What is Telogen Effluvium (TE)?
On a regular day, about 90% of the hairs on the average person’s head are actively growing. This is known as the Anagen phase. The others are resting or what’s known as the Telogen phase. A hair is in the growing phase for two to seven years, then enters the resting phase for about two to four months, and then falls out and is replaced by a new, growing hair. Since we have about 100,000 hairs, the average person naturally loses about 100 hairs a day.
When a body encounters a shock or severe stress, it may push more hairs into the telogen phase. This is called Telogen Effluvium. Typically in this condition, about 30% of the hairs stop growing and go into the resting phase before falling out. So if you have telogen effluvium, it’s normal to lose an average of 300 hairs a day
Shocking events that trigger Telogen effluvium include
- Severe physical stress (illness, fever)
- Severe psychological stress (depression, anxiety)
- Severe weight loss
- Change in diet
- Abrupt hormonal changes, including those associated with childbirth and menopause
- Vitamin deficiency
- Iron deficiency
- Hypothyroidism or hyperthyroidism
Because hairs that enter the telogen phase rest in place for two to four months before falling out, you may not notice any hair loss until two to four months after the event that caused the problem. Many people are already recovered by the time hair starts to fall which is also known as the exogen phase. Telogen effluvium rarely lasts longer than six months, but this is not set in stone.
Although losing a great number of hairs within a short time can be frightening, the condition is usually temporary. Each hair that is pushed prematurely into the telogen phase is replaced by a new, growing hair, so there is no danger of complete baldness. Because hair on the scalp grows slowly, your hair may feel or look thinner than usual for a time, but fullness will return as the new hairs grow in. Hair grows an average of 1/2 an inch per month. Your hair may take a good 3-6 months before noticing regrowth.
Symptoms of Telogen Effluvium
Having telogen effluvium is frightening. Many people are convinced they are going bald. If you have telogen effluvium, you’ll notice more hair than usual accumulating on your pillowcase, on the shower or bathroom floor and in your hairbrush. Your scalp hair may feel or look less dense than usual. Scalp could be more visible under certain lighting. Often, though, the hair loss is subtle, and the hairloss may only be noticeable to the individual.
Telogen Effluvium Diagnosis
Most cases of telogen effluvium can be diagnosed based on medical history and an examination of the scalp and hair. If the hair loss has been occurring for several months, there may be visible thinning patches, but often the hair loss is not dramatic enough for a doctor to notice. If you have large bald patches, you probably don’t have telogen effluvium. If the doctor gently tugs on some hairs on your scalp and four or more hairs come out, you probably have telogen effluvium. Also, the hairs will look like hairs in the telogen phase – they will have a white bulb at the end that was in the scalp, and will not have a gel-like covering around that end of the hair. If the hair does not have a white bulb or gel like covering, the hair may lack protein and is breaking.
You may be asked to gather all hairs that fall out of your head over a 24-hour period, and count them to see if the hair loss is truly excessive. Losing fewer than 100 hairs in a day is considered normal. You also may be asked to gather and count lost hairs every one or two weeks to see when the shedding starts to decline.
In some rare cases, if there is reason to doubt the diagnosis, a biopsy of the scalp may be done. In this procedure, a small piece of the scalp that includes several hair follicles is removed and examined under a microscope. Your doctor also may do blood tests to check for conditions such as thyroid abnormalities that may be contributing to hair loss.
Expected Duration of Telogen Effluvium
Typically, hair loss begins 