Hair Loss - Telogen Effluvium

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What is telogen effluvium?

Under normal conditions, scalp hairs live for about three years (the anagen, or growing, phase); they then enter the telogen, or resting, phase. During the three-month telogen period, the hair root shrivels up into a small "club," then the hair falls out. It is therefore normal to lose about 100 hairs every day, more of them on days when shampooing loosens the hairs that are ready to fall out. The hairs are then replaced by the body.

Sometimes people who worry about losing their hair start noticing hairs on their pillow or in the sink, not realizing that they've always been there. A close look at these will usually reveal the club at the end, showing that these hairs were shed normally. Normally, about 10% of scalp hairs are in the telogen phase.

There are several circumstances that produce a "shock to the system" that alters the hair growth rhythm. As a result, as much as 30%-40% of the hairs can cycle into telogen. Three months later, hairs come out in a massive shedding (effluvium), especially near the front of the scalp. These include

  • childbirth,
  • high fever,
  • sudden weight loss (crash dieting),
  • surgery,
  • severe illness,
  • severe emotional stress or loss.

None of these need be life-threatening, nor does hair loss usually follow them. (Moreover, it can happen after one pregnancy, but not the next.) But when the hair falls out, it's all over the place -- covering the pillow, clogging the drain, and so forth. Paradoxically, the more dramatic the hair loss, the better the prognosis, because when the body gets back into normal rhythm, most if not all of that hair comes back; these people need no special treatment. Normal shampooing can continue, because this only loosens hairs that were going to come out anyway.

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See what others are saying

Comment from: Cindy, 45-54 Female (Patient) Published: January 08

I put the hair dye on my scalp July 17, 2013. Hair has been falling out to date which is now January 6, 2014. I bought Biosil which has helped immediately and continues to help less shed. Also my allergy doctor did diagnose it as allergic contact dermatitis and prescribed me a 4oz bottle of clobetasol shampoo 0.05% for the cost of $474.00 (yes, you read that right!) and a topical solution 4oz bottle for approximately $236.00 plus an $80.00 bottle of anti-histamines. It was months of agony and being terrified; lesson learned.

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Comment from: Cindy, 45-54 Female (Patient) Published: January 08

I had a very full-head of hair until I used a permanent hair color by L'Oreal called Sublime Mousse. I was very sick and my hair was falling out right and left. I lost half of my hair. I didn't take the allergy test but then again who does! Many women have told me they never take the allergy test but if you are sensitive in any manner I suggest the allergy testing for sure. The dermatologist looked through my hair and said you have male pattern baldness and telogen effluvium. I said no sir, I am having an allergic reaction to this hair color I'm holding in my hands. That's when all this started. Male pattern baldness is over a period of years not three months. I have pictures the same month where I have a head full of lush hair.

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