Patient handout · Hair Care
Telogen effluvium (TE) is a widespread hair loss condition characterized by periods of increased hair shedding. You may see an excess amount of hair in your shower drain, in your hairbrush, or on your pillow in the morning. The shedding is NOT subtle. It comes on quickly and can lead to 30-50% scalp hair loss. People who experience TE are understandably upset, thinking that all their hair will fall out.
First, let's discuss what happens in a normal hair cycle.
Typically, 90% of our scalp hairs are in the growth phase (anagen). These anagen hairs stay on our heads for about three years and grow long before turning into resting (telogen) hairs. Telogen hairs makeup about 10% of our scalp and only stay on our scalp for three months before shedding. These telogen hairs are the 100-150 hairs we typically shed each day.
The hair follicle can be very sensitive to changes. When a person experiences a stressful event or "trigger," hair follicles may prematurely switch from the growing anagen phase of the cycle to the resting telogen phase. After a three-month delay, these telogen hairs shed in enormous amounts, up to 300 hairs per day! This over-shedding lasts three months and then stops on its own, without treatment. This three-month delay makes it hard to recognize the association between the trigger and hair loss.
Potential triggers that can cause a TE episode:
• Pregnancy, delivery, or miscarriage
• Illness or fever
• Hospitalization or surgery
• Abnormal thyroid hormone function or change in dose of thyroid medicine
• Significant emotional trauma such as the death of a loved one, divorce, or job loss
• Starting, stopping, or changing hormone medications, including birth control or IUD
• Entering menopause
Kate went on a diet, exercised successfully, and lost 20 pounds by July (the "trigger"). In October (3 months later), she noticed clumps of hair in the shower drain and on her hairbrush. The hair continued to shed at this rate until December (3 months from the start of shedding) and then returned to normal shedding. Her hair then regrew slowly on its own.
The good news: Your hair will regrow.
The bad news: Hair regrowth is slow. Hair grows at a rate of 1 centimetre per month. If your hair length is to your shoulders, your ponytail, or the length of your hair likely won't feel "full" or normal again for 2.5 years! However, you will see short hairs growing on the top of your scalp, and slowly they catch up with the rest of your hair.
Unfortunately, nothing makes this growth happen faster. To date, there are also no treatments proven to prevent TE or to stop the shedding once it starts.
What you can do if you think you've had a TE episode:
1. DON'T PANIC! Hopefully, this information will reassure you that while experiencing TE is not fun, it is a self-resolving form of hair loss.
2. BE PATIENT. Your hair will regrow. You don't need to spend money on supplements or other treatments for this to happen. Take pictures and document your hair regrowth if it helps you.
3. Use keratin fibre thickening agents to conceal thinning hair. There are keratin=fibre products that blend seamlessly with your existing hair to create the appearance of fuller-looking - these are very natural looking and can conceal areas of patchiness while you are waiting for hair volume to be restored. See my recommended products below
4. Most importantly, try to AVOID new potential triggers. Indeed, major life stressors, surgery, and illness are not always avoidable. But, it is essential to maintain a stable weight, not switch around birth control methods frequently, and ensure that your thyroid is functioning correctly.
5. If after six months your shedding doesn't return to normal (100-150 hairs a day) or your hair on top of your scalp does not regrow as it once did, this could be the sign of another type of alopecia. In this case, proper evaluation with a skin specialist is recommended.
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Appointments available at Hillside Medical Clinic in Victoria and Kensington Medical Clinic in Burnaby.