What is telogen effluvium?

We all lose hairs on a daily basis, but telogen effluvium is a condition that involves rapid loss of more hair than usual. It can be upsetting to experience significant hair loss, but you may feel better knowing that this condition generally only causes temporary thinning of the hair.


What's a normal rate of daily hair loss?

We lose between 50 to 100 strands every day.

Hair goes through three stages:

• A growing phase (anagen) that can last three to five years

• A short-lived two-week intermediate phase (catagen)

• A shedding phase (telogen) that takes about 100 days

The hair follicle starts the cycle again at the end of the shedding phase.

There's usually a good balance between growing and shedding hairs to keep our hair looking the same volume. At any one time, around 85 percent of strands are in the growing phase.


What's telogen effluvium?

This condition causes a disruption of the normal hair cycle with many hairs entering the telogen, or shedding, phase. You'll get a higher number of hairs falling out every day to the point where there's some noticeable thinning of the hair. However, there's usually not a complete loss of hair.

Since the telogen phase lasts only 100 days and the hair follicle enters a new growing phase soon after, this condition is usually only temporary.


What are the symptoms?

You'll often get symptoms quite suddenly:

• Increased loss of hair that's more noticeable after you wash your hair. You may also find lost hairs on your pillow in the morning

• General thinning out and loss of volume of your hair


Why does telogen effluvium happen?

This condition often affects people who've gone through a major stressful event that causes 'shock' to the hair follicles, stimulating them to enter the shedding stage. Symptoms usually become more evident three months after the event occurred. Hair strands would be at the end of the telogen stage and ready to fall out.

Some common triggers for telogen effluvium are:

• Childbirth

• A stressful experience like losing a loved one

• Sudden weight loss

• Extreme dieting

• Illness

• Withdrawal or change in levels of a hormone. This can happen at menopause, during pregnancy, or as a result of starting a new medicine

Sometimes, there's no obvious reason why it happens, and in fact, a cause isn't found for a third of people who get telogen effluvium.


Who's more likely to get it?

Women tend to get telogen effluvium more often than men. It's probably because common triggers are often related to women's health like pregnancy, dramatic shifts in hormone levels, giving birth and menopause.


Which other conditions can cause hair loss?

The most common cause for hair loss is pattern baldness, which also causes a receding hairline in men and general thinning of hair in men and women. It's permanent and happens gradually over years and decades. Men may go completely bald but it's very rare for women to lose all their hair.

Some of the following may also cause hair loss:

• Under or overactive thyroid

• Diabetes

• Autoimmune conditions such as lupus

• Nutritional deficiencies, which include a lack of iron or protein

• Cancer treatment, such as chemotherapy


When should I see my GP?

If you're worried and unsure why you're getting hair loss, consider seeing your GP for advice. You'll also be checked for any other conditions that can cause hair loss. It's best to make an appointment with your GP if you notice any of the following:

• Loss of hair in patches

• Clumps of hair falling out

• Pain or burning over your scalp

Your GP will be able to determine the cause for your hair loss and advise you on treatment if necessary.


What's the treatment for telogen effluvium?

Treatment for this condition often isn't necessary. Hair loss is temporary and there's generally spontaneous new growth after a few months, once whatever was triggering it has been resolved.

Make sure you eat a balanced and varied diet, and consider taking supplements if you have a restricted diet. Stopping smoking may also help.

Minoxidil and finasteride can be used for another type of hair loss, but they aren't licensed or effective for telogen effluvium.

It's normal to feel anxious about your hair's appearance and depending on the extent of your hair thinning, you may feel that you need to disguise your hair loss until it grows back. Here are some things you can try:

• Apply sprays with coloured strands over your hair. These give the impression of more volume, but they wash away very easily with sweat, rain or in the shower. You'll need to reapply the spray often during the day and after brushing or washing your hair. Ask your pharmacist for advice if you're considering this option

• Consider wearing a wig or a hairpiece. You can choose from synthetic, real hair or a mix of both


How can I deal with the original stress that triggered my hair loss?

If you're still experiencing lots of stress or effects from the original trauma, consider seeking professional counselling. Your GP will be able to advise you how to access this.

You can also seek support from patient groups such as Alopecia UK. You can find their website at www.alopecia.org.uk. You'll be able to find more information on your hair loss, learn about coping mechanisms and meet others who're going through the same experience as yourself.


Next steps

• Remember that telogen effluvium is only temporary and there'll be regrowth of hair within a few months once the trigger is removed. It's also unlikely you'll experience a complete loss of hair

• Treatment isn't usually necessary. However, you can consider disguising your hair loss if it makes you feel more confident

• Ask your GP for advice on how to manage stress levels. Patient support groups can also offer help