Hair Loss By Telogen Effluvium


The most prevalent form of hair loss is male pattern or female pattern balding, androgenetic alopecia, but telogen effluvium is the second most common form. There are multiple causes of telogen effluvium, TE, and it is not well defined or understood. TE is basically a change in the ratio of hair follicles in a growing stage as opposed to a resting stage.

The appearance of TE is characterized by a general thinning. Thinning may be more severe in some places. Generally hair thins more on the top of the scalp. Hair line recession is rare with TE.

Eighty to ninety percent of the follicles on a healthy scalp will be growing. This is referred to as the anagen phase. The remaining ten to twenty percent of follicles should be in the resting state known as telogen. During this period the strand does not grow. The anagen phase in a healthy person will last two or more years and the telogen phase should last up to two months. At this point the follicle will begin producing a new fiber.

When a person develops TE there is an increase in the amount of follicles going through telogen. This causes an imbalance in the growing cycle and the patient will start shedding more than they are growing. The telogen strands which are shed as a result of this disorder can be identified by the small nub of keratin attached to the tip. Depending on the form of TE, shedding can be either rapid or gradual, but TE patients will never completely go bald. TE is also completely reversible. It is unknown if products like Hairmax or Lilash can improve things.

The most frequent cause of TE is a short term environmental stressor that disturbs the natural growth cycle. This form results in rapid shedding and can become noticeable one to two months after the trigger. Six months is usually the maximum effective period for this type of TE and patients generally have normal density within a year.

TE can also develop from a long term stressor. In this form follicles may not prematurely turn to the telogen phase, but they will not begin producing new fibers through anagen phase. Initial symptoms will take longer to notice as progression will be slow at first, but this form also tends to become a chronic condition.

In some cases a patient may develop a form of TE which actually accelerates the follicle growth cycle. The type is characterized by frequent shedding of short strands.

The most frequent cause of TE is some sort of environmental stressor. Women commonly experience TE after giving birth. A handful of medications can cause TE, as can chronic illness. Dietary deficiencies are also a common cause of TE. When a stressor can be identified, the best treatment for TE is to remove the stressor.

If a specific trigger cannot be isolated, treatment options are limited. Minoxidil is a prescription drug that stimulates hair growth. This option can be very effective, but must be continued indefinitely until the underlying cause is identified and removed or hair loss will return.

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