know about telogen effluvium?

What you should know about telogen effluvium?

Telogen effluvium is a medical condition that affects hair growth. It occurs when the natural process of hair growth is interrupted, most often due to illness or stress. Telogen effluvium can cause hair to fall out in large quantities, and may be accompanied by a fever, sore throat, and body aches. In some cases, telogen effluvium may lead to permanent hair loss. Continue reading this article to learn everything that you should know about this medical condition.

What is telogen effluvium?

Hair thinning is one feature of telogen effluvium

Telogen effluvium is a scalp disorder characterized by diffuse, non-scarring shedding of hair. The term “telogen effluvium” was proposed to differentiate it from excessive shedding of normal club hair. Various hypotheses are put forward regarding the pathophysiology of telogen effluvium. There are five different functional types of telogen effluvium based on alternations in particular phases of the follicular cycle. Whiting defined chronic telogen effluvium as an idiopathic disorder.

What is the cause of telogen effluvium?

There are various factors that can initiate disturbance in the normal hair cycle.


Numerous drugs can cause telogen hair loss and it usually starts after 12 weeks of dosage. Changes in the dosage of drugs can also lead to excessive shedding. Drugs that can cause telogen effluvium include oral contraceptive pills, androgens, retinoids, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, anticonvulsants, antidepressants, and anticoagulants (heparin).

Physiological Stress

Increased physiological stress such as surgical trauma, high fever, chronic systemic illness, and hemorrhage can cause telogen effluvium. Childbirth can also cause excessive hair to enter the telogen phase. This hair loss, telogen gravidarum, occurs approximately three months after childbirth.

Emotional Stress

The relationship between emotional stress and hair loss is ambiguous since hair loss itself is a source of emotional stress to the patient.

Medical Conditions

Numerous medical disorders can lead to telogen effluvium. Both hyper- and hypothyroidism can cause telogen effluvium, and this is reversed once the euthyroid state is achieved. Chronic systemic disorders such as systemic amyloidosis, hepatic failure, chronic renal failure, inflammatory bowel disease, and lymphoproliferative disorders can also cause telogen effluvium. It is also reported in some autoimmune diseases including dermatomyositis, chronic infections such as HIV, and secondary syphilis. Inflammatory disorders such as psoriasis and seborrheic dermatitis can also lead to diffuse telogen hair loss.

Dietary Triggers

Severe protein, fatty acid and zinc deficiency, chronic starvation, and caloric restriction can lead to telogen effluvium. Essential fatty acid deficiency leads to telogen effluvium, and this usually occurs two to four months after insufficient intake. Decreased body iron stores can cause it. However, this relationship is very controversial. Vitamin D is vital for cell growth and, hence, its deficiency could also be a possible cause of it. Another cause can be biotin deficiency but is reportedly very rarely.

Ultraviolet Light

Ultraviolet light may cause telogen effluvium

Researchers found an increased frequency of telogen effluvium between July and October. They hypothesized that it could be actinic effluvium, a summer effect, induced by sunlight and ultraviolet (UV) light, manifesting in autumn. Electron microscopy of hair exposed to sunlight reveals alterations in the cellular components and damage to the hair cuticle and cortex. Both of these mechanisms can be attributed to increased shedding of hair in the telogen phase; however, it is not scientifically proven yet.

Who gets telogen effluvium?

Loose anagen hair syndrome

Telogen effluvium is a hair loss condition that can affect anyone, but it’s more common in women. It occurs when too many hair follicles go into the telogen phase, which is the resting stage of hair growth. This can be caused by a variety of things, such as stress, pregnancy, or a major surgery. Symptoms include excessive shedding and thinning hair. There is no one-size-fits-all treatment for telogen effluvium, but there are ways to help promote new hair growth.

What are the clinical features of acute telogen effluvium?

Interruption of active or anagen hair

Telogen effluvium (TE) is a common hair loss disorder that affects up to 30% of the population. It is characterized by diffuse hair shedding of resting or telogen hair, typically occurring 3 months after a triggering event. The five proposed mechanisms by which shedding of the hair may occur in telogen effluvium are as follows:

  1. Immediate anagen release: This is due to an underlying cause. Hair follicle leaves the anagen phase and enter the telogen phase prematurely, leading to increased shedding two to three months later.
  2. Delayed anagen release: This is due to prolongation of the anagen phase resulting in heavy telogen shedding.
  3. Short anagen syndrome: This is due to idiopathic shortening of the anagen phase, leading to persistent telogen effluvium. The pathogenesis behind most of the cases of chronic telogen effluvium is considered to be the short anagen syndrome.
  4. Immediate telogen release: This is due to the shortening of the telogen phase, resulting in a massive release of club hair.
  5. Delayed telogen release: This is due to a prolonged telogen phase and a delayed transition to anagen phase.

How is telogen effluvium diagnosed?

Laboratory studies are of little use in the diagnosis of telogen effluvium if there is clear history of an inciting event. Scalp biopsy is the most useful test to confirm the diagnosis, although this is seldom necessary if the history is characteristic and a gentle hair pull produces numerous telogen hairs. Telogen hairs are identified by a white bulb and the lack of a gelatinous hair sheath.

If a biopsy is performed, some authors advocate taking three 4-mm punch biopsy specimens, all imbedded horizontally. This method provides a generous sample for determining anagen-to-telogen and terminal-to-vellus ratios and leads to greater diagnostic accuracy.

What is the treatment for telogen effluvium?

Here are some telogen effluvium treatments that experts say could work. First, take care with supplements. Vitamin deficiencies are another issue best addressed with a doctor. Some vitamins, like vitamin A and E, might actually cause hair loss when taken in excess, according to a 2017 study from Dermatology Practical & Conceptual. 

Moreover, the study found that when it comes to biotin — a popular ingredient in hair loss supplements and shampoos — not only are deficiencies rare, there is no evidence that biotin is linked to hair health. The reason behind the marketing of biotin for hair health might be because biotin can help with treating brittle nails.

Second, clear your scalp. Treating scalp issues like dandruff could remove a physical barrier to hair growth. Chacon says. Medicated shampoos can help with exfoliating the scalp, however, it’s important to avoid certain ingredients, like sulfur.

Third, address your diet. Are you eating a balanced diet, or have you changed your diet? What you eat, or don’t eat, could contribute to your hair health and may be effective in beginning hair regrowth. As with all types of hair loss, a nutritious, balanced diet should be followed with plenty of representation from protein, vegetable and fruit groups and no severely restrictive diets excluding important sources of nutrients.

Finally, Minoxidil is an over-the-counter solution that could treat your hair loss if other remedies don’t seem to work. For patients whose hair loss persists and the telogen effluvium is chronic, topical minoxidil can be helpful.

When to see a doctor?

Telogen effluvium is a condition that can cause you to lose hair in clumps. It is usually temporary, but it’s important to see a doctor if you think you might have it. Telogen effluvium can be caused by a number of things, including stress, childbirth, and surgery.

If you’re not sure whether you have telogen effluvium, here are some signs that you might need to see a doctor: your hair is falling out in clumps; your scalp is itchy or sore; you have bald patches; your hair loss is accompanied by fatigue, fever, or weight loss; or your hair has been thinning for more than six months.


In conclusion, telogen effluvium is a hair loss condition that can be caused by a variety of factors. While the condition is not typically serious, it can be frustrating and can cause a significant amount of hair loss. If you are experiencing hair loss and believe you may have telogen effluvium, it is important to speak with a doctor to get a diagnosis and to begin treatment.


How long does telogen effluvium last?

Telogen effluvium (TE) is a diffuse hair loss that usually occurs two to four months after a triggering event. The most common trigger is childbirth, but TE can also be caused by surgery, fever, or psychological stress. Up to 70% of scalp hair may be lost, but the hair follicles are not destroyed and normal hair growth resumes within six to twelve months. TE can be treated with minoxidil or finasteride, but there is no cure.

How do I know if I have telogen effluvium?

Telogen effluvium is a common type of hair loss that can affect both men and women. It is usually confused with androgenetic alopecia or female pattern hair loss. It occurs when there is a sudden shift in the normal hair growth cycle, resulting in a larger number of hairs entering the telogen (resting) phase. As a result, you may experience thinning or shedding hair, especially around the scalp. While telogen effluvium can be distressing, it is usually temporary and resolves on its own within six to twelve months.

If you are concerned that you may be experiencing telogen effluvium, there are a few things you can do to determine if you are affected. First, consult with your doctor or dermatologist for an evaluation. They will be able to determine if your hair loss is due to telogen effluvium or another condition.

Second, it is best to wait until your hair has fully grown again before you begin using a hair loss treatment. This will allow for the most accurate assessment of the condition. Third, if you are experiencing hair loss that is disproportionate to your age, you may want to consider trying a new hair care product.

Will hair grow back after telogen effluvium?

In most cases, telogen effluvium resolves on its own within a few months. However, there is no guarantee that hair will grow back after telogen effluvium. Some people may experience permanent hair loss as a result of telogen effluvium.

What is the best treatment for telogen effluvium?

While the exact cause of telogen effluvium is unknown, experts believe it may be triggered by a number of factors, including stress, childbirth, surgery, or medication. Symptoms of telogen effluvium include excessive shedding and thinning hair.

The best treatment for telogen effluvium depends on the underlying cause. In some cases, treating the underlying cause may help resolve the hair loss. In other cases, specific treatments for telogen effluvium may be needed.

Is acute telogen effluvium permanent?

Telogen effluvium (TE) can be caused by many things, such as a traumatic event, childbirth, major surgery, or severe illness. Most cases of TE are temporary and the hair grows back within 6 to 12 months. However, there is a small percentage of people who experience chronic TE, which means the hair loss continues long after the initial event. There is no known cure for chronic TE and the only way to manage it is through ongoing treatment and management.

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