Telogen Effluvium and Hair Loss

hair loss hamletHair loss is defined as losing more than 100 hairs per day. Hair follicles repeatedly go through three phases in their growth cycle: the anagen phase (growth); the catagen phase (transition); and the telogen phase (dormant). Just before entering the telogen or dormancy phase, the hair falls out. A few months later, a new hair grows. The anagen phase is supposed to last several years, but what if a hair follicle goes to sleep early? Entering the telogen phase prematurely is called telogen effluvium and it is represents hair loss.

“To sleep, perchance to dream — ay, there’s the rub.” Hamlet (III, i, 65-68)

Telogen effluvium can happen as an isolated problem or as part of a disease. Common causes include:

  • severely stressful events or severe emotional disorders
  • childbirth
  • chronic illness
  • major surgery
  • anemia
  • hypothyroidism or hyper
  • certain drugs
  • eating disorders, malnutrition, poor diet, crash diets

This lengthy list implies that anyone experience hair loss should consult a physician before proceeding with treatment. No one else has the training to diagnose the reason for the hair loss.

Sometimes, people notice hair loss and think it might have been caused by something they were exposed to within the past few hours or days. The reality is that hair loss does not usually show up as symptom until 3-6 months after the stressor started. This is related to the hair’s growth cycle. Therefore, no one should try to diagnose the reason for their own hair loss, and should instead consult a qualified medical doctor or dermatologist.

Whether the hair will come out of the telogen phase and grow back on its own depends on the reason for the hair loss and how it is treated. For instance, if surgery is diagnosed as the reason for the hair loss, the scalp will probably recover on its own in time. If the diet is the problem, nutritional treatment is needed.

Most of the time, the antidote to stress-related hair loss is a stress reduction program. Sometimes a stressful event has ended by the time hair loss occurs, so the patient may need no further treatment. Stress-related hair loss usually rebounds on its own.

Women are diagnosed with telogen effluvium more often than men, probably due to their pregnancies and thyroid problems. Hormones often cause pregnant women to have thicker, healthier hair because more hairs stay in the anagen (growth) phase longer. However, when the baby is about three months old, a lot of the mother’s hairs  can fall out as they go into the telogen phase due to the hormonal changes. This hair does not always grow back.

The thyroid produces many important sex hormones for women, and it often misbehaves. Women often think they are having hair loss due to chronic stress when actually, their thyroid is under-active (hypothyroidism) or over-active (hyperthyroidism). A thorough workup and lab tests may be needed to diagnose and treat these types of problems. Sometimes the hair grows back after the hormone problems are treated, but not always.

Some allopathic drugs have “hair loss” listed as a possible side effect. Hair loss can be caused by hormonal changes, so be especially watchful of drugs that affect your hormone levels. Also, you must weigh the benefits and advantages of each medication with your doctor. See a list of drugs that can cause hair loss.

Technically, male pattern baldness, in its beginning stages, could be called telogen effluvium. The anagen phase gets shorter and shorter in response to hormones as a man ages. However, this type of hair loss is progressive and the hairs will not grow back on their own.

After the cause of hair loss has been treated (if possible), and the hairs do not come out of the telogen phase on their own, hair restoration surgery may be a viable option. A hair transplant is the only permanent solution to many types of hair loss.

Look in your sink and on your pillow: too many hairs? Look carefully on your head: balding or thinning? Be certain to consult a doctor if you have having hair loss! Only a doctor can tell you the reason for the hair loss and recommend a course of treatment.