Everything You Need To Know About Telogen Effluvium

Telogen effluvium is a form of temporary hair loss caused by a complex reaction to metabolic stressors, hormonal shifts and various medications.¹

While often associated with hair loss in women,¹ the condition can also affect men. It can cause high levels of concern and anxiety when it occurs due to the sudden nature of the hair loss.² 

However, most cases of telogen effluvium will typically resolve themselves with the proper treatment. 

In this article, we outline all you need to know about telogen effluvium, including why it happens, the symptoms it causes and how to treat it effectively.  

What causes telogen effluvium? 

Telogen effluvium is typically caused by a change in the body as a result of stress, shock or trauma¹. It affects the normal hair growth cycle and causes hair to shed at a much higher rate than normal.   

On a healthy scalp, approximately 85% of hair will be in either the anagen (growth) or catagen (resting) phase and the remaining 15% will be in the telogen (shedding) phase.¹ 

Telogen effluvium affects this final stage of the hair growth cycle when a specific stressor or bodily change causes up to 70% of anagen hair to enter the telogen phase prematurely, leading to hair loss.¹ 

Some of the leading triggers behind telogen effluvium include:¹ 

• Metabolic stress due to grief, depression or psychological trauma
• Hormonal changes after stopping oestrogen-containing medications
• Physical trauma from a major surgery
• Conditions like acute febrile illness, thyroid disease, kidney disease and systemic lupus erythematosus
• Long-term viral infections
• Medications like beta-blockers, retinoids, antidepressants and anticoagulants
• Dietary factors such as excess vitamin A, low protein intake and iron deficiency

What are the symptoms of telogen effluvium? 

Telogen effluvium causes hair loss and thinning all over the scalp. So, it differs from other types of hair loss, like male hair loss or female pattern baldness, which causes hair loss in specific areas.³ 

Research has shown that telogen effluvium can also occur in people of any age, gender or racial background.¹ However, women tend to experience the condition more commonly. This is mainly due to hormonal factors and the psychological stigma of living with the condition that leads women to report it when it happens.¹

After the triggering of telogen effluvium, many patients will report symptoms like:⁴ 

• Increased hair loss – telogen effluvium can cause you to lose between 30% and 50% of your hair
• Thinning hair – this will fall out easily, often while brushing or styling your hair
• Dry clumps of hair – this is often seen on pillows or while showering

However, it’s essential to note that some hair loss is perfectly normal. Most people will typically shed between 50 and 100 hairs a day.⁵ 

Types of telogen effluvium

There are two main types of telogen effluvium: acute and chronic. These cause the same symptoms as listed above but contribute to hair loss over different timescales. 

Acute telogen effluvium happens when a stressful event causes hair across your scalp to switch from the anagen to the telogen phase. These hairs stay in this phase for three months before eventually shedding. 

In most cases, the process will resolve itself within six months and you should recover well. 

However, some people’s hair loss can persist for longer than six months. This is then called chronic telogen effluvium. 

How is telogen effluvium diagnosed? 

Although telogen effluvium is a different condition than other hair loss types, like alopecia areata or female pattern baldness, it can look similar. Therefore, a hair specialist must use various tests to diagnose whether the condition is telogen effluvium. 

Some of these diagnostic tests can include: 

• Physical examination – most healthcare professionals can recognise telogen effluvium by simply examining your scalp to identify the type and pattern of your hair loss.

• Verbal examination – your hair specialist will discuss various things with you, including any medications you take, your circumstances and whether you’ve experienced any particularly stressful or triggering events over recent months. 

• Pull test – often performed during the physical examination, a pull test involves taking a small handful of hairs between the fingers and gently pulling. Normally, the expert will remove one or two hairs from the scalp. However, if you have telogen effluvium, more hairs will come out and they will likely have white bulbs at the root.⁴

• Wash test – similar to the pull test, counting the amount of hair that’s lost when washing could help indicate telogen effluvium. 

• Blood test – this test can help diagnose a potential underlying cause for hair loss, such as anaemia or hypothyroidism.⁴ 

How is telogen effluvium treated? 

After the hair specialist has determined that you have telogen effluvium, they will work with you to find the most appropriate treatment for your circumstances. 

Since one of the leading causes of telogen effluvium is stress or a change in the body, the essential thing is to identify what brought on the condition. 

In cases where a psychological factor triggered telogen effluvium, therapy, counselling and medication can help address the issue. Similarly, a GP can help diagnose any potential underlying conditions you might have. 

Once an expert has addressed the cause, most telogen effluvium cases will resolve without treatment within three to six months.¹

However, you can also take the licensed medication Minoxidil to treat hair loss and speed up regrowth by prolonging the anagen phase of the hair growth cycle.⁶ Certain studies have shown that this treatment can be beneficial for reducing hair shedding in people with chronic telogen effluvium.⁷ However, further research is needed to confirm this link. 

Platelet-rich plasma injections can also help stimulate hair growth and increase hair thickness.⁸ But these are unlicensed and require further research to confirm their effectiveness. 

Can telogen effluvium be prevented? 

Since various psychological and lifestyle factors trigger telogen effluvium, you can easily prevent it by keeping healthy and looking after your wellbeing.   

Some of the best ways to prevent telogen effluvium include the following:⁴ 

• Eat a balanced diet – crash diets, rapid weight loss, iron deficiency and excessive vitamin A consumption may trigger telogen effluvium. Eating a balanced diet filled with fresh fruits, vegetables and naturally sourced vitamins can help keep hair looking and feeling healthy. 

• Take multivitamins and supplements – while there is limited evidence to support their use, multivitamins containing iron or biotin can help promote strong, healthy hair growth.⁹ 

• Manage your stress – stress has an intricate link to hair. Performing stress-management techniques like practising mindfulness, avoiding stressful situations and meditating could all help lower your risk of telogen effluvium. 

• Maintain proper medical management – since telogen effluvium may be triggered by medications or an underlying condition, looking after your health and seeing a healthcare professional when needed can allow for earlier intervention and careful dose management. 

Book a telogen effluvium consultation at The Treatment Rooms London

With such a wide range of associated causes and symptoms, seeking professional guidance from a hair specialist is imperative to effectively diagnosing and treating telogen effluvium. 

The Treatment Rooms London can help. We understand that while telogen effluvium may be temporary and reversible in most cases, experiencing hair loss can cause significant distress and negatively impact your mental health. 

Therefore, if you experience high levels of hair loss while sleeping, showering or brushing your hair, book a consultation with us. 

Our specialist team can identify the cause of your hair loss and put you on the most appropriate treatment plan, helping you start your regrowth and recover sooner. 

Sources 

1. Hughes, E. & Saleh, D. (2023) Telogen Effluvium. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430848/ [Accessed 8 January 2024]
2. Hadshiwer, I., Foitzik, K., Arck, P., et al. (2004) Burden of Hair Loss: Stress and the Underestimated Psychosocial Impact of Telogen Effluvium and Androgenetic Alopecia. Journal of Investigative Dermatology. 123(3): 455 – 457. Available at: https://www.sciencedirect.com/science/article/pii/S0022202X15309635  [Accessed 8 January 2024]
3. Tamashunas, N. Bergfield, W. (2021) Male and female pattern hair loss: Treatable and worth treating. Cleveland Clinic Journal of Medicine. 88(3): 173 – 182. Available at: https://www.ccjm.org/content/88/3/173 [Accessed 8 January 2024]
4. Cleveland Clinic (2022) Telogen Effluvium. Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/24486-telogen-effluvium [Accessed 8 January 2024]
5. NHS (2021) Hair Loss. NHS. Available at: https://www.nhs.uk/conditions/hair-loss/ [Accessed 8 January 2024]
6. Perera, E. & Sinclair, R. (2017) Treatment of chronic telogen effluvium with oral minoxidil: A retrospective study. F1000Res. 6: 1650. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676194/ [Accessed 8 January 2024]
7. Paichitrojjana, A. & Paichitrojjana, A. (2022) Platelet Rich Plasma and Its Use in Hair Regrowth: A Review. Drug Des Devel Ther. 16: 635 – 645. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922312/ [Accessed 8 January 2024]
8. Suchonwanit, P., Thammarucha, S. & Leerunyakul, K. (2019) Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther. 13: 2777 – 2786. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/ [Accessed 8 January 2024]
9. Patel, D., Swink, S. & Castelo-Soccio, L. (2017) A Review of the Use of Biotin for Hair Loss. Skin Appendage Disord. 3(3): 166 – 169. Available at: https://pubmed.ncbi.nlm.nih.gov/28879195/ [Accessed 8 January 2024]