What are the clinical presentations of Telogen effluvium (TE), a scalp disorder characterized by excessive hair shedding?

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From the Research

Telogen effluvium presents as diffuse hair shedding that typically occurs 2-3 months after a triggering event, with patients noticing increased hair loss during washing or brushing, and a hair pull test often being positive. This condition is characterized by an excessive shedding of hair, usually precipitated by physiological stress such as childbirth or sudden weight loss, as noted in a review of the science and current obstacles in the Journal of Dermatological Science 1. The shedding occurs evenly across the scalp without creating distinct bald patches, though the hair may appear noticeably thinner overall. Patients may report a sensation of scalp tenderness or trichodynia preceding the shedding.

Common Triggers and Presentation

Some common triggers include:

  • Physical stressors (surgery, severe illness, childbirth)
  • Emotional stress
  • Rapid weight loss
  • Nutritional deficiencies (particularly iron, zinc, and vitamin D)
  • Certain medications (including beta-blockers, anticoagulants, retinoids, and antithyroid drugs) According to a review of the literature in Cureus, telogen effluvium can present as acute or chronic hair fall with symptoms such as trichodynia 2.

Diagnosis and Management

Diagnosis involves a thorough history to identify potential triggers, physical examination of the scalp, and sometimes blood tests to rule out underlying conditions like thyroid disorders or nutritional deficiencies. A comprehensive review in Clinical, Cosmetic and Investigational Dermatology highlights the importance of proper classification and distinction from androgenetic alopecia, as well as the need for empathy and attention in managing the condition 3. The condition is typically self-limiting, with hair regrowth beginning within 3-6 months as follicles reset to their normal growth cycle. However, if the underlying trigger persists, the shedding may continue. Treatment may involve identifying and removing the causative factors, and using drugs such as corticosteroids, minoxidil, or novel treatments, as discussed in a study on the treatment of chronic telogen effluvium with oral minoxidil in F1000Research 4.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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