Tag: telogen effluvium

Telogen Effluvium

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What is Telogen Effluvium?

Telogen Effluvium is a type of non-scarring hair loss. It is also called “Resting Phase Hair Loss”. Normally, most persons have 90% of the hairs on their head in the Anagen or “growing” phase. That stands to mean that ~10% are in Telogen, the “resting” phase. This is the phase that the hair goes into before it is shed. The new hair that will replace it grows upwards, pushing the hair out allowing for easy extraction when combing, brushing or washing your hair. The shed hair would of course have the white tip at the root.

How does Telogen Effluvium present?

Telogen Effluvium  usually starts 3-4 months after the incident that triggers it. It can be Acute or Chronic. Acute cases usually last 6 months. Anything longer than that indicates some chronicity and usually hints at a persistent problem triggering the hair loss.

In general, most persons lose 50-100 hairs per day, but in Telogen Effluvium, the numbers can rise significantly. This excessive shedding is what alarms persons, as they feel that they cannot control the amount of hair that is lost. Persons usually complain of a significant amount of hair being lost when they wash their hair. Some notice their hair showing up in random places like the floor, car seat, clothes, pillow etc. Or others may notice that when they do comb their hair, an insane amount seems to come out.

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Though it causes diffuse thinning all over the scalp, persons may notice that certain areas seem thinner.  Women may notice that their hair seems thinned out especially the temples, top or crown of their scalp. Their pony tail seems thinner or their “buns” are smaller than usual. Men often notice thinning in the temples.

What causes Telogen Effluvium?

There are several causes of Telogen Effluvium:

  1.  Significant stressful life events: death, divorce, bankruptcy/debt.
  2. Rapid weight loss
  3. Medication- both vitamins (high amounts of Vitamin A),  drugs e.g. certain anti-hypertensives, anaesthetics etc.
  4. Major surgery
  5. Anaemia- mainly Iron deficiency
  6. Poor diet- anorexia nervosa, fad diets, malnutrition
  7. Significant illness – e.g. chronic diarrhoea
  8. Post pregnancy

So how do you treat Telogen Effluvium?

Most persons experiencing Telogen Effluvium will notice that it will spontaneously resolve. However, those who have Chronic Telogen Effluvium, will need to be investigated to find out the exact cause, and have that cause corrected. Additionally, certain products like Minoxidil (Rogaine) will help the hairs to stay in the anagen stage longer, thus prolonging the hair on the head and decrease shedding over time. Once the Telogen Effluvium is resolved, the individual will not need to continue using the Minoxidil.

 

 

Hair Loss After Surgery

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Dear Doc,

I have a friend who did surgery  for weight loss a few months ago. She keeps saying that her current hair loss is due to the surgery. Is this really possible?

 

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Sounds like the two of you have been debating the cause of her hair loss. Well, hair loss after surgery is actually not uncommon, especially after major surgery such as bariatric surgery aka gastric bypass surgery. There are several reasons she could be having hair loss after surgery.

First, the anaesthetics which put her too sleep are quite notorious for inducing hair loss. Any significant blood loss during the surgery could also trigger it. The stress the body undergoes from the surgery alone also causes hair loss. Any deficiencies that she may acquire post surgery, such as low iron, and especially after bariatric surgery, low proteins etc, can also trigger hair loss. The fact that she would have experienced rapid weight loss after the surgery is also a contributor. Hair loss often accompanies rapid weight loss.

The hair loss phenomenon she is experiencing is Telogen Effluvium, a diffuse hair loss characterised by excessive shedding of hair.  It usually occurs a few months after a stressful event, such as surgery.  Eventually, after six months it should correct itself, however, if she is worried about her hair loss, she should seek help from a dermatologist to help with controlling the hair loss after surgery. She should also make sure to follow the dietary regimen and vitamin supplements that her doctor would have prescribed for her.

September’s QOM- Hair growth cycle and hair care

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How can I use the hair growth cycle to help me take care of my hair? What’s the application?

 

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Just to remind you from my blog post, the hair growth cycle is divided into three stages: Anagen (growth), Telogen (rest) and Catagen (degeneration). The majority of hairs on anyone’s head is usually in the Anagen phase. Therefore, the best way to ensure good hair growth is to make sure that you do not disrupt your hair growth cycle. This can be done by having a healthy diet. That way, you won’t prematurely shunt hairs meant to be in anagen into telogen because of vitamin or mineral deficiencies.

If that were to happen, you would get a Telogen Effluvium where you will find excessive shedding of your hair. In the acute phase, a Telogen Effluvium doesn’t last long. However, once it goes on for more than six months, it becomes chronic and you can experience significant reduction in the number of hairs on your head. So it is imperative to have a good diet, especially a good Iron intake.

Other than a good diet, and general good health, there’s nothing that you can do to speed up anagen because the body does its own thing. You can ,however, extend the anagen phase especially with hairs undergoing Telogen Effluvium. Products such as Rogaine (Minoxidil) have been shown to extend the anagen phase thus reducing hair loss from this Telogen Effluvium.

About 

Dr. Llorenia Muir-Green is a practising dermatologist in Jamaica. She has an avid interest in hair and scalp disorders.  She is a member of the Medical Association of Jamaica,  Dermatology Association of Jamaica and is an Associate Member of the Caribbean Dermatology Association. She was a recipient of the 2013 Fellowship in Hair and Scalp Disorders at the University of British Columbia. Send in your questions to ask@askthehairdoc.com. Maybe you will see your question posted.