Telogen Effluvium (hair Shedding). Dermnet Nz
Telogen effluvium (hair shedding). DermNet NZ
12/24/2007 07:16 PM
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Telogen effluvium
Telogen effluvium is the name for temporary hair loss due to shedding of resting or telogen hair after some
shock to the system. New hair continues to grow. Telogen hair has a bulb or club-shaped tip.
It should be distinguished from anagen effluvium, in which the hair shedding is due to interruption of active or
anagen hair growth by drugs, toxins or inflammation (e.g. alopecia areata). Anagen hair has a pointed or tapered
tip.
Telogen effluvium
What is the cause of telogen effluvium?
In a normal healthy person's scalp about 85% of the hair follicles are actively growing hair (anagen hair) and 15%
are resting hair (telogen hair). A hair follicle usually grows anagen hair for 4 years or so, then rests for about 4
months. The resting or telogen hair has a club or bulb at the tip. A new anagen hair begins to grow under the
resting telogen hair and pushes it out.
Thus, it is normal to lose up to about 100 hairs a day on one's comb, brush, in the basin or on the pillow, as a
result of the normal scalp hair cycle.
If there is some shock to the system, as many as 70% of the anagen hairs can be precipitated into telogen, thus
reversing the usual ratio. Typical precipitants include:
Illness, especially if there is fever
Surgical operation
Accident
Childbirth
Nervous shock
Weight loss or unusual diet
Certain medications
Discontinuing the contraceptive pill
Overseas travel resulting in jetlag
Excessive sun exposure
The resting scalp hairs, now in the form of club hairs, remain firmly attached to the hair follicles at first. It is only
about 2 months after the shock that the new hairs coming up through the scalp push out the "dead" club hairs
and increased hair fall is noticed.
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Telogen effluvium (hair shedding). DermNet NZ
12/24/2007 07:16 PM
Thus, paradoxically, with this type of hair loss, hair fall is a sign of hair regrowth. As the new hair first comes up
through the scalp and pushes out the dead hair a fine fringe of new hair is often evident along the forehead
hairline. At first the fall of club hairs is profuse and a general thinning of the scalp hair may become evident but
after several months a peak is reached and hair fall begins to lessen, gradually tapering back to normal over 6-9
months. As the hair fall tapers off the scalp thickens back up to normal, but recovery may be incomplete in some
cases.
Because nail and hair growth are under the same influences, an arrest in hair growth is often mirrored in the nails
by a groove across them coinciding with the time of the shock to the system. This is called a Beau's line. The time
of the shock can be estimated from the fact that a finger nail takes 5 months to grow from the posterior nail fold
to the free edge. So if the groove in the nail is half way down the nail then the shock must have been 2 1/2
months ago.
Beau line
Transverse leukonychia
Chronic telogen effluvium
In some patients, hair shedding continues to be intermittently or continuously greater than normal for long
periods of time, sometimes for years. The hair cycle appears to be reset so that the anagen period is shortened.
Chronic telogen effluvium often presents in women that actually continue to have quite thick and moderately long
hair – this is because they notice the shed hair more than those with finer or shorter hair. Telogen effluvium does
not cause complete baldness, although it may unmask a genetic tendency to genetic balding i.e. female pattern
hair loss , or in men, male pattern hair loss.
What is the treatment for telogen effluvium?
Telogen effluvium is self-correcting. It is really not influenced by any treatment that can be given. However,
gentle handling of the hair, avoiding over-vigorous combing, brushing and any type of scalp massage are
important.
You should also ensure a nutritious diet, with plenty of protein, fruit and vegetables.
The doctor may check your thyroid function, and levels of iron, vitamin B12 and folic acid, as any deficiency in
these can slow hair growth.
Related information
On DermNet NZ:
Hair loss
Female pattern hair loss
Alopecia areata
Other websites:
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Telogen effluvium (hair shedding). DermNet NZ
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Telogen effluvium – emedicine dermatology, the on-line textbook
DermNet does not provide an on-line consultation service.
If you have any concerns with your skin or its treatment, see a dermatologist for advice.
Created 1997. Last updated 08 Sep 2007. © 2007 NZDS. Disclaimer.
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