Telogen Effluvium
Telogen effluvium (TE) is a condition that affects the hair growth cycle, causing temporary hair thinning or shedding. Our hair goes through different phases of growth, including the anagen (growth) phase and the telogen (resting) phase. During the anagen phase, hair follicles actively produce new hair cells, while the telogen phase is a resting period where we shed hair before the hair follicle restarts activity and new growth. Normally, only a small percentage of hair follicles are in the telogen phase at any given time, resulting in a steady daily loss of about 50-100 strands. However, under certain circumstances, such as extreme stress, illness, or unknown triggers, a large number of hair follicles synchronise and prematurely enter the telogen phase, causing them to shed simultaneously. We experience this as rapid hair loss.
The good news is that telogen effluvium is temporary. In most cases, the hair will begin regrowing within a few months as the affected follicles transition back to the anagen phase. It's important to note that the regrowth process may vary for each individual. Some people may experience a slow gradual recovery, while others may see quick regrowth.
What causes telogen effluvium?
Telogen effluvium can be triggered by various factors. One of the most common triggers is significant physical or emotional stress. This could include traumatic events like major surgery, childbirth, severe illness, or even emotional stressors such as the loss of a loved one or a major life change. The stress experienced by the body can disrupt the hair growth cycle, pushing a larger number of follicles into the telogen phase. Hormonal changes, such as those occurring after pregnancy or during menopause, can also cause telogen effluvium. In addition, nutritional deficiencies, particularly those related to iron, zinc, or protein, can impact hair health and lead to temporary shedding.
What are the symptoms of telogen effluvium?
Telogen effluvium is characterized by a general thinning of hair rather than localized bald patches, as seen in conditions like alopecia. This diffuse thinning can be observed throughout the scalp, and it may take time to notice a gradual reduction in hair density. One of the first signs is an increased amount of hair in your hairbrush or comb, or more hair loss when washing your hair. Wet hair is more prone to breakage, so the combination of wetness and brushing can cause excessive hair loss during washes. Due to the weakened state of the hair and rapid shedding, you may also experience scalp irritation and tenderness.
Another symptom of telogen effluvium, although rarely talked about, is greasy hair. This occurs because your scalp continues to produce the same amount of oils, yet the density of your hair reduces, which means the remaining strands are exposed to more oils. In some case, the extra grease produces a ‘wet’ effect, making hair softer and more susceptible to getting pulled out at the slightest tug. Telogen effluvium can be a disheartening and frustrating condition, washing hair weakens the strands and leads to hair loss, not washing hair makes them greasy and also leads to hair loss, as does combing/brushing, or even the slightest tug. No matter how careful someone is, hair will fall out. This was one of the biggest challenges I experienced with telogen effluvium. But according to dermatologists, hair follicles in the telogen phase are simply in that phase, and there is no amount of gentleness or coddling that can prevent the shedding process. This was a liberating fact to learn, because, prior to that point, I had been driving myself crazy about not ‘worsening’ the hair loss.
How is telogen effluvium treated?
There is no specific treatment for telogen effluvium since it is a self-limiting condition. This means that once the hair falls out, the follicle will reset and return to its normal cycle - provided the underlying cause is treated. It is therefore important to seek medical advice and consult a dermatologist specializing in hair disorders to determine the cause of your hair loss.
Adopting stress-reducing techniques is particularly important for those whose telogen effluvium is stress-induced. Engaging in activities such as exercise, prayer, meditation, deep breathing exercises, or counseling can help manage stress levels and promote overall well-being. Additionally, ensuring you have a balanced diet, rich in essential nutrients, such as iron, zinc, vitamin D, and protein, can support hair health and growth.
Supplements I’m currently taking
My advice as someone who has recovered from telogen effluvium
Having personally experienced telogen effluvium, I can empathize with the traumatic and stressful nature of this condition. If you are currently going through it, it's understandable that you may feel worried or frustrated. However, it's important to remember that it is (generally) a temporary condition, and in almost all cases, your hair will grow back.
Find peace with the process. Outside of addressing the root cause of your hair loss, there is little else you can do to stop hair destined to fall out from falling out. I appreciate that it is a lot easier to say once I am on the other side, but try to relax, and let things take their course (of course while working with your doctor to address any underlying issues).
If you are anything like me, you may feel too scared to wash, not wash, style, or not style your hair. As mentioned above there is literally nothing you can do to stop these hairs from falling out, so wash and style your hair as you need. That said try to avoid harsh treatments like colouring or keratin treatment etc.
Another important piece of advice is to specifically seek a dermatologist, especially one that specializes in hair, as they have more experience in diagnosing this issue. For instance, during my investigation, my general practitioner tested for anemia using a hemoglobin test. However, my dermatologist understood that ferritin was a far better indicator of anemia that can cause telogen effluvium. It was only after taking the ferritin test (amongst many others) that we identified I was severely anemic.
If you are worried about your doctor not prioritising this issue—or in my case, not believing me because I had such thick hair despite extreme hair loss—it can be helpful to document the amount of hair you're losing.
In conclusion, remember that telogen effluvium will end, while it is a horrible and stressful symptom, we must also be thankful because there are many people dealing with far worse conditions on a more permanent basis. Gratitude is key.