Telogen effluvium - What,
Where, When and Why?

This page fully explains telogen effluvium - its symptoms, its cause, and who suffers from it. You'll also find out the best way to treat it.

This type of hair loss involves a disruption in the normal growth cycle of scalp hair.

Hair grows in a repeating cycle of stages. These include anagen (the growth stage) and telogen (a period of rest). If you're in general good health, up to 90% of your scalp hair will be in anagen at any one time. The other 10% is usually in telogen. This hair then falls out after a few months and this natural cycle restarts.

What all this basically amounts to, is that everyone loses about 100 hairs per day as part of the normal growth cycle of hair.

Find out more: Hair and hair growth cycle - the facts.

Hair loss by telogen effluvium happens when trauma of some kind adversely affects the body, and forces hair into the telogen stage. This hair will first start to thin, and then fall. However, as stated above, there can be a few months delay before this shedding actually begins.

Picture of telogen effluvium provided by Dermnet.com

It's mostly women who suffer from this type of hair loss. But, because the growth cycle of hair is the same for all of us, men can be affected too.

There are many things that can cause this type of hair loss:

• Severe infection - Also, a high fever, the flu, etc.
• Serious chronic (long-term) illness
• Medications
• Physical trauma
• Psychological stress
• Diet - A drastic change can lead to inadequate protein, iron deficiency or poor health.
• Sudden hormone disruption - This can include pregnancy, the menopause and thyroid conditions.

• Chronic telogen effluvium (CTE)
• Acute telogen effluvium
• Post-partum telogen effluvium

Chronic telogen effluvium (CTE)

This can be a very long-term, persistent form of hair loss. It's caused by an iron deficiency, and can affect both men and women.

CTE is evenly distributed hair loss (diffuse thinning) across the entire scalp.This means that it's not patchy (like alopecia areata ) or restricted to the crown of the head - as in alopecia androgenetica -

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CTE is very common in women. In fact, between them, CTE and alopecia androgenetica (genetic hair loss) account for up to 95% of all female hair loss cases. CTE in women is mostly due to a gradual depletion of iron from the loss of blood during menstruation (monthly period). Because of this, they are usually between the ages of 18 and 50.

Picture of telogen effluvium

(This means that, if you suffer heavy periods each month, you could have low iron stores in your body - this deficiency, and then CTE, can take a few years to develop).

The richest source of dietary iron comes from red meat. So, it's possible that a vegetarian diet (or one that lacks red meat) can also lead to CTE.

Men, of course, can be vegetarians (or avoid red meat) just as much as women. This means that they too might develop an iron deficiency and, in time, also suffer CTE. Men are usually affected by CTE between the ages of 30 and 60. It can start quite suddenly, and last on and off for a period of years.

Blood tests can help identify CTE (especially in women - a low serum ferritin level will usually result from menstruation blood loss).

The most common blood test measures the haemoglobin level, but this will only diagnose whether or not you're anaemic. No link has yet been made between hair loss and haemoglobin levels. In fact, it's not unusual to find you have a normal haemoglobin level despite low levels of stored iron (serum ferritin level).

Treatment for CTE

If an iron deficiency is corrected, and the serum ferritin level raised to a certain point, then hair growth will restart.

So, can you eat your way to a full head of hair?

Eating a large portion of red meat everyday would definately raise iron levels. But this is not really a practical option for most people. A high strength iron supplement is the quickest way to increase ferritin levels (but even this will take about 6 months to achieve).

Also, even a high dose iron supplement with additional vitamin C (which helps iron absorption) might not be enough to raise ferritin levels in many cases.

Learn about Nutrihair (Florisene) and other hair loss products for CTE.

Acute telogen effluvium

This condition involves a sudden increase in hair loss 2 to 5 months after a seriously traumatic event takes place. As much as 70% of the scalp hair can be forced into the telogen (resting) stage, and then start to fall.

This rapid form of hair loss could be caused in many ways including physical trauma (e.g., major surgery) or a radical change to your diet:

Severe calorie restriction (crash diets or those providing less than 1200 calories per day) can place the body under stress and trigger acute telogen effluvium. If it receives insufficient nutrients (especially protein) the human body can react by shutting down hair production - protein will be saved if healthy hairs are shifted into telogen. (This is just one way in which the body can redirect energy and so help conserve its essential organs).

Note: Don't confuse Acute telogen effluvium with alopecia areata which can similarly cause rapid hair loss.

Post-partum telogen effluvium

During pregnancy, there's a big rise in female hormone levels (oestrogen and progesterone). This causes an increased percentage of scalp hairs to stay in the anagen growth phase (and often makes a womans hair seem much more thick and glossy).

But, immediately after giving birth, there is a corresponding fall in the levels of these hormones. This throws the normal hair growth cycle temporarily out of sync, and more hair than usual enters the telogen stage. As a result, 1 to 5 months after giving birth, hair can start to fall out dramatically - much more hair will be found in the hairbrush, the sink plughole, and even in the fists of the newborn child!

This human moult condition will occur in approximately 50% of all women after childbirth, but normally corrects itself within a year - more and more follicles gradually reverting back into the anagen growth stage.

However, it can last much longer if you have a genetic tendency towards hair loss (alopecia androgenetica) or have the skin disease alopecia areata. Long term telogen effluvium like this requires a medical evaluation to rule out other forms of hair loss or metabolic conditions.

Many women connect their hair loss to breastfeeding by mistake. That's because both events may begin some months after giving birth. However, this is merely coincidence - breastfeeding does not cause hair loss.

Note: Don't confuse postpartum telogen effluvium with post-partum thyroiditis - This condition develops in about 10% of women 6 to 12 months after they've given birth. Learn more about post-partum thyroiditis.

Coping with telogen effluvium

Should any type of hair loss be persistant or severe, you should see a qualified dermatologist to help effectively diagnose it.

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